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                     A Decade of Tribal Environmental
                     Health Research:

                     Results and Impacts from EPA's Extramural
                     Grants and Fellowship Programs

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                                 A.

                                         SEPA
                                       United States
                                       Environmental Protection
                                       Agency


                                       Office of Research and Development

                                       National Center for Environmental Research

                                       Tribal Environmental Health Research Prograr

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Prepared for:
U.S. Environmental Protection Agency
Office of Research and Development
National Center for Environmental Research
Washington, D.C. 20460

Prepared by:
The Scientific Consulting Group, Inc.
656 Quince Orchard Road, Suite 210
Gaithersburg, MD  20878
Under EPA Contract No. EP-C-08-010
Disclaimer
The research described in this document has been funded wholly by the U.S. Environmental Protection Agency (EPA) under the
Science To Achieve Results (STAR) grants program. The information provided does not necessarily reflect the views of the Agency,
and no official endorsement should be inferred. Mention of trade names or commercial products does not constitute endorsement
or recommendation by EPA for use. The information presented in this synthesis report is intended to provide the reader with insights
about the progress and scientific achievements of STAR research grants. The report lists the grantees whose research is discussed,
and it also  indicates where more detailed peer-reviewed scientific data can be found. This report is not sufficiently detailed nor is it
intended to be used directly for environmental assessments or decision making. Readers with these interests should instead consult
the peer-reviewed publications produced  by the STAR grants and conduct necessary data quality evaluations as required for their
assessments.

EPA and/or  its contractor has received permission to use the images within this document, most of which were obtained from
grantees of the research projects described herein. A minority of the images are stock images obtained by the contractor.
                                                              Terms Used in This Document
                                                              There are many different terms that indigenous peoples of the United States use to identify themselves. For the purposes of this
                                                              document, the National Center for Environmental Research has chosen to use the term "American Indian  and Alaska Native"
                                                              (abbreviated AI/AN) and the term "citizen" to denote an Alaska Native village or tribal member. EPA recognizes that some Native
                                                              communities may prefer to refer to themselves using different terminology. Terms such as "Native American,""American Indian,"
                                                              "Alaska Natives,""Alaska Native people," "tribes," "tribal members" or similar may be found in grantees' project descriptions, reports and
                                                              publications, as well as on the program's website and in Requests For Applications.

                                                              A "lifestyle" is the typical way of life of an individual, group or culture. The term "lifeways" generally is understood to mean the specific
                                                              customs  and practices of a culture; in this report "lifeways" refers to the traditional lifestyles of AI/AN people prior to First Contact.

                                                              Finally, "environmental justice communities" is a standard term used  by  EPA to refer to communities with  environmental justice
                                                              concerns. These communities are commonly identified as those in which residents: predominantly are minorities or low-income; have
                                                              been excluded from the environmental policy-setting or decision-making process; are subject to disproportionate  impact from one
                                                              or more environmental hazards; and experience disparate  implementation of environmental regulations, requirements, practices and
                                                              activities  in their communities.
                                                              List of Acronyms
                                                              AI/AN   American Indian and Alaska Native
                                                              EPA    U.S. Environmental Protection Agency
                                                              NCER   National Center for Environmental Research
                                                              ORD    Office of Research and Development
                                                              P3     People, Prosperity and the Planet Student Design Competition for Sustainability
                                                              RFA    Request for Applications
                                                              STAR   Science To Achieve  Results

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Executive Summary	

Introduction/Background	

Results of the Tribal Research Funded by EPA	
    Cultural  Practices, Language and Traditional Ecological Knowledge	
    Subsistence Foods and Water Resources	
    Community-Based Participatory Research and Community Outreach and Education	
    Risk Assessment and Sensitive Populations	
    Impacts  on Regulations and Management Plans	

Future Directions for Tribal Research	

Conclusion	

References	

 Appendix A: Summary of Tribal Environmental Health Research Program STAR
Grants by RFA	

Appendix B: Outputs From Tribal Environmental  Health Research Program STAR
Grants	

Appendix C: Tribal Environmental Health  Research Program Presentations	

 ppendix D: Overview of Tribal Environmental Health Research Program Grantee
Webinars	

Appendix E: Summary Tables of EPA Tribal Research Projects Discussed Within
the Report	

Appendix F: Practical Applications of EPA Tribal Research	
Appendix G: Additional Resources.

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  xecutive  Summary

American Indian and Alaska Native (AI/AN)
communities have been inextricably linked to  their
environments for millennia. Because of their reliance
on natural resources to maintain traditional diets,
lifeways, customs and  languages, there is a unique
need for tribal-focused research to identify impacts
of pollution, dietary exposure, cumulative risk  and
climate change as well as to inform decisions to
reduce health risks in these areas.
Recognizing this need, the National Center for
Environmental  Research (NCER), within the U.S.
Environmental  Protection Agency's  (EPA) Office of
Research and Development, was tasked to establish
the Agency's Tribal Environmental Health Research
Program in 2000 through the Science To Achieve
Results (STAR) grants program. Since its inception,
the program has funded  10 STAR grants for tribal
environmental  health research, many of which  are
carried out on  tribal lands by researchers from
tribal colleges  and  universities and tribal  health
organizations. EPA also supports tribal environmental
research via its STAR and Greater Research
Opportunities fellowship programs; People, Prosperity
and the Planet Student Design Competition for
Sustainability (P3); and Small Business Innovation
Research program. In addition, NCER, as the
program lead, collaborates with EPA-sponsored
partnership groups (e.g.. National Tribal Operations
Committee, National EPA-Tribal Science Council)
to ensure that its extramural research  program is
responsive to tribal needs and research priorities.
These grants, programs and partnerships support
tribally led research projects that encompass
traditional and nontraditional scientific approaches
to collect baseline data linking culture and  exposure.

To highlight the research conducted within the
Tribal Environmental Health Research  Program,
NCER sponsored a series of webinars  in 2009 and
2012. NCER leadership realized that it was  critical
to develop a synthesis document to communicate
the  outputs and outcomes of the program and
expand awareness  in this essential  research area.
This document describes outcomes  of past  EPA
tribal environmental research and discusses future
directions and initiatives.

The first step in identifying the tribal research
outcomes was to develop a list of relevant tribal
grants, fellowships, P3 grants and Small Business
Innovation Research projects. This list was compiled
through a targeted search of the NCER Research
Project Database. The investigators for these studies
were contacted to obtain annual and final reports
for their grants/projects as well as information on
the  outputs and subsequent outcomes  of their
research. The information collected was analyzed
to identify common themes  throughout the various
projects. Five themes emerged:
•  Cultural practices, language and traditional
   ecological knowledge.

•  Subsistence foods and water resources.

•  Community-based participatory research and
   community outreach and education.

•  Risk assessment and sensitive populations.

•  Impacts on regulations and management plans.

These themes serve as the basis for the format of
this synthesis report.

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Executive Summary
What Are the Outcomes of the Tribal
Environmental Health Research Program?

After more than a decade of funding research addressing
the unique needs of AI/AN communities, EPA's Tribal
Environmental Health  Research Program and  other Agency
tribal research has yielded data, tools, products, methods
and knowledge. These help to:

•  better define and reduce the health  risks of tribal
   populations,

•  protect natural resources essential to cultural and
   spiritual practices, and

•  encourage the ecological knowledge and  tribal
   practices of protecting and preserving the earth for
   future generations.

Some of these outcomes are described briefly in the
following  paragraphs.

(Cultural Practices, Language and
Traditional  geological  j\jiow!edge

Each AI/AN community has its own unique set of
cultural practices, language and traditional ecological
knowledge. EPA has funded several STAR grants that
strive to support tribal citizens in continuing their cultural
practices  with reduced health risks. These  projects also
help to strengthen native language skills and increase
culturally  relevant communication of traditional ecological
knowledge. Highlights of this research include:

•  Alaska Native communities use STAR research
   to  inform their wellness planning surrounding
   consumption  of subsistence  and medicinal berries,
   which are being threatened by pollution and climate
   change.
•  A library of resources in the Mohawk language has
   been created for the Haudenosaunee Confederacy
   to enhance education about toxic substances and
   empower the community to protect the health of
   its citizens while practicing traditional subsistence
   lifeways.

•  A booklet on Cherokee wild plant knowledge was
   created to increase tribal ecological plant knowledge
   and revitalize the culture; the  booklet has been
   translated  into the Cherokee language  and serves
   as a textbook for Cherokee Nation Immersion School
   students.
Subsistence  \ oods and
Resources
AI/AN communities place an emphasis on following
traditional diets, many of which include an abundance of
fish and seafood. In addition, water is sacred and plays
an important role in tribal  cultural and spiritual practices.
Several STAR grants focused on reducing health effects
associated with consumption of contaminated traditional
subsistence foods. These research projects have resulted in
the following outcomes:

•  Fish advisory maps for inland lakes in  the Great
   Lakes region have been created to allow tribal
   citizens to pursue their traditional  subsistence
   fishing practices while  reducing their risk of mercury
   exposure.

•  Personal participation geographic  information system
   maps have been developed for tribes residing near
   the  Klamath River Basin (California) that provide
   information about historic and contemporary
   contaminant information, raising awareness of
   potential exposures.
•  The Swinomish Indian Tribal Community issued
   voluntary consumption limits for shellfish to reduce
   its citizens' exposures to toxic chemicals.

•  The Makah Nation used STAR data to support
   its claim that its citizens had significantly higher
   contaminant exposures from locally caught fish than
   had been  previously determined via contaminant-
   exposure models.

•  Researchers are developing an inexpensive, easy-
   to-use technology from an indigenous material to
   remove contaminants from groundwater used by
   residents of the Pine Ridge Indian Reservation in
   South Dakota.

(_j3mmunitu~L)ased [articipatoru
Research and (_^ommunitu (^yutreacn
and
Indigenous populations have experienced historical trauma
as a result of past unethical research imposed on them.
Utilizing community-based participatory approaches
in tribal research is crucial to ensure that researchers
partner with AI/AN people in planning and implementing
needed research. Community-based participatory research,
education and outreach continue as longstanding,
important components of STAR grants and fellowships
funded under the Tribal Environmental  Health Research
Program. Most of the grants use community outreach
and tribal consultations to obtain input that guides the
research projects. Tribal citizens learn about the results of
the grants through community presentations, training and
workshops, books, DVDs, maps, radio interviews and  other
means. Some outcomes of this research  are:

•  Researchers actively engaged the Yurok Tribal Council
   and community in their data-gathering process,
A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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                                                                                                                                                        Executive Summary
   which allowed the scientists to identify community
   perceptions about the quality and abundance of the
   tribes important resources and their relationship to
   community health.

•  Crow Nation tribal elders described previous water
   quality conditions of the Little  Big Horn River,
   providing the researchers with valuable information
   that  drove their research project, which was focused
   on developing risk assessment methodology for
   multimedia exposure to contaminants in water and
   wastewater.

•  Presentations made to the Anishinaabe tribal citizens,
   including children, increased awareness about fish
   advisory maps that could be used to reduce their
   exposure to mercury from consuming subsistence
   fish.

•  Researchers used teacher training and in-class
   workshops to teach environmental risk and cultural
   practices to teachers and students at a tribal school.
   These workshops were completed entirely in the
   Mohawk language using oral tradition and hands-on
   participatory response techniques to share meaning.

•  STAR research resulted in a traditional food book,
   coloring book and documentary that promote safe
   Swinomish fish and shellfish consumption.

Rjsk /Assessment and Sensitive
Populations

Tribal citizens experience unique risks because of their
traditional  lifestyles and use of natural resources. As a
result, risk assessments and exposure scenarios must be
tailored  to the distinct needs of each AI/AN community.
Several  notable outcomes of the research efforts that have
focused on risk assessment and tribal populations include:
•  A Traditional Tribal Subsistence Exposure Scenario
   and Risk Assessment Guidance Manual was
   published to help each tribe to identify its specific
   exposure risks.

•  Researchers developed specific fish consumption
   guidelines for high-risk and sensitive populations in
   Great Lakes tribal communities to decrease mercury
   exposure in these populations.

•  A Swinomish Traditional Cultural Lifeways Exposure
   Scenario was developed to decrease toxic chemical
   exposure in tribal citizens who pursue traditional
   lifeways. Subsequent research has identified a set of
   environmental  public health indicators for additional
   tribes in the Pacific Northwest.

Impacts on pyeguiations and
Management  ) !ans

State and tribal officials have incorporated results from
STAR grants and fellowships to refine their regulations and
management plans. For example:

•  The states of Washington and Oregon are using STAR
   data to reexamine and revise their state water quality
   standards. These revisions offer greater protection
   of tribal populations whose cultural practices and
   traditional lifeways could result in greater exposures
   to contaminants in water resources.

•  To protect its citizens from exposure to toxic
   chemicals,  the Makah Nation implemented more
   protective water quality standards than those issued
   by the state of Washington as a result of data
   produced by a STAR fellowship.

•  The Cherokee Nation used the results of another
   STAR fellowship to design its Tribal Integrated
   Resource Management Plan, which provides
   guidance for Cherokee land and resource planning
   and management.

•  Other STAR research has resulted in the development
   of tribal aquatic water quality monitoring plans for a
   number of tribes. These stricter standards and plans
   protect the resources that are  important to the tribes'
   cultural and spiritual practices.

Where  Will the Tribal Environmental Health
Research Program  Go From Here?

Future STAR tribal  research will  explore new strategies,
methods  and tools to assess environmental health
exposure among tribal populations. The program also
will identify other research opportunities for advancing
health protection while maintaining traditional tribal
lifeways. The program recently released its latest Request
for Applications (RFA), "Science for Sustainable and
Healthy Tribes," in February 2013 (U.S. EPA, 2013a). EPA
solicited tribal input regarding current tribal environmental
challenges to help determine the RFA's focus. This input
initially was gathered from tribal citizens and  EPA staff at
the National EPA-Tribal Science Council-sponsored 2010
National Tribal Science Forum; members of the  National
EPA-Tribal Science Council continue to provide input. Also,
STAR Graduate Fellowship solicitations now include a
topic focused specifically on Native populations. The goal
of this category is to protect the environment and these
communities, with specific focus on related environmental
health, sustainability and pollution prevention/remediation
strategies and issues.

As it has  done for more than a decade, EPA's Tribal
Environmental Health Research Program will continue
to engage and collaborate with AI/AN communities
and partners to support them in maintaining their
long-standing, intricate relationships with the natural
environment even in the face of the myriad stressors
threatening their health, wellness  and lifeways. •
                                                                  A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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Introduction/Background

Many traditional American Indian and Alaska
Native (AI/AN) populations maintain  intricate and
ecologically interdependent relationships with the
natural environment, as they have for millennia.
To restore and protect the health and knowledge
base of their communities, tribal  nations encourage
traditional diets, religious practices, customs
and language use. This emphasis on traditional,
healthy lifeways for AI/AN communities requires
that the unique health and environmental impacts
of pollution, dietary exposure, cumulative risk and
climate change be identified to reduce tribal health
rj|ksjiJ.S. EPA, 2012e).

The relationships between tribal citizens and their
environments are being affected adversely by a
variety of stressors. Industrial chemical pollution,
    Cate change, the availability of processed foods,
    social  and political isolation threaten the
health, wellness and lifeways of AI/AN communities.
Contaminated sites, pesticide drift, bioaccumulation
and rights of access issues have an  effect on
exposures from subsistence lifestyles and diets (U.S.
EPA, 2012e).

The U.S. Environmental Protection Agency (EPA)
and its tribal partners recognized that AI/AN
populations have distinct research needs as a
result of their unique relationship with the natural
environment. To address these needs, the Agency
directed the Office of Research and Development's
(ORD) National Center for Environmental Research
(NCER) to establish its Tribal Environmental Health
Research Program. In 2010, the EPA Administrator
made strengthening tribal partnerships one of
the Agency's seven priorities, demonstrating ERA'S
commitment to support and, when possible, bolster
tribal capacity (U.S. EPA, 2010a).To underscore this
commitment, the FY2011-2015 EPA Strategic Plan
includes strengthening of tribal partnerships as a
cross-cutting fundamental strategy for EPA (U.S. EPA,
201 Ob).

To meet the specific needs of the tribes, EPA
supports research that focuses on  assessment and
reduction of risk in susceptible populations. Tribal
populations may be at increased risk for
environmentally  induced diseases as a result of
unique lifestyle practices, community activities,
occupations and  customs, and/or environmental
releases that significantly affect tribal lands. EPA's
Tribal  Environmental Health Research Program
has supported studies to better understand the
health effects of environmental contaminants on
tribal populations. Through the Agency's Science To
Achieve Results (STAR) grants program, NCER has
expanded its Tribal Environmental Health  Research
Program from a single grant in 2000 focused on
environmental justice in tribal communities to
include nine additional STAR grants that explore
tribal environmental risks, particularly cumulative
chemical exposure and how global climate change
may affect AI/AN  populations (U.S. EPA, 2012e).
These grants were funded  under three  Requests for
Applications (RFAs) for a total of approximately
$6 million (U.S. EPA, 2012c). A summary of the
goals and objectives of the research projects
organized by RFA is included in Appendix A, and a
list of outputs of these grants, including publications
and presentations, is provided in Appendix B. Past
STAR tribal environmental health research has
focused on  identifying and quantifying  cumulative
risk, determining the  impacts of climate change on
tribal populations, and  identifying dietary exposure
risks of traditional subsistence diets (U.S. EPA,
2012c,2012e).

Relationships between tribal
citizens  and their environments
are  being affected negatively  by
a variety of stressors.

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Introduction/Background
EPA also funds fellowships for undergraduate (Greater
Research Opportunities Undergraduate Fellowships) and
graduate (STAR Fellowships) students investigating tribal
environmental health. In addition, several P3 grants, which
provide funding to undergraduate and graduate students
to design solutions for a sustainable future, have  been
focused on tribal  projects. The majority of the STAR grant
and fellowship research funded  by the Tribal Environmental
Health Research Program is being or has been carried out
at tribal  colleges and  universities. These schools include
Fort Belknap College, Haskell Indian  Nations University,
Salish Kootenai College, Northwest Indian College, Dine
College  and Little Big  Horn  College. Other opportunities
for early-career development for tribal citizens include
postgraduate fellowships  coordinated by NCER (e.g.,
American Association  for  the Advancement of Science
Science and Engineering Fellows Program, Association of
Schools of  Public Health  Fellows Program,  EPA Marshall
Scholarship Program). More information about these
fellowships may be found via the links in Appendix G.

The Tribal Environmental Health  Research Program
broadly aligns with EPA's Air, Climate and Energy Research
Program  by addressing climate change as  well as indoor
air related research, while specifically addressing  impacts
on AI/AN communities (U.S. EPA, 2012a). This research
synergizes with one of the National EPA-Tribal Science
Council's National Tribal Science Priorities announced in
2011, which is devoted to climate change. Also, NCER
developed a category beginning in 2011 for its STAR
Graduate Fellowship solicitations that is focused on
"tribes and American  Indian/Alaska  Native/Pacific  Islander
communities" (U.S. EPA, 2012b,  2012g, 2012h). The
focus is on investigations that protect the environment
and these communities, with specific emphasis on
related environmental health, sustainability and pollution
prevention/remediation strategies and issues. For  example,
projects within this category could assess the impacts of
environmental challenges on these populations or explore
how traditional lifeways may be connected to unique
risk and exposure pathways. Other projects could explore
sustainability through tribes'traditional or local ecological
knowledge or expand the understanding of cumulative risk
in  Native communities (U.S. EPA, 2012b, 2012g, 2012h).

The STAR tribal program  also supports EPA's Sustainable
and  Healthy Communities Research  Program. The
STAR tribal  program supports EPA's mission under the
Sustainable and  Healthy Communities Research Program.
The newly released Tribal Environmental  Health Research
Program solicitation, "Science for Sustainable and Healthy
Tribes," specifically supports this theme by focusing  on
improving understanding of tribal exposures and health
impacts. The Sustainable and Healthy Communities
Research Program research action plans and projects are
available at http:// www.epa.gov/ord/research-programs.
htm. The  relationships among EPA's six integrated research
programs are highlighted in the accompanying figure.
 Sustainab
 & Healthy
 Communities
EPA's Six Integrated Research Programs. EPA's six
research programs emphasize coordination and
integration. The Sustainable and Healthy Communities
program integrates research across the environmental
spectrum. Air, climate, water and chemical research
all inform the Agency's risk assessment and homeland
security research efforts.
                            O EPA Tribal Environmental Health Research Program
                             Academic Institution and Tribal Locations
                            O STAR/GRO Fellowship Locations at Tribal Colleges
                             and Universities
                            • P3 Award Project Location
Locations of EPA Tribal-Related Research Highlighted in
This Document. Although the NCER grants and fellowships
program is a national program, only a relatively small
number of projects have been funded as a result of the
competitive process driven by identified research gaps.
There may be additional tribal project locations that are
not identified in this report because they were recently
awarded and have not generated outcomes or are
funded by other EPA programs or federal agencies.

Recognizing the importance of this research program and
the need to communicate  its results, NCER staff members
made several presentations to  EPA and external partners/
stakeholders (Breville, 2011; McOliver, 2013b). More
information about these presentations  can be found  in
Appendix C. NCER also has established a website devoted
to tribal environmental  health issues (http:/Avww.epa.gov/
ncer/tribalresearch) to disseminate the results of the tribal
research  and communicate with AI/AN stakeholders. The
Tribal  Environmental Health Research Program conducted
a webinar series in 2009 in partnership with the National
EPA-Tribal Science Council  and a second series in 2012.
The presentations can be found at http://www.epa.gov/
ncer/tribalresearch/recipients.html  and http:/Avww.epa.gov/
ncer/tribalresearch/multimedia/index.html.

The webinars were designed to translate and disseminate
recent findings of STAR-funded research addressing the
A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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                                                                                                                                                          Introduction/Background
environmental health and exposure concerns of AI/AN
subsistence populations. The series highlighted research
goals and preliminary findings of projects focused on
cumulative risk and climate change. The webinars featured
tribal  communities and  their research partners who are
conducting research on dietary exposure, cumulative risk,
climate change health effects and risk reduction. This
research aimed to quantify and reduce  environmental  risks
and encourage or restore traditional, healthy lifeways for
AI/AN communities (U.S. EPA, 2012e). More information
about these webinars is available  in Appendix D.

Based on the attendance at and response to webinars
sponsored by EPA to communicate the outcomes and
accomplishments of STAR research across the Agency's
programs, this form of dissemination is  highly  important
and useful. AI/AN people can attend webinars  to obtain
information relevant to their communities on a variety  of
critical topics across broad program  areas (e.g., water, air,
sustainable communities). Information about webinars and
other events can  be found at http://epa.gov/ncer/events/.

To ensure that the Agency's grants are responsive to
tribal  needs, NCER communicates  with Agency-sponsored
partnership groups, such as EPA's National Tribal
Operations Committee1 and  National EPA-Tribal Science
Council. The National EPA-Tribal Science  Council helps
to integrate Agency and tribal interests, specifically with
respect to environmental science issues (U.S. EPA, 2012d).
NCER has worked with the National Tribal Operations
Committee and National EPA-Tribal Science Council to
identify tribal research priorities. For example, a session at
the National EPA-Tribal Science Council-sponsored 2010
National Tribal Science Forum encouraged the tribes to
provide direct input in developing the Tribal Environmental
Health Research Program's most recent RFA (Breville,
2011), "Science for Sustainable and Healthy Tribes,"
which was released  in February 2013 (U.S. EPA, 2013a).
Following the strategy session, several members of the
National EPA-Tribal Science Council continued to provide
     $3,000,000


     $2,500,000


     $2,000,000


     $1,500,000


     $1,000,000


      $500,000


            $0
                   2000       2002       2007

               | Nontribal Organization or Academic Institution
               | Nontribal Organization or Academic Institution
                 With a Tribal Partner
               I Tribal Organization or Academic Institution

Tribal Environmental Health Research Program Funding
by Institution. The amount of STAR funding granted by the
Program to tribal and nontribal institutions is presented
by RFA. The majority of funding is provided to tribal
organizations or institutions with tribal partners.


substantive input on updated drafts of the  RFA, serving as
writing team  members and reviewers (McOliver, 2013a).
EPA sponsored a series of informational webinars  in
March, May and June of 2013 to disseminate information
about the RFA. The  purpose of the webinars was to
describe the  major  research elements of the RFA;  review
any administrative,  electronic filing, eligibility and peer
review concerns; and share answers to frequently  asked
questions about the RFA and application process (U.S. EPA,
2013a,2013b).
Because research projects funded by the Tribal
Environmental Health Research Program resulted in
important and beneficial outcomes, EPA leadership
recognized the need to publicize them to  benefit as
many AI/AN communities as possible. This synthesis
report, which highlights the outputs and outcomes of this
research, is one of the results. This document focuses
on tribal-related research funded by  EPA, including STAR
grants and fellowships. It does not describe any of the
tribal  research sponsored by other EPA offices, such as the
Tribal  ecoAmbassadors Program2, or  programs such as the
Indian General Assistance Program3.  The synthesis report
describes outcomes for past NCER tribal environmental
research and discusses future directions and initiatives
while  recognizing that each AI/AN community  is unique
and not all research  issues nor results apply to all
communities. The goal is that the lessons learned through
the research will result in practical applications that can
be used broadly by AI/AN and other  communities as well
as the general  public. This research has been  conducted
to address complex problems within  NCER's scope, and is
just part of the wide  variety of AI/AN  research that supports
the protection of human and environmental health  being
undertaken throughout EPA and  other federal agencies.  It
also is important to note that the research may  be  more
qualitative than quantitative in nature, focusing on public
health protection and community-level risks rather than
individual risk.

To develop this document, all former STAR grantees who
had received funding under the Tribal Environmental
Health Research Program were contacted  to determine
the outcomes and impacts of the research, including
those that occurred after the  funding period ended.
1 The National Tribal Operations Committee comprises 19 tribal leaders (the National Tribal Caucus) and EPA's senior leadership, including the
 Administrator, Deputy Administrator, and Assistant and Regional Administrators (U.S. EPA, 2012f).
2 Through the Tribal ecoAmbassadors Program, EPA conducts research in partnership with tribal colleges and universities to solve the environmental
 problems most important to their tribal communities.
3 The General Assistance Program assists tribes in building capacity to plan and establish environmental protection programs and develop and
 implement solid and hazardous waste programs in accordance with their individual needs.
                                                                    A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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Introduction/Background
The researchers were asked whether their research had
been  utilized by the Agency; tribal, local, state or federal
agencies; and/or other interest groups or stakeholders.
Examples of such utilization may include educating tribal
populations, developing regulations or management plans,
taking actions to mitigate climate change and so forth.

Next,  all NCER grantees, fellows and contractors were
identified—including those  from its STAR, P3 and Small
Business Innovation Research programs—who had
conducted tribal-related research outside of the Tribal
Environmental Health Research  Program. This was
accomplished through relevant  keyword searches of the
NCER Research Project Database (U.S. EPA, 2012c) as
                         well as input from NCER staff. These researchers were
                         contacted and asked the same questions to determine
                         whether other  EPA-funded  research had resulted in
                         outcomes that benefited tribal communities; before
                         the report was finalized, the Tribal Environmental Health
                         Research Program grantees were contacted again to
                         ensure that the most up-to-date  information  about
                         outcomes was included in the report. In addition, a
                         bibliometric search was performed to assess how often
                         the publications  from tribal-related research funded by EPA
                         were cited by other researchers.

                         NCER staff members also contacted the project officers
                         for the  STAR grants and asked them to identify any
                                                               additional tribal-related research that may not have been
                                                               captured in the database search and investigator contacts.
                                                               Finally, after all of the information was collected, it was
                                                               analyzed, organized by common themes within research
                                                               projects, and developed into the synthesis report. The
                                                               research  projects identified in the search and their results/
                                                               impacts are described by theme in the next section
                                                               and summarized in Appendix E. Several  of the research
                                                               projects encompassed multiple themes and, therefore,
                                                               may be described in  more than one section. Practical
                                                               applications of EPA's  tribal research can  be found in
                                                               Appendix F, and Appendix G contains a list  of additional
                                                               online resources. •
Summary of NCER-Funded Tribal Grants and Fellowships Discussed in This Report
             Project Title
      (Grant/Fellowship Number)
      Institution(s)
 Tribal Environmental Health Research Program STAR Grants
 * An Epidemiologic Study of Time Trends
 and Health Effects of Persistent Organic
 Pollutants, Mercury and Micronutrients
 (R833705)
 * Community-Based Risk Assessment
 of Exposure to Contaminants via Water
 Sources on the Crow Reservation in
 Montana (R833706)
 Impacts of Climate Change on Health
 Benefits of a Tribal Alaskan Resource:
 Integrating Traditional Ecological Knowledge
 with Risk Assessment Through Local
 Monitoring (R833707)
 * Understanding the Cumulative Effects of
 Environmental and Psycho-Social Stressors
 thatThreaten the Pohlik-lah and Ner-er-
 nerLifeway:TheYurok Tribe's Approach
 (R833708)
 Environmental Contaminants in Foodstuffs
 of Siberian Yupiks from St. Lawrence Island,
 Alaska (R831043)
 lakotisa'tstentsera:wis Ne Ohontsia:
 Reducing Risk by Restoring Relationships
 (R831044)
Alaska Native Tribal Health
Consortium
Montana State University
and
University of New England

University of Illinois at
Urbana-Champaign
YurokTribe Environmental
Program
Alaska Community Action
on Toxics

AkwesasneTask Force
on the Environment
and Haudenosaunee
Environmental Task Force
        Location(s)
Total Amount
 of Funding
Yukon-Kuskokwim River Delta,   $948,121
Alaska
Crow Reservation (Crow        $329,532
Agency, Montana) and
Big Horn County, Montana

Akutan, Point Hope and         $300,000
Seldovia, Alaska
Klamath River Basin, California   $974,389
St. Lawrence Island, Gambell    $449,510
and Savoonga,Alaska
Akwesasne Freedom School
(Hogansburg, New York)
$450,000
            Identified Theme(s)1
              > Risk Assessment and Sensitive Populations
              > Subsistence Foods and Water Resources
              • Community-Based Participatory Research and
               Community Outreach and Education

              > Cultural Practices, Language and Traditional
               Ecological Knowledge
              > Subsistence Foods and Water Resources
              • Community-Based Participatory Research and
               Community Outreach and Education
              • Subsistence Foods and Water Resources
              > Community-Based Participatory Research and
               Community Outreach and Education
• Subsistence Foods and Water Resources
> Community-Based Participatory Research and
 Community Outreach and Education
> Cultural Practices, Language and Traditional
 Ecological Knowledge
• Community-Based Participatory Research and
 Community Outreach and Education
"These grants still are active at the time of publication.
1 These themes were identified after analyzing all of the information provided by the grantees and fellows; this synthesis report is organized by these themes.
2 These research areas are based on the RFA needs that the projects addressed as well as relevant keywords assigned to the projects.


A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs
          Research Area(s)2
                                            > Tribal cumulative exposures
                                            • Impacts of climate change on cultural and
                                             physical health

                                            • Tribal cumulative exposures
                                            • Subsistence-based risk reduction
                                             > Impacts of climate change on cultural and
                                              physical health
                                             > Subsistence-based risk reduction
                                            • Tribal cumulative exposures
                                            • Subsistence-based risk reduction
• Tribal cumulative exposures
• Subsistence-based risk reduction

• Language preservation and education
• Subsistence-based risk reduction

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                                                                                                                                                                                 Introduction/Background
              Project Title
       (Grant/Fellowship Number)
 Risks to Northern Alaskan Inupiat: Assessing
 Potential Effects of Oil Contamination on
 Subsistence Lifestyles, Health and Nutrition
 (R831045)
 Lifestyle and Cultural Practices of
 Tribal Populations and Risks From Toxic
 Substances in the Environment (R831046)
 Reducing Risks of the Anishinaabe From
 Methyl Mercury (R831047)
 Bioaccumulative Toxics in Native American
 Shellfish (R829476)
      Institution(s)
Mote Marine Laboratory
        Location(s)
Kaktovik, Barrow and
Wainwright.Alaska
Oregon State University      National Scope
Great Lakes Indian Fish and
Wildlife Commission
Swinomish Tribal
Community
Michigan, Minnesota and
Wisconsin
Padilla, Fidalgoand Skagit
Bays (state of Washington)
Total Amount
 of Funding
$437,399




$449,970



$445,830






$1,170,389
 NCER Grants and Fellowships Awarded Outside of the Tribal Environmental Health Research Program
 Tribal Environmental Public Health
 Indicators (R834791)
 Midwest Hazardous Substance Research
 Center (R828770)

 Space-Time Aquatic Resources Modeling
 and Analysis Program (R829095)

 Rocky Mountain Training and Technical
 Assistance to Brownfields Communities
 Program (TR831579) (STAR Training Grant)
 Linking Traditional Knowledge and
 Environmental Policy in the Cherokee
 Nation of Oklahoma (F5C30541) (STAR
 Graduate Fellowship)
 Dine Bikeyah: Environment, Cultural Identity
 and Gender in Navajo Country (U915164)
 (STAR Graduate Fellowship)
 Makah Traditional Environmental Knowledge
 and Gray Whale Conservation (U914970)
 (STAR Graduate Fellowship)
 Use of Bone Char for the Removal of
 Arsenic and Uranium from Groundwaterat
 the Pine Ridge Reservation (SU834713 and
 SU835069) (P3 Grant)
Swinomish Tribal
Community
Kansas State University (in
partnership with Haskell
Indian Nations University)
Colorado State University
Colorado State University
and Montana Tech of the
University of Montana (in
partnership with Aaniih
Nakoda College [formerly
Fort Belknap College])
University of California,
Berkeley
University of Wisconsin-
Madison
University of Washington
University of Illinois at
Urbana-Champaign (in
partnership with Oglala
Lakota College)
Puget Sound, Washington

Tribal communities throughout
the Midwest

National via available Internet
resources

Montana, North Dakota,
Colorado and Missouri
Cherokee Nation of Oklahoma
(Tahlequah, Oklahoma)
Kayenta,Arizona, and Kirtland,
New Mexico
Neah Bay (state of
Washington)

Pine Ridge Indian Reservation
(Pine Ridge, South Dakota)
$235,517

$501,000
$2,998,331
$180,000
$106,722
$102,000
$102,000
Phase 1:
$10,000
Phase 2:
$75,000
             Identified Theme(s)1
> Community-Based Participatory Research and
 Community Outreach and Education
• Community-Based Participatory Research and
 Community Outreach and Education
> Risk Assessment and Sensitive Populations
> Cultural Practices, Language and Traditional
 Ecological Knowledge
• Subsistence Food and Water Resources
• Community-Based Participatory Research and
 Community Outreach and Education
> Risk Assessment and Sensitive Populations
> Subsistence Foods and Water Resources
• Community-Based Participatory Research and
 Community Outreach and Education
> Risk Assessment and Sensitive Populations
> Impacts on Regulations and Management Plans
• Risk Assessment and Sensitive Populations

• Community-Based Participatory Research and
 Community Outreach and Education

> Community-Based Participatory Research and
 Community Outreach and Education
• Impacts on  Regulations and Management Plans
> Community-Based Participatory Research and
 Community Outreach and Education
> Cultural Practices, Language and Traditional
 Ecological Knowledge
• Impacts on Regulations and Management Plans

> Community-Based Participatory Research and
 Community Outreach and Education

• Subsistence Foods and Water Resources
• Impacts on Regulations and Management Plans

> Subsistence Foods and Water Resources
> Community-Based Participatory Research and
 Community Outreach and Education
* These grants still are active at the time of publication.
1 These themes were identified after analyzing all of the information provided by the grantees and fellows; this synthesis report is organized by these themes.
2These research areas are based on the RFA needs that the projects addressed as well as relevant keywords assigned to the projects.
          Research Area(s)2
> Subsistence-based exposure quantification
> Subsistence-based risk reduction
> Risk assessment and exposure scenarios
> Culturally sensitive education and guidance

> Subsistence-based exposure quantification
> Subsistence-based risk reduction
> Researcher/tribal community partnership
> Community-based, culturally sensitive
 education
• Tribal-specific health indicators
• Tribal community health
• Hazardous exposure reduction
• Community-based, culturally sensitive
 education
• Learning materials development
• Tribal aquatic water quality monitoring plan
 development
• Hazardous exposure reduction
• Community-based, culturally sensitive
 education
• Cultural revitalization and resource
 sustainability
• Community-based, culturally sensitive
 education
• Tribal cultural and environmental historical
 perspectives

• Tribal cumulative exposures
• Subsistence-based risk reduction

• Subsistence-based risk reduction
• Inexpensive technology development
                                                                              A Decade of Tribal Environmental Health  Research:  Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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Funded  by  EPA
The tribal environmental research funded by EPA
for more than a decade has resulted in myriad
outcomes and outputs, including but not limited to:

•  methods to reduce environmental and social
   impacts on tribes,

•  standards and regulations that offer greater
   protection to tribal communities,

•  advisories that reduce exposure associated with
   traditional subsistence lifeways,

•  tribal education and outreach, and
 1 peer-reviewed publications.
This section provides greater detail about the five
overarching themes that have emerged from the
tribal research conducted under the program:

•  Cultural practices, language and fradifional
   ecological knowledge are of great significance to
  tribes, and many of the tribal grants fi
  EPA reflect their importance.

• AI/AN  populations still rely heavily on traditional
  subsistence foods and water resources,
  considering water a sacred resource to be
  revered and protected.

• Because the tribes are  involved with the
  community-based participatory research and
  community outreach and education that EPA
  researchers conduct, they are invested in the
  research and outcomes and benefit from them.

• Many  EPA tribal researchers focus on risk
  assessment and sensitive populations.

• A number of tribal research projects have
  had beneficial impacts on  regulations and
  management plans.

It is important that AI/AN communities, the larger
public, researchers, health departments, practitioners.
state and local regulators, and other stakeholders
understand how tribal research conducted within the
STAR Tribal  Environmental Health Research Program
and other EPA initiatives can provide them with
practical applications and approaches that may be
replicated in their own communities as they confront
real-world environmental health issues. These
practical applications and methods are highlighted
in call-out boxes within each theme below, and
more detailed information is provided in Appendix F.
 STAR-funded  research  is
 addressing  environmental
 concerns  of American
 Indian and Alaska Native
 communities so that  their
 members can continue  their
 cultural practices with  reduced
 health  risks.

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                                                             Each AI/AN community has its own unique set of
                                                             cultural practices, language and traditional ecological
                                                         knowledge. STAR-funded research strives to support citizens
                                                         of these communities as they continue their cultural
                                                         practices with reduced health risks. For example, as a
                                                         result of the grant, "Reducing Risks of the Anishinaabe
                                                         From  Methyl Mercury," there is greater awareness of fish
                                                         advisory maps that help to protect the health of tribal
                                                         citizens residing in Michigan, Minnesota and Wisconsin.
                                                         These maps allow them to continue their traditional
                                                         consumption  of subsistence fish by harvesting in less-
                                                         contaminated waters (DeWeese et al., 2007; Kmiecik and
                                                         Foran, 2007;  Madsen et al., 2007). Additional details about
                                                         this project are described under the theme of "Subsistence
                                                         Foods and Water Resources."
                                                         Anishinaabe Fishermen Harvesting Walleye Using
                                                         Spears. Fish advisory maps developed with STAR funding
                                                         allow the fishermen to practice traditional lifeways with
                                                         reduced risk of mercury exposure.
A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs
STAR-funded research also helps to strengthen native
language skills and increase culturally relevant
communication of  traditional ecological knowledge.
For example, the researchers of a STAR grant,
"lakotisa'tstentsem:wis Ne Ohontsia: Reducing Risk
by Restoring Relationships," focused  on teaching
environmental  risk  of cultural practices to teachers and
students at the Akwesasne Freedom School in upstate
New York. During the 3-year project,  more than 100
tribal citizens learned about toxic substances while also
learning the Mohawk language and  skills associated with
traditional  cultural  practices. Workshops were completed
entirely in  the Mohawk language using oral tradition
and hands-on  participatory response techniques to
share meaning. A library of resources has been created,
including posters, books, pictures and charts written in
the Mohawk language, which will be shared with other
immersion schools and educational  programs throughout
the Haudenosaunee Confederacy. Through this effort, the
community understands  risk issues and can take action to
protect tribal citizens' health while engaging in traditional
subsistence practices (Arquette et al., 2008).

Traditional ecological knowledge of Alaska Native
people has long considered wild indigenous berries a
health-promoting, life-sustaining resource. The results
of a STAR grant, "Impacts of Climate Change on  Health
Benefits of a Tribal  Alaskan Resource: Integrating
Traditional Ecological Knowledge with Risk Assessment
Through Local  Monitoring," confirmed this traditional
ecological knowledge, which held that the berries have

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                                                                                                                      Cultural Practices, Language and Traditional Ecological Knowledge

                                                             Practical Application

                                                             •  Create culturally relevant educational
                                                                and training materials to  help community
                                                                members understand risks and actions that
                                                                will promote healthier lives while practicing
                                                                their traditions.
Alaska Natives Picking Wild Indigenous Berries.

medicinal properties. The research was carried out with
the communities of Akutan, Point Hope and Seldovia,
Alaska. The wild berries also were confirmed to play
a key role in community wellness beyond nutrition
because of the social  and outdoor activities associated
with harvesting. These  benefits, however, are potentially
threatened by  uncertain impacts from contamination,
climate change, and sociocultural and behavioral changes
that shift focus away from locally available foods. Research
findings are informing  community wellness planning
by the Alaska Native Tribal Health Consortium and have
served as important learning opportunities for community
members, particularly youth. The researchers concluded
that a strong sense of community and solidarity clearly
centered on the annual wild  berry yields in Alaska Native
communities. Scouting, family-centered wildcrafting
and harvests, and preparations are highly anticipated
events. Community members' perspectives about the
impacts of climate change on this tradition varied, and
often  risks were categorized along with other perceived
threats (e.g., pollution) to the subsistence berries. Several
public interviews resulted from  this work, including those
on National Public Radio and in The Ecologist (Lila et al.,
2012).

A STAR graduate fellowship, "Linking Traditional Knowledge
and Environmental Policy in the Cherokee Nation of
Oklahoma," summarized information on culturally
significant plant communities of the Cherokee Nation in
northeastern Oklahoma. This  information is being used
to target the plant communities for conservation while
simultaneously encouraging the sustainable, cultural
use of the resources by tribal citizens. Related work on
the  revitalization of Cherokee ethnobotanical knowledge
has been performed. As a result of interviews with tribal
elders conducted under the grant, an advisory group to
the  Natural Resources Department of the Cherokee Nation
of Oklahoma has been created. The group, composed of
Cherokee elders who are knowledgeable on the subject
of Cherokee ethnobotany, will focus on the issue of
Cherokee plant knowledge. The group also  works with
Natural Resources Department staff on Tribal Integrated
Resource Management Plan  implementation, as well  as
on larger goals of cultural and environmental protection.
One significant product from  this collaboration is a
booklet on Cherokee wild plant knowledge, Wild Plants
of the Cherokee Nation, which is intended to serve as
an instrument to increase awareness about this subject
among tribal citizens and promote cultural revitalization.
The entire booklet has been translated into the Cherokee
language and is being  used  as a  textbook in the Cherokee
Nation Immersion School (Carroll, 2011). •
                                                                  A Decade of Tribal Environmental Health Research:  Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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Subsistence  |5   oods  and  Water  Resources

                                                            Tribes emphasize consumption of traditional diets,
                                                            many of which include an abundance of fish and
                                                        seafood. In addition to food supply, water plays an
                                                        important role in tribal cultural and spiritual practices.
                                                        Several STAR grants have focused on  identifying the
                                                        environmental and health risks and approaches for
                                                        reducing health effects associated with consumption  of
                                                        traditional subsistence foods.

                                                        The Siberian Yupik people, who live on Saint Lawrence
                                                        Island, Alaska, in the northern  Bering Sea region, follow
                                                        a traditional lifestyle that relies on a  diet of seal, whale,
                                                        walrus, sea bird eggs, fish, reindeer, berries and  local
                                                        plants. These traditionally harvested foods  play a vital
                                                        role in their health and prosperity, and the ability to
                                                        maintain this diet and continue to engage in  communal
                                                        harvesting is critical to their physical, cultural, social
                                                        and economic well-being. The research team for the
                                                        STAR grant, "Environmental Contaminants in Foodstuffs
                                                        of Siberian Yupiks from St. Lawrence  Island, Alaska,"
                                                        examined these Yupik traditional foods for  polychlorinated
                                                        biphenyls, chlorinated pesticides and  heavy metals. The
                                                        team worked with Yupik  hunters and  heads of households
                                                        to collect tissue samples from freshly killed animals and
                                                        those that had undergone preparation for  consumption.
                                                        The researchers found that rendered oils (e.g., mungtak
                                                        and blubber) are  major  dietary sources of polychlorinated
                                                        biphenyls, because these oils  are vital components of the
                                                        traditional diet and consumed on a regular basis by the
                                                        St.  Lawrence Island Yupik people. Organ meats of certain
                                                        animals, such as  reindeer and walrus, contain levels of
                                                        mercury that exceed health-based standards, although
                                                        these organ meats are consumed less frequently. The
                  ronmental Health Research:  Results and Impacts from EPA's Extramural Grants and Fellowship Programs
Anishinaabe Fisherman Harvesting Walleye Using
Nets. Fish advisory maps help to protect the health
of Anishinaabe people who consume mercury-
contaminated walleye.

researchers concluded that proactive policies are essential
to the protection of the health of present and future
generations of the St. Lawrence Island Yupik. The leaders
of the communities emphasized the need to continue
collaborative community-based research. The St. Lawrence
Island communities will examine methods to reduce
exposures while continuing to rely on their traditional
subsistence diet (Miller et al., 2010).

Great Lakes Anishinaabe tribal citizens rely on  traditional
lifeways, which include the harvesting  and consumption
of indigenous freshwater fish; this cultural tradition
places the tribe at a greater risk for exposure to elevated
concentrations of methyl mercury. As a result of the STAR-

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                                                                                                                                          Subsistence Foods and Water Resources
The mouth of the Klamath River; the river is an important subsistence resource for the Yurok Tribe.
funded grant, "Reducing Risks of the Anishinaabe From
Methyl Mercury," there is greater awareness of the fish
advisory maps (see example maps on pages 16 and 17)
produced by the Great Lakes Indian  Fish and Wildlife
Commission. This  increased awareness helps to protect
the health of Anishinaabe tribal citizens who consume
mercury-contaminated walleye. Tribal citizens use the
fish advisory maps to reduce their risk of methyl mercury
exposure through lake-specific meal consumption advice
and information that helps them select lakes for harvest
where walleye contain lower mercury concentrations. The
data collected under the grant were sufficient to provide
consumption  advice for 293 of the 449 lakes assessed
in the study. Most of these carried a recommendation
of no more than four meals per month for the general
population, and no more than one meal per month for the
sensitive population. A significant increase in preference
for smaller walleye occurred among tribal harvesters
in Wisconsin, Michigan and Minnesota  but not among
women of childbearing age. The Great Lakes Indian
Fish  and Wildlife map-based advisory program did not
adversely affect tribal harvest of walleye, which increased
from 63,000 to 88,000  less-contaminated fish in the three
states following the intervention (DeWeese et al, 2007;
Kmiecik and Foran, 2007; Madsen et al., 2007).

Coastal and river resources are primary and secondary
food sources for a majority of Yurok tribal citizens,
particularly those residing near or within Yurok ancestral
territory in northern California. The researchers involved
in the grant, "Understanding the Cumulative Effects of
Environmental and Psycho-Social Stressors that Threaten
the Pohlik-lah and Ner-er-ner Lifeway. The Yurok Tribes
Approach," combined ethnography and qualitative  data on
subsistence resources and practices from previous and
current tribal studies with quantitative data on chemical
exposures and epidemiological analyses of health data.
The goal was to determine how these factors interact
to affect the health of various vulnerable populations
within the tribe. Using personal (or public) participation
geographic information system methods to better
incorporate the tribe s local geographic awareness, the
researchers were able to develop a series of 12 maps
with  the Yurok Tribe that provide historic and contemporary
contaminant information on the Klamath River Basin in
California (Sloan et al., 2011). Although the full impact of
the research has not been realized because the project
                                                                  A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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Subsistence Foods and Water Resources
This map is to help you find safe Ogaa (Walleye) in lakes harvested by Lac Courte Oreilles
                                    NELSON L
                              SMITH L
                                                     SPIDER L   LOST LAND L
                                                                                     LOWER CLAM L
                                                TIGER CAT FL
                                      V               \
                                           ROUND L
                           LITTLE ROUND L
                        TEALL

                    MOOSE
\f
       WASHBURN
       BARRON
                  LAC COURTE OREILLES
                                                                                  BARBER L
                          BIRCH L
                  WINDFALL L
                                                                                                   f
                                                                                         L OF THE PINES
                                               SAWYER
      MILLE LACS

     fc
     fcrttf
                                     RUSK
                                                                                 OTTER L
                                                                                                                       CHIPPEWA
                                                                                                         PRIG
                                               EAU CLAIRE
                                                      L EAU CLAIRE
                                         For Ogaa Smaller than 20 Inches:
                                             |  Eat up to 8 meals or 64 ounces per month.
                                             |  Eat up to 4 meals or 32 ounces per month.
                                               Eat up to 2 meals or 16 ounces per month-
                                               Eat up to 1 meal or 3 ounces per month.
                                             |  Do not eat ogaa from these lakes
                                               Not enough information available.
                                         Number of meals is based on an 8 ounce meal size. IF your
                                         meal size is larger, you should reduce the number of meals
                                         you eat per month.
                                               Lac Courte Oreilles Reservation
                                               County Boundary
                                         i nbai reservation boundaries are representations and may not be the actual
                                         legally binding boundaries
                                                    THORNAPPLE FL
                                   MAP FOR USE BY PREGNANT WOMEN. WOMEN OF CHILDBEARING
                                   AGE, AND CHILDREN UNDER 15 YEARS OF AGE.
                                   DO NOT EAT OGAA LARGER THAN 20 INCHES.
                                   EAT OGAA LESS THAN 20 INCHES AND CHOOSE EVEN SMALLER
                                   OGAA TO FURTHER REDUCE MERCURY EXPOSURE.
AMACOY L

This is an example of a fish consumption advisory map developed by the Great Lakes Indian Fish and Wildlife Commission for tribal fishermen in Michigan,
Minnesota and Wisconsin.
A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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                                                                                                                      Subsistence Foods and Water Resources
This map is to help you find safe Ogaa (Walleye) in select Walleye lakes in the Michigan 1842 Ceded Territory
 MAP FOR USE BY PREGNANT WOMEN, WOMEN OF CHILDBEARING AGE.
 AND CHILDREN UNDER 15 YEARS OF AGE.
 DO NOT EAT OGAA LARGER THAN 20  INCHES.
 EAT OGAA LESS THAN 20 INCHES AND CHOOSE EVEN SMALLER OGAA
 TO FURTHER REDUCE MERCURY EXPOSURE.
                ONTONAGON
       SUNDAY L
   GOGEBIC
                           SIX MILE L
                           -
                          SUDDEN L

                                             VICTORIA RESERVOIR
                                 L GOGEBIC
                                                                            HOUGHTON
                                                                                                                             BARAGA
       BOND FALLS FL
                                  NORWAY L
                                                                             STE KATHRYN L
                                      BEATONS L
           POMEROY L
                     0
LITTLE OXBOW L
                                    LANGFORD L
                                       *
                  PAINT POND
CLOVERLEAF L
            MARION L
                                                                                     WINSLOW L
                                              CLEARWATER L

    PORTAGE L
                                                                          TAMARACK L
                                                   For Ogaa Smaller than 20 Inches:
                                                       | Eat up to 8 meals or 64 ounces per month.
                                                       | Eat up to 4 meals or 32 ounces per month.
                                                         Eat up to 2 meats or 16 ounces per month.
                                                         Eat up to 1 meal or 8 ounces per month.
                                                         Do not eat ogaa from these fakes.
                                                         Not enough information available.
        Number of meals is based on an 8 ounce meal size. If your
        meal size is larger, you should reduce the number of meals
  ;RCH ' you eat per month,
9   i
               Lac Vieux Desert and Keweenaw Bay
               Reservation
               County Boundary
        Tribal reservation and ceded territory boundaries are representations and may
        not be the actual legally binding boundaries.
                                    CISCO L CHAIN   DUCK L

          ALLENL
             DINNER L
                                                                                               IRON
                                                                                 JAMES L
                                                                                                          GIBSON L
                                                                                                                    MICHIGAMME RES
                                                      BIRCH L

                                                       LAC VIEUX DESERT
                                                                                           IRON L
                                 OTTAWAL
                                                                          .ArPRUAN ,
                                                                         HAGERMAN L
                                                                                             STANLEY L

     SUNSET L
                 SWAN L

            ' EMILY L
              CHICAGON L
                                                                                          onmn i
                                                                                                          IklHIAM 1
                                                                                                           RUNKLE L
                                                                                                                MARY 1

                                                                                                        PEAVY POND
This is another example of a fish consumption advisory map developed by the Great Lakes Indian Fish and Wildlife Commission for tribal fishermen in
Michigan, Minnesota and Wisconsin.
                                                         A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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Subsistence Foods and Water Resources
is ongoing, these maps will allow the tribal citizens to
avoid contaminated areas during harvesting. Another
product of the grant was the development of a geographic
information system eco-toxicological tool that models and
calculates residual contaminants, which allows the tribe
to model the amount of contaminants in a specific area.
Contaminant queries may be made from disparate data
sources and formats, ultimately generating a statistical
report on these data. This is useful  as pesticide and
contaminant data reporting standards and formats change
over time and vary among states (Sloan, 2013).

An April 19, 2007, article in the Seattle Times reported
that Swinomish tribal leaders were  advising citizens to
Stock photograph of little neck clams.
restrict their consumption of clams and crabs gathered
in and around their reservation after a 4-year study
funded by EPA's STAR program, "Bioaccumulative Toxics in
Native American Shellfish," found that they contain toxic
chemicals. This caused some concern for many tribal
citizens, who consume approximately 20 times more
shellfish than average Americans. Researchers analyzed
Dungeness crabs and two species of clams, including
little neck clams, harvested in several sites near the
reservation  and found traces of toxic chemicals, including
polychlorinated biphenyls; various industrial chemicals,
including arsenic; and oil and gas derivatives. The tribe
issued voluntary limits of up to three meals per week of
shellfish from the sampled beaches in the Padilla, Fidalgo
and Skagit  Bays in the state of Washington. The limits
varied depending on the consumers age. The limits are
considered  temporary until the tribe can institute  a long-
term solution. The study found that many tribal citizens
already had been decreasing their consumption of
shellfish, some because of concern about  pollution. One
outcome of the study was for the tribe to create its own
definition of health to use in the  cost-benefit analysis of
gauging risk. The social, cultural and spiritual benefits of
gathering and eating shellfish could, in some instances,
outweigh the risks of contamination (Mapes, 2007).

The STAR grant, "Impacts of Climate Change on Health
Benefits of  a Tribal Alaskan Resource:  Integrating Traditional
Ecological Knowledge with Risk Assessment Through Local
Monitoring," focused on subsistence berries consumed
by residents of Alaska Native villages  (Akutan, Point
Hope and Seldovia, Alaska). The results indicate that
the berries  studied contain A-type proanthocyanidins, a
relatively rare configuration. For commercially available
berries, the configuration is found only in cranberries and
blueberries. The significance of this unique component
in the berries is that the A-type proanthocyanidin  has
anti-adhesin properties, effectively disabling the bacteria
that cause  urinary tract infections and dental decay.
The cloudberry (Rubus chamaemorus) is an important
component of Alaska Native subsistence diets.

Therefore, these berries provide an alternative natural
therapy for these microbial diseases (Lila et al., 2012). The
proanthocyanidin content in the berries also was found  to
be highly effective at lowering lipid deposition into adipose
tissue, which has implications for prevention of metabolic
syndrome. The unique complement of anthocyanins
(pigments)  in the berries proved to be particularly effective
in reducing blood glucose levels in vivo in a diabetic
mouse model; the consumption of the berries may prove
to be an  important deterrent to the development  of type
II diabetes mellitus in adults. The discovery of these
properties and the unique components that contribute to
them supports the local traditional, medicinal use of the
berries (Lila et al., 2012).

The quantitative chemical, mineral and microbial  water
quality data from the STAR grant, "Community-Based
Risk Assessment of Exposure to Contaminants via Water
Sources on the Crow Reservation in  Montana," revealed
A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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                                                                                                                                        Subsistence Foods and Water Resources
    Practical Applications

    •  Utilize community-based research to inform
       and develop wellness plans that allow
       communities to consume  their traditional
       foods with less health risks.
    •  Use data on contaminant levels to help
       community members protect their health
       while eating their traditional diets.
that 55 percent of the wells tested exceed EPA primary
standards or health advisories (Ford, 2013). These data
were provided recently to the Crow Tribes Office of Water
Resources, which is using the data as a baseline in
planning  a rural water distribution network for the Crow
Reservation and Big Horn County in Montana (Eggers,
2013). The project coordinator and leader continue to
meet with tribal elders on the Crow Reservation to discuss
the microbial contamination of a spring and a creek  on
the reservation. The elders supported the submittal of
an additional grant proposal to the EPA Environmental
Justice Small Grants Program to begin addressing the
contamination, and this new grant has been awarded
(Eggers, 2013). The researchers also continue to provide
data  and support to the Apsaalooke Water and Wastewater
Authority, which  has begun its next phase of water and
wastewater infrastructure improvement for the town of
Crow Agency, Montana (Eggers, 2013).

The results of a STAR fellowship, "Makah Traditional
Environmental Knowledge and Gray Whale Conservation,"
collected data from Neah Bay in the state of Washington,
near the  main settlement of the Makah Nation, which
indicated that tribal consumption of locally caught fish was
significantly higher than the levels used in contaminant
exposure models. As the previous water quality standards
had been  based on these models, they were not as
protective  as possible. The tribe had been contending
that this was true for years, and the STAR data provided
the Makah Nation with the evidence that it needed to
effectively  argue its case and revise the standards to
be more protective. These data  also were utilized by the
tribe  to support its request to the International  Whaling
Commission for an annual subsistence quota of five
(nonendangered) gray whales. The tribe also used the
data  extensively in the revised draft Environmental Impact
Statement by the National  Marine Fisheries Service on the
Makah whaling quota (Sepez, 2011).

Many residents of the Pine Ridge Indian Reservation in
southwest South Dakota, home to the Oglala Sioux Tribe
(also known as the Oglala Lakota Nation), rely on private
wells as their drinking water source. A number of studies
revealed that significant levels of arsenic and uranium
contaminate the reservations groundwater (Werth et al.,
2010). A P3 grant, "Use of  Bone Char for the Removal of
Arsenic and Uranium from  Groundwater at the Pine  Ridge
Reservation," focuses on the development of inexpensive,
 The P3 team that traveled to the Pine River Reservation
 to obtain water samples for the EPA-funded project.
A local Pine River Reservation resident works on a pump
to provide a house with well water.

easy-to-use technology based on bone char, an
indigenous material, to remove arsenic and uranium from
the groundwater used by the residents of the reservation.
The researchers tested reservation wells and developed a
map that highlights the location of contaminated sources.
The team is working with citizens of the reservation and
local leaders  of the Oglala Lakota College to  determine
whether the use of bone  char filter for water purification
is appropriate for the reservation; feedback based on the
presentation of a working prototype has been positive
(Becraft and Werth, 2012).*
                                                                  A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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                                                                                                                                        arid  F .Plication
                                                             Utilizing community-based participatory research in
                                                             Tribal Environmental Health Research Program is
                                                         crucial to ensure that researchers partner with AI/AN
                                                         people in planning and implementing needed research. As
                                                         such, community-based participatory research, education
                                                         and outreach have been and continue to be important
                                                         components of STAR grants and fellowships funded under
                                                         the Tribal Environmental Health Research  Program. In
                                                         community-based participatory research, the community
                                                         is actively involved in every phase of the research  project
                                                         being  conducted. The researchers must understand the
                                                         particular culture of the people with whom they are
                                                         partnering in research and recognize the  sovereignty
                                                         of their government. For example, the researchers of
                                                         the EPA  grant, "Understanding the Cumulative Effects
                                                         of Environmental and Psycho-Social Stressors that
                                                         Threaten the Pohlik-lah and Ner-er-ner Lifeway. The Yurok
                                                         Tribes Approach," developed their research questions by
                                                         consulting the Yurok Tribal Council and community, which
                                                         is located in northern California. Phase 2  of their research
                                                         actively engaged the community in the data-gathering
                                                         process  (Sloan, 2010), presenting about the project at
                                                         the annual Yurok Tribe Klamath Salmon Festival and
                                                         annual tribal membership meeting during each year of
                                                         the project period (Sloan, 2013). Tribal community input
                                                         via scoping sessions, oral interviews and questionnaires
                                                         allowed  the researchers to identify key resource species.
                                                         The researchers also ascertained community perceptions
                                                         about  resource quality and  abundance, resource conditions
                                                         across time, and the relationship between resources and
                                                         community health (Sloan and Fluharty, 2010). The  grant
                                                         allowed  the researchers to perform sustained environmental
                                                         research that addresses community concerns, enabling
                                                         them to  collect valuable  data and provide answers about
                                                         the health of the community's environment and culturally
                                                         significant and key subsistence species. The community
A Di               ironmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs
                                                                                                              has been grateful for this information, as these long-
                                                                                                              standing concerns had not been adequately researched
                                                                                                              or addressed previously (Sloan, 2013). The quantitative
                                                                                                              data collected and analyzed  during the project resulted
                                                                                                              in the development of a Yurok Community Health Profile,
                                                                                                              which the researchers shared with the tribe via the Yurok
                                                                                                              Tribal Environmental Program website. A final version will be
                                                                                                              printed and distributed with other project materials to the
                                                                                                              tribe (Sloan etal.,2013).

                                                                                                              Because community and traditional communal activities
                                                                                                              and  lifeways are important to the Siberian Yupiks, the
                                                                                                              research team for one STAR grant, "Environmental
                                                                                                              Contaminants in Foodstuffs of Siberian Yupiks from St.
                                                                                                              Lawrence Island, Alaska," conducted a series of meetings
                                                                                                              with  the tribal leadership of the Alaska Native villages of
                                                                                                              Gambell and Savoonga and with the people in the villages
                                                                                                               Crow people "going after water" in the Little Big Horn
                                                                                                               River, Montana, in the late 1800s. (Photo courtesy Little
                                                                                                               Big Horn College Archives; original at the Smithsonian
                                                                                                               Institution)
;cade of Tribal Environ

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                                                                                                         Community-Based Participatory Research and Community Outreach and Education
    Practical Applications

    •  Work in strong partnership with communities
       so that they not only endorse research
       projects, but are full participants in design/
       development, translation, and ultimately
       application of the research findings to
       improve their health and protect their local
       environments.
    •  Communicate  and disseminate research  to
       community members and other stakeholders
       respectfully, creatively and effectively while
       explaining how they can use the results  to
       protect their health.
of St. Lawrence Island. At these meetings, the researchers
and the communities discussed the implications of the
project results, with the awareness that traditional foods are
vital to the well-being and culture of the Yupik people. The
research team discussed the results in the context of the
recognized  nutritional and cultural benefits of the traditional
diet. The leadership of the St. Lawrence Island communities
emphasized the need to continue collaborative community-
based research and find methods to reduce  exposures
while continuing reliance on the traditional diet (Miller et
al.,2010).

Elders are respected and revered among AI/AN populations.
They carry much of the cultural and traditional ecological
knowledge of their tribes and villages and pass their
wisdom and knowledge on to the younger generations.
Understanding the importance of elders, the  researchers
involved in the project, "Community-Based Risk Assessment
of Exposure to Contaminants via Water Sources on the
Crow Reservation  in Montana," reached out to Crow tribal
elders, who described how the water quality  in the  Little
Big Horn River had deteriorated during the past 50 years.
The elders reminded the younger tribal citizens, as well
as the researchers, that they do not appreciate water as
a precious resource as  previous generations did  because
they no longer must haul it themselves. From the tribal
elders, younger generations and academic partners learned
about the high respect that the Crow people always have
had for water and the importance of protecting this natural
resource (Cummins et al., 2010). The tribal elders also
helped to guide the research project via their involvement
in the Crow Environmental Health Steering Committee
(Ford, 2010). To ensure that community outreach and
education were successful, the researchers provided
Crow Reservation residents comprehensive reports about
their water quality, potential health issues and suggested
treatments. The researchers provided in-home followup,
often in the Crow language, to increase residents'
understanding of the  research results (Ford, 2010).

The researchers involved with  the grant, "Reducing Risks
of the Anishinaabe From Methyl Mercury," used community
outreach and education to increase awareness of Great
Lakes Indian Fish and Wildlife-produced fish advisory
maps among the tribal community. Through the grant,
researchers explained how to  use the maps to tribal
leaders, health care providers, fish harvesters, mothers
with young children, women of childbearing age, children
and elders in Michigan, Minnesota and Wisconsin. These
maps help to protect  the  health of tribal citizens by
supporting them in their efforts to reduce consumption
of mercury-contaminated  walleye. Large fish advisory
maps were posted  at locations in which spearing and
netting permits were  issued; maps were distributed to on-
reservation health service providers  and posted at public
locations on the reservation (e.g., tribal administration
buildings, grocery stores, libraries, health clinics, natural
resources departments, elder centers and community
centers). Researchers presented about the maps at
various meetings and to children at Boys' and Girls' Club
gatherings. The children were provided with maps to take
home and encouraged to share them with their families.
Postintervention surveys showed that the percentage
of survey participants who indicated awareness of the
advisory maps significantly increased among fish harvesters
in Wisconsin, Michigan and Minnesota  and among women
of childbearing age in Wisconsin (DeWeese et al., 2007;
Present-day Crow Nation members and their academic
partners obtaining water samples from the Little Big Horn
River, Montana.

Kmiecik and Foran, 2007; Madsen et al., 2007). The
researchers have continued to update, publish online and
distribute the maps and have created additional outreach
materials targeted toward the two groups for which the
outreach/intervention had been less effective  (women  of
child-bearing age and fish harvesters in Michigan and
Minnesota), as identified by the research (Moses, 2013).

The approach used for another STAR grant
("lakotisa'tstentsera:wis Ne Ohontsia Reducing Risk by
Restoring Relationships") was to work with teachers at
the Akwesasne Freedom School in upstate New York and
environmental staff in the Haudenosaunee Confederacy to
develop intervention materials and education programs. The
project worked to transfer expertise about environmental
risk and cultural practices to teachers and students at
the Akwesasne Freedom School. This was accomplished
through teacher training and in-class workshops in
which students were engaged in subsistence practices.
During each of the 3 years of the project, 20 professional
development days per year were offered to more than
25 teachers, staff members, assistant teachers and
environmental research scientists. As a result, more than
100 youth, teachers, teacher assistants and environmental
                                                                  A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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Community-Based Participatory Research and Community Outreach and Education
scientists learned about toxic substances while also
learning the Mohawk language and skills associated
with traditional cultural practices (Arquette et al., 2008).
Workshops were conducted entirely in the Mohawk
language using oral tradition and hands-on  participatory
response techniques to share meaning. A library of
resources has been created, including posters, books,
pictures and charts written in the Mohawk language,
which will be shared with other immersion schools and
educational programs  throughout the Haudenosaunee
Confederacy. Through this effort, community  members
understand risk issues and can take action to protect their
health while engaging in traditional subsistence practices
(Arquette et al., 2008).

It is important to foster a positive working relationship—
based on trust, credibility and appropriate communica-
tion—among researchers and community members. One
of the goals of another tribal STAR grant ("Risks to Northern
Alaskan Inupiat: Assessing Potential Effects of Oil Contami-
nation on Subsistence Lifestyles, Health  and Nutrition")
was to strengthen relationships with Native leaders and
communities. The principal investigators worked to develop
community ties in various ways, including attending pub-
lic functions. These efforts have led to recognition of the
researchers in the community. The principal  investigators
made numerous public presentations, met with school
children, provided radio interviews and met in  small groups
with community leaders to present the results  of the study.
Presentations of the data typically were preceded by dis-
cussions with research staff to ensure that scientific infor-
mation was provided in a culturally relevant and sensitive
manner (Wetzel et al., 2008). The researchers presented at
a number of town council meetings in Kaktovik, Barrow and
Wainwright, Alaska, as well as other towns, to inform the
Inupiat people about the study and the outcomes (Wetzel,
2010).

Community education and outreach have continued
beyond the end of the grant, "Impacts of Climate Change
on Health  Benefits of a Tribal Alaskan Resource: Integrating
Traditional Ecological Knowledge With Risk Assessment
                           Through  Local Monitoring."
                           The research continues to
                           generate requests from AI/AN
                           groups, with the  researchers
                           presenting follow-up
                           workshops on the research
                           in North  Dakota  and Alaska.
                           Additionally, the  project
                           partners  in North Dakota
                           and Alaska traveled to North
                           Carolina, where the lead
                           researcher had relocated,
                           to learn how the results
                           of their field biodiscovery
                           of tribal resources would
                           translate to the next level of
                           laboratory investigation and
                           validation. The researchers'
                           training techniques are being
                           used in high school and
                           community college classes at
The Swinomish Indian Tribal Community was able to develop this DVD documentary
with a STAR grant.
A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs
AI/AN institutions in Alaska and North Dakota (Lila, 2013a,
2013b).

The researchers of the grant, "Lifestyle and Cultural
Practices of Tribal  Populations and Risks From Toxic
Substances in the Environment," sponsored a tribal
research symposium  in April 2010 that focused on issues
addressed in  the grant. Participants discussed important
matters and perspectives to consider when performing
research with tribal communities, including tribal legal
issues, research ethics, indigenous and Western science
concepts, and integration of sociocultural  health indicators
in tribal risk research. The symposium featured speakers
from several tribes as well as  a tribal legal scholar;
university researchers, members of the public, public
agency staff and others  interested in tribal issues attended
(Harding, 2013).

The researchers of a  Tribal Environmental  Health Research
Program  STAR grant, "Bioaccumulative Toxics in Native
American Shellfish," used the research conducted in
the state of Washington to publish several outreach
and educational pieces  about safe Swinomish fish and
shellfish consumption, including the  Swinomish 73 Moons
traditional food book, Swinomish  73 Moons Coloring Book,
the Slow Bum documentary and several posters. Numerous
oral presentations were given  at independent and  EPA-
sponsored conferences and symposia to communicate the
results of this grant (Donatuto, 2010).

As is the case for STAR grants funded through EPA's Tribal
Environmental Health Research Program, education and
outreach also are important for other tribally relevant
STAR grants and fellowships. A STAR fellowship, "D/ne
Bikeyah: Environment, Cultural Identity and Gender in
Navajo Country," resulted in the book, Dreaming of Sheep
in Navajo Counfry.The publication has been used  in
workshops with high  school teachers on the reservation,
and the author participated in workshops  in Navajo
communities  in Kayenta, Arizona, and Kirtland, New Mexico.
These workshops focused on the environmental health
of grasslands, grazing issues and oral histories about a

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                                                                                                          Community-Based Participatory Research and Community Outreach and Education
One output of a STAR grant was the 13 Moons1 book about how the 13 annual
lunar phases guide the Swinomish people in using their natural resources.
conservation program in the 1930s known colloquially as
"livestock reduction" (Weisiger, 2011). The award-winning
book provides an important historical  perspective about
Navajo pastoralism, allowing tribal citizens and other
readers to understand the  environmental history of the
reservation  and policies that led to current conditions.

The researchers of a  STAR  training grant, "Rocky Mountain
Training and Technical Assistance to Brownfields
Communities Program," found that outreach is more
effective when it is partnered with education. The
researchers provided  one-on-one training and outreach to
neighborhoods, tribes and  tribal communities in Montana,
North Dakota, Colorado and Missouri. The training was
developed based on tribal  needs and focused on topics
that the tribes identified as useful, such as education
about hazardous materials and how to write Environmental
Impact Statements. Approximately 25  culturally sensitive
                       courses were developed with  Fort
                       Belknap College (now known  as
                       Aaniiih Nakoda College) faculty
                       members and consultants. The
                       courses addressed specific
                       Brownfields issues and innovative
                       environmental technologies that
                       could be used to remediate
                       these sites. They were offered  as
                       full-credit courses for community
                       members; continuing-education
                       credits also could be earned
                       for professional development
                       (Burgher, 2011).

                       Education and outreach were
                       particularly important for
                       two tribal-relevant projects
                       conducted by the STAR-funded
                       Midwest Hazardous  Substance
                       Research Center. The centers
                       Technical Outreach  Services
for Communities and Technical Outreach Services for
Native American Communities programs used university
educational and technical  resources to  help community
groups throughout the Midwest understand the technical
issues and impacts of hazardous waste sites. The two
outreach programs empowered the communities to
participate substantively in the decision-making process
regarding  their hazardous substance problems, including
environmental assessment and clean-up needs. The
projects provided a link between the community and
the university, serving the needs of environmental justice
communities. These outreach programs provided technical
assistance, such as reviewing and explaining technical
reports and offering information and training, to AI/AN
communities  (Banks et al., 2007).

The Technical Outreach Services for Native American
Communities  program was national in scope  and
coordinated primarily through the Haskell Environmental
Research Studies Center at Haskell Indian Nations University.
Services included first contact, needs assessment, initial
support and long-term technical support arrangements
by regional Technical Outreach  Services for Communities
programs and other resources as necessary (Banks et al.,
2007). The researchers  conducted a number of outreach
activities over many years. The most significant outcome of
this work is the increased level  and capacity for community
involvement at Superfund and other environmental issue
sites. Training materials  and various models for successful
community involvement that address tribal risk (subsistence
and cultural lifestyle exposures), technical clean-up issues,
and environmental  justice dynamics at clean-up sites were
developed (Leven, 201 l).The Center provided support to
24 AI/AN communities in  13 states (Center for Hazardous
Substance Research, 2009).

Another STAR-funded center with tribal education  and
outreach  as one of its goals, "Space-Time Aquatic
Resources Modeling and Analysis Program," developed  and
tested learning materials  related to environmental sampling
that were made available on the Internet. A variety of
people, including those associated with tribes, indicated an
interest in using these materials. Direct contact, education,
outreach  and support were offered to the tribes as a result
of this  project (Urquhart, 2011).

In addition to focusing  on the development of water-
purification technology, a  P3 grant, "Use of  Bone Char for
the Removal of Arsenic and Uranium from Groundwater
at the Pine Ridge Reservation," also aims to educate the
residents of the Pine Ridge Indian Reservation in  southwest
South Dakota about the importance of water quality. The
researchers are developing a 2- to 4-minute video about
the project to be used in  conjunction with a water quality
educational outreach effort for  children. The researchers
also are creating an educational handout that includes
water quality education materials for the residents of the
reservation (Becraft and Werth, 2012). •
 This book is in its second printing. EPA does not endorse or promote any product, but if you would like more information, please contact Todd Mitchell, Swinomish Water Resources Coordinator, at tmitchell@swinomish.nsn.us,
 11430 Moorage Way, La Conner, WA 98257.
                                                                   A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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                                                            Some tribal citizens have unique risks as a result of
                                                            their traditional lifestyles and extensive reliance on
                                                         natural resources. As a result, risk assessments and
                                                         exposure scenarios must be tailored to the tribes' distinct
                                                         needs. The Traditional Tribal Subsistence Exposure Scenario
                                                         and Risk Assessment Guidance Manual, based on the
                                                         major ecological zones across the mainland United
                                                         States, was published as a result of a  Tribal Environmental
                                                         Health Research Program STAR  grant, "Lifestyles and
                                                         Cultural  Practices of Tribal Populations and Risks From
                                                         Toxic Substances in the Environment."The researchers'
                                                         goal was to develop regional traditional tribal subsistence
                                                         multipathway exposure scenarios based on eco-cultural
                                                         zone delineations and  descriptions, major exposure factors,
                                                         regional food patterns and unique exposure pathways. The
                                                         manual  can  be used by the tribes to modify, refine and
                                                         adapt the regional scenarios for their site-specific and/
                                                         or individual  tribal situations. It  is particularly useful to
                                                         assist the tribes in compliance with the Comprehensive
                                                         Environmental Response, Compensation and Liability
                                                         Act, which includes a risk-based process. To comply,
                                                         the tribes have been requesting risk tools that reflect
                                                         their  activity  patterns and potential exposures. If a
                                                         tribal scenario is not available early in the compliance
                                                         process, the  results may not be protective of tribal uses.
                                                         This research resulted in model regional tribal exposure
                                                         scenarios that are formatted for standard Comprehensive
                                                         Environmental Response, Compensation and Liability Act
                                                         risk assessments, which can be progressively modified
                                                         as site-specific information becomes available (Harper et
                                                         al., 2007). The researchers have received many requests
                                                         for the Traditional Tribal Subsistence Exposure Scenario
                                                         and Risk Assessment Guidance Manual'from EPA staff,
A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs
consultants in the private sector, academics, graduate
students and others working on tribal issues (Harding,
2013).

Under the grant, "Reducing Risks of the Anishinaabe From
Methyl Mercury," researchers explained to those considered
to have increased risk from  exposure to mercury—mothers
with young children, women  of childbearing age, children
and elders—who consume  mercury-contaminated walleye
in Michigan, Minnesota and Wisconsin how to use
Great Lakes Indian  Fish and Wildlife fish advisory maps
to reduce their risk. The data collected under the grant
were used to recommend that  no more than one walleye
meal per month from the affected lakes be consumed by
these people. To reduce risk in  children, the researchers
presented fish advisory information  at Boys' and Girls' Club
gatherings. The  children were provided with maps  to take
home and encouraged to share them with  their families
(DeWeese et al, 2007; Kmiecik and Foran, 2007; Madsen
et al., 2007). For more information  about how data
    Practical Applications

    •  Use methods that better assess the exposui
       risk of sensitive populations to help these
       individuals avoid or reduce exposures and
       protect their health.
    •  Develop environmental public health
       indicators that reflect the community's heath
       views and priorities to assess and improve
       the health status of its members.

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                                                                                                                                       Risk Assessment and Sensitive Populations
Jim Gibson, Swinomish shellfish biologist, provides an offering and asks for abundant
harvests and protection from harm during the upcoming fishing seasons in a ceremony
called the Blessing of the Fleet. Also known as the First Salmon Ceremony, the ceremony
is enacted by many Pacific Northwest tribes.
generated through this grant were used to develop the
cumulative risk scenarios and fish advisory maps, please
see the section entitled, Subsistence Foods and Water
Resources.

Risk assessment was an important component of another
Tribal  Environmental Health Research  Program STAR grant,
"Bioaccumulative Toxics in Native American Shellfish."
The researchers partnered with Oregon State University to
develop a Swinomish Traditional Cultural  Lifeways Exposure
Scenario and perform  passive air monitoring of polycyclic
aromatic hydrocarbons, one of the suite of chemicals
identified as potentially hazardous in the STAR research.
A partnership with Seattle  University was used to explore
the issues of treaty rights and fish consumption (Donatuto,
2010). For more information about how data from this
grant  were used to develop the exposure scenario, please
see the section entitled, Subsistence Foods and Water
Resources. Although the grant has been completed,
                              the researchers have
                              continued the work
                              initiated in the original
                              STAR grant by partnering
                              with the Puget Sound
                              Partnership and
                              representatives from the
                              Lower Elwha Tribe, the
                              Suquamish Tribe and the
                              Port Gamble S'Kllalam
                              Tribe to develop tribal-
                              specific health indicators
                              for the Salish  Sea. This
                              research is being carried
                              out under a new  STAR
                              grant, "Tribal Environmental
                              Public Health  Indicators."
                              During the first year of the
                              project, the researchers
                              were able to establish
                              a set of environmental
public health indicators for Coast Salish communities
near Puget Sound, Washington, that  reflect how the
communities view and prioritize health. These "Indigenous
Health Indicators" include six key health indicators, each
with three components:

•   Resources security (abundance, access and sharing).

•   Community connection (cooperation, participation/
    roles and familiarity.

•   Ceremonial use (gatherings/ceremonies, giving
    thanks and feeding the Spirit).

•   Education (elders, youth and the Teachings).

•   Self determination (healing, economic development
    and restoration).
•  Well-being (connection to nature, confidence and
   resilience).

The next step is to test the indicator set with tribal citizens
by employing it to assess the health status of the tribal
communities (Donatuto, 2012).

The researchers of the grant, "An Epidemiologic Study
of Time Trends and Health Effects of Persistent Organic
Pollutants, Mercury and Micronutrients," investigated
risks to Alaska Native Yupik newborn infants and their
mothers, who live in the Yukon-Kuskokwim River Delta  of
southwestern Alaska and consume  the traditional marine
subsistence  diet. Data regarding blood levels of mercury,
lead, cadmium, arsenic and  omega-3 fatty acids in these
populations  have been collected and are  being analyzed.
These data will allow any potential  associations  between
maternal exposure and potential adverse pregnancy
outcomes (e.g., gestational diabetes mellitus, hypertension,
preterm delivery, birth  defects, growth abnormalities)
to be examined as well as any associations between
micronutrients and positive pregnancy and infant health
outcomes. The researchers also  collected salmon tissue
for parallel analysis. The results will be used to inform the
Alaska Native residents of the Yukon-Kuskokwim River Delta
about trends in human tissue levels and any evidence of
negative and positive  health  outcomes. The salmon data,
combined with sea mammal data from other studies,
will  enable subsistence hunters  and consumers to have
confidence in the low contaminant levels  in the salmon
and consume those sea mammal species that have
been found  to have the lowest levels of contaminants.
Village-specific harvest adaptation plans will  be developed
to ensure the lowest exposure for pregnant women and
children while still preserving the enormous cultural and
public health value of the traditional diet (Berner, 2013). •
                                                                  A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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       acts on  Kegulations  and  Management
                                                           Several STAR grants and fellowships have influenced
                                                           state regulations and tribal management plans.
                                                        Based on the results of a STAR grant, "Bioaccumulative
                                                        Toxics in Native American Shellfish," and other studies
                                                        that have found high levels of toxins in fish and shellfish
                                                        in and around tribal gathering places, the Washington
                                                        Department of Ecology began re-examining the states
                                                        water quality standards in the fall of 2010 (Brooks, 2010).
                                                        Oregon's Department of Environmental Quality  has been
                                                        working closely with state, federal and tribal governments
                                                        and industries to set a stricter water quality standard, one
                                                        that would allow people to safely eat not just one serving
                                                        of fish or shellfish per month but one serving per day
                                                        (State of Oregon, 2007). EPA has encouraged individual
                                                        states to set standards based on data that show how
                                                        much  fish people  typically consume from state waters. In
                                                        the absence of those data, the federal standard of about
                                                        one 7-ounce serving of fish per month applies, and this
                                                        has been the state of Washington's standard for more
                                                        than 2 decades (State of Washington, 2009,2010). In the
                                                        state review of the fish consumption rate, the Swinomish
                                                        are advocating for historical consumption rates, which are
                                                        perhaps as high as 1  pound of fish per person per day
                                                        (Brooks, 2010). At the time of publication of this report,
                                                        the state of Washington  had  not revised its limits;  more
                                                        information can be found at  the Washington Department
                                                        of Ecology website.
The quantitative data produced by a STAR fellowship,
"Makah Traditional Environmental Knowledge and Gray
Whale  Conservation," were used by a tribal biologist
to support the implementation of stricter water quality
standards on the Makah Nation reservation than those
issued  by the state of Washington. The data indicated that
tribal consumption of  locally caught fish was significantly
higher  than the levels used to develop the previous
standards (Sepez, 2011).

The results of a STAR fellowship, "Linking Traditional
Knowledge and Environmental Policy in the Cherokee
Nation  of Oklahoma," continue to be  used internally by
the  Cherokee Nation in northeastern Oklahoma to design
its Tribal Integrated Resource Management Plan. The
plan serves as  formal guidance for all of the Cherokee
Nation's land and resource planning and management
issues.  The grant resulted in the formation of a group,
composed of Cherokee elders who are  knowledgeable
on the  subject  of Cherokee ethnobotany, to advise the
Cherokee Nation Natural Resources Department. The  elders
work with departmental staff on Tribal Integrated Resource
Management Plan implementation, as well as on larger
goals of cultural and environmental  protection (Carroll,
2011).
A Decade of Tribal Environmental Health Research:     ;lts and Impacts from EPA's Extramural Grants and Fellowship Programs

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                                                                                                                                  Impacts on Regulations and Management Plans
    Practical Applications

    •  Use research to help establish environmental
       quality standards that take into account
       community practices and unique exposures
       of special populations to protect their health.
    •  Help communities develop conservation
       plans that allow them to manage and
       monitor their resources so that community
                can continue to safely use them.
The "Space-Time Aquatic Resources Modeling and Analysis
Program," a STAR-funded center, worked with 10 tribes in
four states to assist with the development of tribal aquatic
water quality monitoring plans that take into account
definitive tribal needs for monitoring cultural uses of tribal
water. The tribes  involved in the research actively pursued
the protection of culturally  sensitive water uses, such as
hand-dredging of clay for pottery  making and wetland
plant harvesting for construction of sweat lodges and
cradle boards (Johnson, 2003). •
                                                                  A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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Future tribal research supported by EPA will
explore  new strategies, methods and tools to
assess environmental health exposure among Al/
AN populations as well as identify other research
opportunities for advancing health protection while
maintaining traditional tribal lifeways. Ongoing
research needs for many tribal communities include
protection of drinking water from enteric pathogens
such as Escherichia coll, protection and  survival
of native plants, better understanding of health
issues surrounding climate change, the impacts of
widespread pesticide use and endocrine disrupting
chemicals, indoor air quality, and the extent and
impacts of consumption of contaminated meat from
animals that  tribal communities raise or harvest
(e.g., bison, deer, elk). Past and current STAR
research has attempted  to address components of
many of these issues (e.g., climate change impacts,
endocrine disrupting chemicals, indoor air quality,
cumulative risk related to subsistence foods),
although not always in tribal settings.

An emerging topic of concern for many tribes is
hydraulic fracturing (tracking). In addition to sharing
in the immense  benefits of tracking, tribal, Alaska
Native and other communities  in the United States
are in need  of research and guidance related to
potential adverse ecological and human health
impacts of this activity. For  example, what are the
considerations regarding the quality and availability
of fresh water resources used for pumping? What
are the  potential health impacts of and exposure
scenarios related to the chemical mixtures used in
the extraction processes? What are waste disposal
concerns and approaches that safeguard the
ecosystem and human health?  In addition, there
are considerations involving air quality, groundwater
contamination, and destabilization of rock formations
and topography from drilling.
An ongoing issue is related to the ability of tribal
community members and staff to gain technical
expertise and capacity for applying for grants and
responding to solicitations. Please see Appendix
G for information about training and workshops
that  are available from EPA's Office of Grants and
Debarment and the contact information for the
current Regional Tribal  Program Managers  in Regions
9 and 10, where the majority of tribes reside.

Finally, there is  an opportunity to establish regional
tribal research partnerships that would serve as a
resource for National EPA-Tribal Science Council
Tribal Representatives in linking regional priorities
to tribal research  needs. This effort would develop a
systematic method to connect ORD scientists (e.g..
Regional Science  Liaisons and scientists in the
regional research  facilities) with tribal scientists to
collaborate on shared goals, communicate current
research efforts and pursue common scientific goals
for communities. It also is expected that the National
EPA-Tribal Science Council's semiannual meetings
will continue to provide an opportunity for research
and science communication across tribes and
regions, including participation by STAR grantees.
EPA's Air, Climate and Energy Research Program
released its 2012 RFA,"Measurements and Modeling
for Quantifying Air Quality and Climatic Impacts
of Residential Biomass or Coal Combustion for
Cooking, Heating, and Lighting." This solicitation
included a component that focused on the
"developing world and Indian tribes and Alaska
Native  groups." The goal is to quantify the  extent that
interventions for cleaner cooking, heating or lighting
can impact air quality and climate, which  in turn
affect human health  and  welfare (U.S. EPA, 2012a).

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Future Directions for Tribal Research
The Tribal  Environmental Health Research Program
released its latest RFA, "Science for Sustainable and
Healthy Tribes," in February 2013 (U.S. EPA, 2013a). In
preparation for this RFA and  to help identify tribal research
priorities, the  program hosted an RFA Strategy Session at
the National EPA-Tribal Science Council-sponsored  2010
National Tribal Science Forum in Traverse City, Michigan.
EPA and Tribal Representatives discussed current tribal
environmental challenges as a basis for determining  the
focus of the RFA. Many topics of interest were identified
during the session. Climate change was acknowledged
as an overarching issue; of specific concern was tribal
adaptability to climate change. Water concerns included
drinking water quality and quantity as well as the presence
of wastewater and heavy metals in rivers. Indoor air quality
was another tribal concern, specifically exposure to mold,
radon and formaldehyde. Mercury contamination in fish
is considered a global issue, with dietary change and
adaptation being a specific concern among AI/AN people.
Stewardship of tribal  lands and tribal control of research
performed on these lands also emerged as important
topics. Another key issue discussed was environmental
enforcement and protection  against unlawful agricultural
practices on reservations (Breville, 2011).

Building on its 2006 priorities, the National  EPA-Tribal
Science Council  initiated a tribally driven process to
identify priority science issues of national significance
in Indian country. The process commenced with the
publication of a  document that outlined the  background
of the National Tribal Science Priorities (U.S.  EPA, 201 la).
The document was sent to all federally recognized tribes
and other tribal organizations and included criteria to
allow them to identify their science priorities for Agency
consideration as national priorities. An initial  set of
environmental concerns for AI/AN populations to  consider
included:

•  Climate change impacts  on tribal health, well being,
   and  safety as well as on local food sources (with
   emphasis on adaptation/mitigation strategies).

•  Off-reservation sources adversely affecting ambient
   air quality conditions in tribal communities and
   comprehensive monitoring for environmental triggers
   of respiratory distress.

•  Impacts of indoor air quality associated with building
   ventilation  (i.e., to assess and mitigate for mold,
   radon and asbestos) and other sources of pollution
   (e.g., wood stoves, tobacco consumption, open  dump
   burning) (U.S. EPA, 201 la).

As a result of the process, the  National EPA-Tribal Science
Council  highlighted climate change and the  integration of
traditional ecological knowledge in environmental science,
policy and decision making as two primary research
concerns for Agency action (U.S. EPA, 2011 b, 2011 c).
At the July 2011 National Tribal Operations Committee
meeting, the National Tribal Caucus and EPA Administrator
Lisa Jackson endorsed these  priorities as issues that align
with their respective efforts to protect human health and
the environment in Indian country (U.S. EPA, 20121).

Building on the priority-setting efforts of the National EPA-
Tribal Science  Council, this solicitation invites applications
for research on climate change and indoor air quality that
integrates traditional ecological  knowledge for  informed
science, policy and decision making (U.S. EPA, 2013a).
Since the  RFA  strategy  session at the 2010 National Tribal
Science Forum, several EPA members of the National
EPA-Tribal  Science Council have continued to provide
substantive input on  updated  drafts of the RFA, serving as
writing team members and reviewers (McOliver, 2013a).
The RFA was developed with input from four EPA program
offices (Office  of Science Policy, Office of Children's Health
Protection, American Indian Environmental Office and the
Indoor Environments Division  within the Office  of Radiation
and Indoor Air); three regional offices (Regions 5, 7 and
10); and three ORD laboratories and centers (National
Risk Management Research Laboratory, National Exposure
Research Laboratory and National Center for Environmental
Assessment) (Breville, 2011; McOliver, 2013b). •
A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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   onclusion
The synthesis of more than a decade of research
conducted under EPA's Tribal Environmental Health
Research Program has resulted in the identification
of practical applications that apply to each of the
                of cultural practices, language a
traditional ecological knowledge, it is important to
understand and integrate the cultural aspects of
the community into research  and  develop culturally
relevant educational materials, such as a booklet
on wild  plant knowledge in the Cherokee language,
to explain risks and how to mitigate them to more
effectively reduce exposures of sensitive populations
as they  engage in traditional  practices.
One practical application regarding subsistence foods
and water resources is that it is necessary to utilize
community-based research to develop wellness plans,
such as those being developed by the Alaska Native
Tribal  Health Consortium around sustenance berry
use, that preserve traditional diets while managing
risk and protecting public health. Another is that
using  quantitative data on contaminant levels, such
as those used by the St. Lawrence Island Yupik
people to assess the contaminants in rendered oils
and organ meat that are part of their traditional
diet, can help communities avoid or  reduce the risks
associ<
Community-based participatory research and
community outreach and education are very
important when partnering  with AI/AN communities.
It is essential to develop strong partnerships with
the community and enlist community representatives
to guide the research design and implementation,
as was done for the research project on the
Crow Reservation that was  guided by the Crow
Environmental Health Steering Committee. This
approach ensures that the  research is informed  by
the local culture and relevant to the communities'
needs and, ultimately, that  the results will be more
readily accepted and used  to protect community
health and  natural resources. It also is important
'o communicate research results to community
 lembers in a culturally sensitive manner, as was
done, for example, during the town council meetings
     i Northern Alaskan Ifiupiat, and provide personal
followup in the native language, such as the in-
home followup in the Crow language provided to
Crow residents, to increase the community members'
understanding of the results and how to use
them to reduce their exposures to environmental
contaminants.

In terms of risk assessment and sensitive
populations, incorporating risk assessment
methodologies to create exposure scenarios that
can be applied at the national, regional and local
levels, such as those detailed  in the  Traditional
Tribal Subsistence Exposure Scenario  and Risk
Assessment Guidance Manual, ultimately help
sensitive populations to reduce exposures and
protect community and  environmental health.  Also,
stakeholders must use the knowledge obtained
from environmental  public health indicators that are
reflective of communities' health views and  priorities,
such as the Tribal Environmental Public Health
Indicators  that were  developed for Salish Sea  tribes,
to assess and improve the health status of these
communities and their members.

-------
Conclusions
Finally, grants funded under EPA's Tribal Environmental
Health Research Program have had positive impacts
on regulations and management plans. One practical
application of the research is to develop and use
quantitative data to establish environmental quality
standards that more accurately reflect the unique
exposures of special populations, such as the stricter water
quality standards established by the Makah Nation based
on STAR grant data, to ultimately reduce their risks and
protect their health and culturally important resources.
Research also can be used to assist communities in
developing resource management and monitoring plans,
such as the tribal aquatic water quality monitoring plans
developed by several tribes to monitor cultural uses of
tribal water, that protect environmental resources and
community health.
As they have done for more than a decade, EPA's Tribal
Environmental Health Research  Program and the Agency
research programs that it helps to support will continue
to engage and collaborate with AI/AN communities
and partners. These programs will continue to provide
opportunities for tribal and Alaska Native citizens, scientists
and engineers and other partners to participate in
collaborative partnerships that further their communities'
capacity for identifying environmental health concerns and
research strategies, developing sustainable and  culturally
relevant solutions, and supporting decision making, with
the goal of protecting the health and the environment of
AI/AN communities.
These EPA programs play an important role in addressing
the myriad stressors threatening the health, wellness and
lifeways of AI/AN populations that are  striving to maintain
their long-standing, intricate relationships with the natural
environment. The research funded under the STAR Tribal
Environmental Health Research Program has supported
the critical research  priorities of importance to tribal
communities. NCER anticipates that future collaborations
with the National  EPA-Tribal Science Council and other
tribal science partners will ensure that the EPA STAR
grants program continues to fund critical, leading-edge
research that results in improved human  heath for
tribal communities and protection of the tribal natural
resources. •
A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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 eferences
Appendix A: Summary of Tribal Environmental Health
            Research Program STAR Grants by RFA

Appendix B: Outputs From Tribal  Environmental Health
            Research Program STAR Grants

Appendix C: Tribal  Environmental Health Research Program
            Presentations

Appendix D: Overview of Tribal Environmental Health Research
            Program Grantee Webinars
Appendix E: Summary Tables of EPA Tribal Research Projects
            Discussed Within the Report

Appendix F: Practical Applications of EPA Tribal Research

Appendix G: Additional Resources

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References
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Berner J. 2013. Email communication. 29 October.

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DeWeese AD, Kmiecik NE, Chiriboga ED, and  Foran JA. 2009. Efficacy of
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Johnson SW. 2003. Needs Assessment of Tribal Requirements for
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Kmiecik N  and  Foran J. 2007. Reducing Risk of the Anishinaabe From
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Leven B. 2011. Email communication. 1 March.

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Lila MA, Flint C, Johnson J, and  Raskin  1.2012. Impacts of Climate
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Madsen ER, DeWeese AD, Kmiecik  NE, Foran JA, and Chiriboga
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Mapes LV. 2007. Swinomish are Told to Restrict Shellfish. Seattle Times.
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McOliver C. 2013b. Personal communication. 11 February.

Miller PK, Carpenter DO, Eckstein L, Waghiyi V, and Welfinger-Smith G.
2010. Environmental Contaminants in Foodstuffs of Siberian Yupiks from
St. Lawrence Island, Alaska: Final Report to EPA. 28 February.
Moses S. 2013. Email communication. 28 October.

Sepez J. 2011. Email communication. 11 February.

Sloan K. 2013. Email communication. 28 October.

Sloan K. 2010. Email communication. 1  September.

Sloan Kand Fluharty S. 2010. Understanding the Cumulative Effects of
Environmental and Psycho-Social Stressors That Threaten the Pohlik-lah
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Sloan K, Fluharty S, Steinberg SJ, and Steinberg  S. 2013. Understanding
the Cumulative Effects of Environmental and Psycho-Social Stressors
that Threaten the Pohlik-lah and Ner-er-ner Lifeway: The Yurok Tribe's
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Sloan K, Fluharty S, Steinberg SJ, and Steinberg  S. 2012. Understanding
the Cumulative Effects of Environmental and Psycho-Social Stressors
That Threaten the Pohlik-lah and Ner-er-ner Lifeway: The Yurok Tribe's
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State of  Oregon. 2007. Question and Answer Document. Derived from
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Urquhart NS. 2011. Email communication. 7 March.

U.S. Environmental Protection Agency (EPA). 2013a. Funding Opportunity:
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A Decade of  Tribal  Environmental  Health  Research:  Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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                                                                                A Decade of Tribal Environmental  Health  Research: Results and Impacts from EPA's Extramural Grants and Fellowship  Programs

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Appendix A: Summary of Prior NCER  Tribal Research
Appendix A: Summary of Tribal
Environmental  Health  Research
Program STAR Grants by RFA
Issues in Tribal Environmental  Research and Health
Promotion:  Novel Approaches for Assessing and Managing
Cumulative Risks and Impacts  of Global Climate Change
(2007 RFA)

The U.S. Environmental Protection Agency (EPA) recognized the need
to increase capacity within the tribes  to assess differential subsistence-
based exposures related to cumulative chemical exposures and global
climate changes. As a result, this solicitation was designed to stimulate
community-based participatory research  to generate data that identified
subsistence resources, sensitive populations within tribal communities,
complex chemical exposures  from multiple sources and routes, and
links between environmental stressors and health outcomes. The Agency
was interested in research proposals  that developed culturally relevant
strategies for exposure mitigation  and/or health promotion. Four grants
were awarded under this RFA (U.S. EPA. 2012e). The remaining research
projects are scheduled to conclude in 2014.

R833705: An  Epidemiologic Study of Time Trends and Health
          Effects of Persistent Organic Pollutants,  Mercury and
          Micronutrients

This project is being carried out in Yupik Alaska Native residents living
in the Yukon-Kuskokwim River Delta of southwestern Alaska. Salmon
are the largest component of the  subsistence diet  for Alaska Native
people in the  delta, with seals being  second  in importance in coastal
communities.  Prior work has shown that  pregnant Yupik women  have
levels of persistent organic pollutants similar to other Arctic women, with
higher toxaphene, brominated flame retardants and mercury  levels than
most other Arctic pregnant women.

The objectives of the research project were to: (1)  determine time
trends in tissue levels of persistent organic pollutants, mercury and
omega-3 fatty acids in a cohort of 200 pregnant Yupik women and
infants (because climate change  has increased atmospheric and ocean
transport of persistent organic pollutants and mercury to Alaska  and
the Bering Sea, resulting in persistent organic pollutants and mercury
uptake by salmon, marine mammals  and humans) and (2) determine,
using health record review, physical exam and statistical analysis, any
association between maternal levels  of persistent organic pollutants and
mercury and risk for adverse health outcomes in mothers, infants and
prior cohort children between 4 and 7 years  of age (because Alaska
Native infants have a  higher risk of a serious infection in the first year
of life and a higher risk for congenital heart disease). The proposal
is examining the relative risk of these outcomes if they are prenatally
exposed to persistent  organic pollutants  in the highest tercile of the
cohort. Alaska Native 4- to 7-year-old  children in the highest  tercile of
prenatal mercury exposure are being  compared to  determine whether
they have significantly higher blood pressure than those in the lowest
tercile. Alaska Native women with blood levels of persistent organic
pollutants in the highest tercile are being compared with those having
POP levels in the lowest tercile to determine they have a greater  risk of
diabetes.

R833706: Community-Based  Risk Assessment of Exposure to
         Contaminants via Water Sources on the Crow Reservation
         in Montana

This project is a community-based participatory research project that
involves the  University of New  England, Montana State University, Little
Big Horn College and the Crow Tribe in developing risk assessment
methodology for multimedia exposure to contaminants in water and
wastewater.The objectives of the research were to: (1) establish a
sampling and analysis program to assess contaminant loadings to
water and aquatic/wetland subsistence foods, (2) evaluate lifestyle and
cultural  practices that contribute to exposure risk from water sources,
(3) supplement the current Tribal Lifeline™ software to include water
contamination  and exposure factors specific to reservation settings, and
(4) design and support culturally appropriate risk communication and
risk management  measures that minimize impact on subsistence and
other traditional practices, which may  be transferable to other tribes. This
research will test the following hypotheses:

•  Contamination  is not adequately monitored, and water resources on
   the reservation  are more contaminated than similar rural,  non-AI/AN
   communities.

•  Subsistence lifestyles and cultural practices of Crow Reservation
   communities place them  at increased risk of exposure to
   environmental  contaminants.

•  The Tribal Lifeline™ software will more accurately assess  risks if it
   includes  exposure to water contaminants.

•  A community-based participatory research approach to understanding
   exposure  pathways will contribute to developing culturally appropriate
   mitigation strategies

•  Including  the local tribal college in  risk assessment  and management
   will substantially strengthen and sustain community-based
   participatory research methodology on reservations.

R833707: Impacts of  Climate Change on Health  Benefits of a Tribal
         Alaskan Resource:  Integrating Traditional Ecological
         Knowledge With  Risk Assessment Through Local
         Monitoring

Within Alaska Native communities, traditional ecological knowledge
has long held that wild indigenous berries are a health-promoting, life-
sustaining resource. Modern science recently has elucidated specific
health-protective, adaptogenic  properties of the natural components
within berry fruits. This project  integrates biological scientific  data
relevant to wild berry bioactive properties with community perceptions
of risk under the threat of global climate change and encroachment
on the  habitat of the berry resources. The research hypothesis is that
there are predictable links between climatic stress factors and shifts
in climatic regimes, berry fruit composition and the  preventative/
therapeutic value of berries to combat diabetes and other complications
of metabolic syndrome. It also is expected that tribal community
approaches to mitigating health risks through  dietary berries will be
conditioned by community-held  risk perceptions, local tribal knowledge
and uncertainties regarding global climate change impacts on these
valued  resources.

The objectives of the research project were to: (1) provide a baseline
assessment of the bioactivity (health risk  mitigation  properties) of  berry
resources as influenced by climatic stress factors relevant to global
climate change  via cross-comparison of two Alaska  tribal communities
characterized by inherently different climatic regimes and (2) assess
local traditional  knowledge and  risk perceptions regarding community
health, berries and climate change and integrate these aspects with
biophysical findings for informed local health-related decision-making.

R833708: Understanding the Cumulative Effects of Environmental
          and  Psycho-Social Stressors that  Threaten the Pohlik-lah
          and  Ner-er-ner Lifeway: The Yurok Tribe's Approach

Coastal and river resources are  primary and secondary food sources for
a majority of Yurok tribal members, particularly those residing near or
within Yurok ancestral territory. The researchers combined ethnography
and qualitative data on subsistence resources and  practices from
previous and current tribal studies with  quantitative  data on chemical
exposures and  epidemiological analyses of health data to determine
how these factors interact to affect the  health  of various vulnerable
populations within the Yurok Tribe.

The specific objectives of this research  project were to: (1) identify the
chemical stressors and contaminants known to be  used or to occur
historically and contemporarily throughout the Klamath River Basin and
watershed, (2) identify the common mechanism groups, pathways and
contaminants known to be used or to occur throughout the Klamath
Basin that are associated with adverse  health  outcomes, (3) collect
primary data on the current conditions  of Klamath River water and
select key subsistence species by testing for selected contaminants and
chemical stressors as identified  in the first two objectives, (4) identify
relationships between resource health and tribal member health, and
(5) develop geographic information system tools, educational materials,
measures and policies designed to reduce, minimize or prevent  risks of
exposures by subsistence  practitioners to  improve and protect Klamath
River tribal members' and  resource health. During the course of  the
project, the researchers identified  three  additional research questions:
What contaminants currently are detectable in the river and  key aquatic
subsistence resources? Is  there  a  relationship  between environmental
health as reflected by resource health and community health? How can
this study and the data produced  from this study be used to identify and
reduce risk and  improve tribal member  and resource health?
A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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                                                                                                                                                            Appendix A:  Summary of Prior NCER Tribal Research
Lifestyle and Cultural Practices of Tribal Populations  and
Risks From Toxic Substances in the Environment (2002
RFA)

This  RFA focused on the need to develop methods to assess
subsistence-based exposure and increase capacity within the tribes
to assess environmental health threats from subsistence life styles. It
was  designed to promote research that would  help understand the
risks derived from the combined or "cumulative" exposure experience
associated with concurrent dietary, cultural and related  practices. The
solicitation invited applications in two areas: (1) exposure and effects
assessment methods that can be broadly applied across geographic
regions and tribal populations and (2) risk management strategies and
options that would lead to reduction in risk from exposure. Five grants
were awarded under this RFA (U.S. EPA, 2012e).

R831043: Environmental Contaminants in Foodstuffs of Siberian
          Yupiks from St. Lawrence Island, Alaska

The researchers previously showed that the Siberian Yupik people
of St. Lawrence  Island, Alaska, have relatively high serum levels of
polychlorinated  biphenyls and pesticides. This project examined
traditional foods of the Yupik people for polychlorinated biphenyls, three
pesticides and several metals to determine those that are the most
significant sources of exposure and how preparation for consumption
influences the level of contaminants.

R831044: lakotisa'tstentsera:wis Ne Ohontsia: Reducing Risk by
          Restoring Relationships

This  project aimed to develop and implement a research program to
examine the  impacts that toxic substances have had on the traditional
cultural practices of Haudenosaunee Nations.This project provided training
to teachers, youth and Haudenosaunee Environmental Task Force staff
who  are dealing with a variety of toxic substances impacting their health,
lands and future. Community-based participatory research methodologies
were used to develop culturally appropriate intervention materials  and
design educational strategies based on oral tradition.The objectives of
the research  project were to: (1) empower and strengthen the capacity
of Haudenosaunee scientists, environmental staff and educators; (2)
build on existing partnerships to share expertise and experiences; and
(3) provide hands-on training about the relationship between toxic
substances and traditional cultural practices. Secondary objectives were
to identify culturally appropriate strategies that effectively communicate
environmental health issues to Haudenosaunee, including youth, and
identify strategies that effectively evaluate the success of the project.

R831045: Risks to Northern Alaskan  Ifiupiat: Assessing Potential
          Effects of Oil Contamination on Subsistence  Lifestyles,
          Health and Nutrition

Scientists have focused on the potential effects of toxic substances on
Native American populations with subsistence  lifestyles  in the Arctic
and found that risks from toxicant exposures range from direct health
hazards to changes  in lifestyle that may impair nutrition and health.
Also, petroleum  hydrocarbons may enter the Arctic environment in a
variety of ways and can enter humans through species that form a
major part of the Ifiupiat diet. In Barrow, Alaska, 75 percent of Ifiupiat
households consume bowhead whale  (Balaena mysticetus), and
nearly 50 percent consume bearded seals (Erignathus barbatus).
Marine mammals are exposed to petroleum  directly or through their
diet and may metabolically transform petroleum-related compounds.
Based on indications from toxicological properties, polycyclic aromatic
hydrocarbons in the human diet should be investigated. At the time of
the grant application, limited information was available  on the extent to
which species eaten by the Ifiupiat were exposed to and contaminated
by petroleum. Contamination could cause Ifiupiat households to avoid
eating traditional foods, and handling and preparation of foods affect
levels of ingested polycyclic aromatic hydrocarbons.

The focus of this project was to evaluate the potential exposure  to
the native Eskimos from petroleum exploration and drilling on their
subsistence harvested foods. The specific objectives of the research
were to: (1) characterize levels of  polycyclic  aromatic hydrocarbons
in  a range of tissues from  bowhead whales and  bearded  seals,  (2)
characterize PAH levels in meat and  other food items following their
handling and preparation  for consumption, (3) document traditional
biomarkers  that hunters and field scientists could use to accept  or
reject tissues for consumption following harvest,  (4) assess chemical or
histological assays that could serve as low cost biomarkers of exposure,
(5) use published information and the results of this study to  develop
a risk assessment model incorporating health risks associated with
ingestion of petroleum-related compounds and cultural  and nutritional
risks related to avoidance of certain foods, and (6) develop outreach
and public awareness programs to inform residents in northern Alaska  of
issues, potential consequences and options.

R831046: Lifestyles and  Cultural Practices of Tribal Populations and
         Risks From Toxic Substances in  the Environment

The overall  goals of the project were to prepare a set of regional
traditional tribal subsistence exposure scenarios  based on the major
ecological zones across the lower 48 states. The specific objectives
were to: (1) establish an advisory  board of tribal  and university
community members to provide expertise in  tribal cultural lifestyles,
nutrition, ecology and activity  patterns; actively guide the  project;
validate scenarios for cultural  and numerical accuracy; and ensure
that they meet tribal needs; (2) develop regional traditional tribal
subsistence multipathway exposure scenarios based on ecocultural zone
delineations, major exposure factors, regional food patterns and  unique
exposure pathways; and (3) develop a draft Tribal Exposure Scenario
Guidance Manual for use by tribes to modify, refine and adapt these
regional scenarios for their site-specific and/or individual tribal situations.

R831047: Reducing Risks of the Anishinaabe From Methyl  Mercury

The purpose of this study was to develop, implement, evaluate and
document a comprehensive, systematic and  culturally sensitive
intervention program to the reduce risks associated with subsistence-
based consumption of methyl mercury-contaminated fish. This research
project was built on EPA and National Academy of Sciences evaluations
of  the toxicology of methyl mercury.
This study attempted to revise the Great Lakes Indian Fish and Wildlife
Commission's geographic information system-based fish advisory
methodology to comply with EPA risk-based fish consumption guidance
while  not significantly compromising Anishinaabe culture. Secondly,
the study aimed to develop connections to social-tribal networks and
systematically train health care providers, tribal fish harvesters, elders
and youth in the use of the geographic information system-based fish
advisory. Third, the research project aimed to implement the geographic
information system-based intervention program through established
networks to reach mothers with young children, women of childbearing
age, pregnant mothers, breastfeeding mothers and children  under the
age of 15. Finally, the study evaluated and documented the efficacy
of the geographic information system-based  intervention program
by measuring the change in knowledge and behaviors of targeted
populations as well  as the educators of those populations before and
after implementation.

Environmental  Justice: Partnerships for Communication
(2000 RFA)

The goal of this RFA was to promote research aimed at achieving
environmental justice by identifying and addressing disproportionately
high and adverse effects of environmental agents on human health
in low-income and minority populations. The Agency desired to
promote research activities such as the development of  methods for
risk communication  in low-income and underserved communities
unfavorably impacted by environmental hazards; development of
community-based, culturally sensitive educational programs to reduce
adverse health effects from environmental toxicants in low-income and
underserved communities; promotion of public awareness through
community-based training to increase environmental health  literacy; and
raising the awareness of health care providers about disorders resulting
from exposure to environmental  hazards. One grant was awarded under
this RFA (U.S. EPA, 2012e).

R829476:  Bioaccumulative Toxics in Native American Shellfish

The two-part central  hypothesis of this research project stated that the
Swinomish people are exposed to low-level, chronic, bioaccumulative
toxics when participating in subsistence consumption of shellfish in tra-
ditional harvesting areas and that this exposure contributes to the high
incidences of health-related problems on the reservation.The two primary
objectives  of the project were to: (1)  determine the type and concentra-
tions of bioaccumulative toxics present in shellfish and (2) determine
what,  if any, connections exist between shellfish toxics and the health
of the Swinomish people.The secondary objective was to communicate
effective and culturally appropriate information regarding  identified health
risks to the Swinomish community and nearby tribes who also participate
in subsistence shellfish harvesting to develop and implement mitigation
measures to reduce  health risks from shellfish consumption.

This project was intended to complement  other ongoing, funded projects,
such as the  paralytic sheljfish poison monitoring program, fresh and
marine water quality monitoring  programs, ambient air quality program,
the EPA nonpoint source poljution Clean Water Act Section 319 program,
and the Swinomish  indoor air quality/medical clinic health monitoring
program.
                                                                                 A Decade of Tribal Environmental  Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship  Programs

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Appendix B: Outputs From Tribal Environmental Health Research Program STAR Grants
Appendix B:  Outputs  From Tribal
Environmental Health  Research Program
STAR Grants
Peer-Reviewed Journal Articles

Broadaway SC, Eggers MJ, Hamner S, Parker A, Camper AK, and Pyle
BH. 2013. Detection of  Cryptosporidium using Fluorescent in situ
Hybridization and Solid Phase Laser Cytometry (in preparation).

Christopher S, Saha R, Lachapelle P, Jennings D, Colclough Y, Cooper C,
Cummins C, Eggers MJ, FourStar K, Harris K, Kuntz SW, LaFromboise V,
LaVeaux D, McDonald T, Bird JR, Rink E, and Webster L. 2011. Applying
Indigenous Community-Based Participatory Research Principles to
Partnership Development  in Health Disparities Research.fa/m'/yana1
Community Health 34(3):246-255.

Cummins C, Doyle JT, Kindness L, Lefthand MJ, Bear Don't Walk UJ,
Bends A, Broadaway SC, Camper AK, Fitch R, Ford TE, Hamner S, Morrison
AR, Richards CL, Young  SL, and Eggers MJ. 2010. Community-Based
Participatory Research in  Indian Country: Improving  Health Through
Water Quality Research and Awareness. Family and Community Health
33(3): 166-174.

DeWeese AD,  Kmiecik NE, Chiriboga ED, and Foran JA. 2009. Efficacy
of Risk-Based, Culturally Sensitive Ogaa (Walleye) Consumption Advice
for Anishinaabe Tribal Members in the Great Lakes Region. Risk Analysis
29(5)729-742.

Donatuto J and Harper BL. 2008. Issues  in Evaluating Fish  Consumption
Rates for Native American Tribes. Risk Analysis 28:1497-1506.

Doyle JT, Redsteer MH, and Eggers MJ. 2013 Exploring  Effects of Climate
Change on Northern  Plains American Indian Health. Climatic Change
120(3):643-655.

Flint  CG, Robinson ES, Kellogg J, Ferguson G, BouFajreldin L, Dolan
M, Raskin I, and Lila MA. Promoting Wellness in Alaskan Villages:
Integrating Traditional Knowledge and Science of Wild  Berries. EcoHealth
2011;8(2): 199-209.

Foran JA, DeWeese AD, Hudson MJ, and  Kmiecik NE. 2010. Evaluation
of Mercury Exposure  Reduction Through a Fish Consumption Advisory
Program for Anishinaabe Tribal Members in Northern Wisconsin,
Michigan, and Minnesota. Journal of Environmental and Public Health.
Article ID 802584,7  pp. (doi: 10.1155/2010/802584)
Hamner S, Broadaway SC, Berg E, Stettner S, Pyle BH, Big Man N,
Old Elk J, Eggers MJ, Doyle J, Kindness L, Good Luck B, Ford TE, and
Camper AK. 2013. Detection  and Source Tracking of  Escherichia coli,
Harboring Intimin and Shiga Toxin Genes, Isolated From the Little Bighorn
River, Montana. International Journal of Environmental Health Research.
doi: 10. 1080/096031 23.201 3.835030. E-published 17 Sept.

Harding AK, Harper B, Stone D, O'Neill C, Berger P, Harris S, and Donatuto
J. 2012. Conducting Research With Tribal  Communities: Sovereignty,
Ethics, and Data-Sharing Issues. Environmental Health Perspectives
Harper BL, Harding AK, Harris S, and Berger P. 2012. Subsistence
Exposure Scenarios for Tribal Applications. Human and Ecological Risk
Assessment: An International Journal 1 8(4) :81 0-831 .

Judd NL, Drew CH.Acharya  C, Marine Resources for Future Generations,
Mitchell TA, Donatuto JL, Burns GW, BurbacherTM, and Faustman  EM.
2005. Framing Scientific Analyses for Risk Management of Environmental
Hazards by Communities: Case Studies With Seafood Safety Issues.
Environmental Health Perspectives 113(11):! 502- 1 508 .

Kellogg J, Higgs C, and Lila  MA. 201 1 . Prospects for Commercialisation
of an Alaska Native Wild Resource as a Commodity Crop. The Journal of
Entrepreneurship 20(1)77-101 .

Kellogg J, Joseph G.Andrae-Marobela  K, SosomeA, Flint C, Kormarnytsky
S, Fear G, Struwe L, Raskin I, and Lila MA. 2010. Screens-to-Nature:
Opening Doors to Traditional Knowledge and Hands-on Science
Education. NACTA Journal 54(3):41-48.

Kellogg J.Wang J, Flint C, Ribnicky D, Kuhn P, Gonzalez De Mejia E,
Raskin  I, and Lila MA. 201 0. Alaskan Wild Berry Resources and Human
Health  Under the Cloud of Climate Change. Journal of Agricultural and
Food C/iem/sfry 58(7):3884-3900.

Light AR. 2008. Beyond the  Myth of Everglades  Settlement: The Need for
Sustainability Jurisprudence. Tulsa /.aw/?ew'enM4(l):253-274.

Light AR. 2006. The Waiter at the  Party: A Parable of Ecosystem
Management  in the Everglades. ELR News and Analysis 36(10):10771-
10785.

Lila MA, Kellogg J,  Flint C, and Raskin 1. 2010. Arctic Berries: Stressed for
Success. Pharmaceutical Biology 48 (Suppl  1):2.

Madsen ER, DeWeese AD, Kmiecik N, Foran JA,  and Chiriboga  ED.
2008. Methods To  Develop Consumption Advice for Methyl Mercury-
Contaminated Walleye Harvested  by Ojibwe Tribes in the 1837 and 1842
Ceded Territories of Michigan, Minnesota, and Wisconsin, USA. Integrated
Environmental Assessment and Management 4 ( 1 ) : 1 1 8- 1 24 .
Sepez J. 2008. Historical Ecology of Makah Subsistence Foraging
Patterns. Journal of Ethnobiology 2S,(])\] 10-133.

Sepez J. 2002.Treaty Rights and the Right to Culture: Native American
Subsistence Issues in U.S. Law. Cultural Dynamics  14(2):143-159.

Sepez J. 1998. Aboriginal Whaling—Biological Diversity Meets Cultural
Diversity. Northwest Science 72(2): 142-145.

Sepez J and Lazrus H (eds.). 2005. Special Theme Issue:Traditional
Environmental Knowledge in Federal Natural Resource Management
Agencies. Practicing Anthropology 27(1): 1 -48.

Solomon M. A Sacred Duty:Tribal  "Treatment as State" Under the Clean
Water Act and Restoring Native Fisheries in the Upper Columbia River
Basin. Society & Natural Resources  (in review).

Solomon M. Culture Matters: A Game Theoretic Analysis of Tribal/State
Water Resource Conflicts in the Upper Columbia River Basin. The Social
Science Journal (in review).

Wei CA and Woodin T. 2011. Undergraduate Research Experiences in
Biology: Alternatives to the Apprenticeship Model. CBE—Life Sciences
Education  10(2):123-131.

Welfinger-Smith G, Minholz JL, Byrne S, Waghiyi V, Gologergen J, Kava
J, Apatiki M, Ungott E, Miller PK, Arnason JG, and Carpenter DO. 2011.
Organochlorine and Metal Contaminants in Traditional Foods From St.
Lawrence Island, Alaska. Journal of Toxicology and Environmental Health,
Part A, 74(18):! 195-1214.

Welfinger-Smith G. 2008. Contaminants in the Traditional Foods of
the Yupik People of St. Lawrence Island, Alaska—Exposure Pathways,
Collaborative Interventions, and Prevention. Epidemiology 19(6):S72-
S73.

Zota AR, Schaider LA, Ettinger AS, Wright RO, Shine JP, and Spengler JD.
2011. Metal Sources and Exposures in the Homes of Young Children
Living Near a Mining-Impacted Superfund Site. Journal of Exposure
Science and Environmental Epidemiology 2011;21 (5):495-505.

Zota AR, Willis R, Jim R, Norris GA, Shine JP, Duvall RM, Schaider LA,
and Spengler JD. 2009. Impact of Mine Waste on Airborne Respirable
Particulates in Northeastern, Oklahoma, United States. Journal of the Air
&  Waste Management Association 59(11): 1347-1357.

Books, Proceedings, Technical Reports, Guidance Manuals and Other
Publications

Arquette M and Cole M. 2004. Restoring Our Relationships for the Future.
In: Blaser M, Feit HA, and McRae G (eds). In the Way of Development:
Indigenous Peoples, Life Projects and Globalization. ZedBooks: London,
pp. 332-350.
A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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                                                                                                                          Appendix B: Outputs From Tribal Environmental Health Research Program STAR Grants
Basabe FA and Donatuto J. 2001. Bioaccumulative Toxics in Native
American Shellfish Quality Assurance Project Plan. Swinomish Indian
Tribal Community: La Conner, Washington.

California Tribal Epidemiology Center. 2012.  Yurok Tribe Environmental
Community Health Profile 2004-2011. California Tribal Epidemiology
Center, California Rural Indian Health  Board: Sacramento, California.
March.

Cherokee Nation  Natural Resources Department. 2009. Wild Plants of
the Cherokee Nation. Cherokee Nation Foundation: Tahlequah, Oklahoma.

Donatuto J. 2002. Quality Assurance Project Plan for Speciated Arsenic
Analyses in Saxidomis giganteus. Swinomish Indian Tribal Community: La
Conner, Washington.

Eggers MJ, Lefthand MJ, Young SL, Doyle JT, and Plenty Hoops A. 2013.
When It Comes to Water, We Are All Close Neighbors. Published on  It All
Starts With Science: An EPA Blog About Science Matters.  6 June, http://
blog. epa. gov/science/2013/06/when-it-comes-to-water-we-are-all-close-
neighbors/

Etnier M and Sepez J. 2008. Changing Patterns of Sea Mammal
Exploitation among  the  Makah. In: Layton R, Maschner H, and
Papagianni  D (eds.). Time and Change: Archaeology and Anthropological
Perspectives on the Long-Term in Hunter-Gatherer Societies. Oxbow
Press: Woodbridge, Connecticut, pp. 143-158.

Fitch JH. 2009. Pedagogic Opportunities in Designing and Developing
Sustainable Affordable Housing and Outdoor Classrooms in  Southwest
Florida. Greening of the Campus VIII Conference Proceedings,
Indianapolis, Indiana, 20-23 September.

Harper BL, Harding AK, Waterhouse T, and Harris S. 2007. Traditional Tribal
Subsistence Exposure Scenario and Risk Assessment Guidance Manual.
Oregon State  University  Printing and  Mailing: Corvallis, Oregon.

Johnson SW. 2003. Needs Assessment of Tribal Requirements for
Instruction in the Use of Statistically-Based Aquatic Water Quality
Monitoring Techniques. Final Report prepared by Water Quality
Technology, Inc.: Fort Collins, Colorado. 12 pp.

Johnson W and  Sepez-Aradanas J. 1999. Harvest From the Sea
(editorial). The New York Times, The Seattle Times, and The Port Angeles
Daily News. 2] May.

Kellogg J, Yousef  GG, Grace MH, Flint  C, Raskin I, and Lila MA. 2009.
Partnering With Alaskan  Communities To Examine Health Benefits
of Traditional Wild Berries. The FASEB  Journal 23(Meeting Abstract
Supplement):LB469.

Kellogg JJ. 2009. Bioexploration of Wild Alaskan Berries:  From Field
Screening to Functional Food. M.S. Thesis. University of Illinois at Urbana-
Champaign: Urbana, Illinois.
Lila MA, Kellogg J, Flint C, and Raskin I. 2010. Arctic Berries: Stressed for
Success. Pharmaceutical Biology 48(Suppl 1):2.

Native Lens Video. 2006. Slow Bum (documentary film).

Norman K, Sepez J, Lazrus H, Milne N, Package C, Russell S, Grant K,
Petersen Lewis R, Primo J, Springer E, Styles M.Tilt  B, and Vaccaro I.
2007. Community Profiles for West Coast and  North Pacific Fisheries-
Washington, Oregon, California, and other U.S. States. National Oceanic
and Atmospheric Administration Technical  Memorandum  NMFS-
NWFSC-85. 602 pp.

Reynolds III JE and Wetzel DL. 2007. Polycyclic Aromatic Hydrocarbon
(PAH) Residues in  Matrices of Bowhead Whales (Balaena mysticetus)
and Bearded Seals (Erignathus barbatus). Proceedings of the  17th
Biennial Conference  on the Biology of Marine  Mammals, Cape Town,
South Africa, 29 November-3 December.

Reynolds III JE, Wetzel  DL, Hanns C, Mercuric P, and O'Hara TM. 2005.
Analyses of Polycyclic Aromatic Hydrocarbons  in Sediments, Fish and
Marine Mammals From the North  Slope of Alaska. Proceedings of
International Symposium on Oil and Gas Activities in the Arctic, St.
Petersburg, Russia, 13-15  September, pp.  594-598.

Rickard PM and Hargrove G.  2008. KANIEN'KEHA:KA: Living the Language.
Video aired on the Aboriginal Peoples Television Network, Fall.

Sepez-Aradanas J  and Tweedie A. 1999. Makah Harpoons vs. Media
Hype: Cultural Stereotypes, Academic Research, and Public Policy. Oregon
Humanities Magazine Fall  1999:48-53.

Swinomish 13 Moons Coloring Book.

Swinomish 13 Moons Traditional Foods Book.

Swinomish Tribe Office of Planning and Community. 2006.
Bioaccumulative Toxics in Subsistence-Harvested Shellfish—Contaminant
Results and Risk Assessment. 1 December.

Urquhart NS and Moore JC. 2004. Statistics in EPA's STAR Program:
Learning Materials for Surface Water Monitoring. OPPTS Tribal News
4(3):45-46.

Wapner J. 2011 .The Struggle to Save Alaska's 'Illness-Busting'Wild
Berries. The EcologistJ September.

Weisiger M. 2009. Dreaming of Sheep in Navajo Country. University of
Washington Press: Seattle, Washington.

Wetzel DL, Mercuric P, Reynolds  III JE, and George JC. 2007. The Pursuit
of Precise  and Accurate Methods To Determine Ages of Bowhead Whales
(Balaena mysticetus). Proceedings of the  17th Biennial Conference
on the Biology of Marine Mammals, Capetown, South Africa, 29
November-3 December.
Wetzel DL and Reynolds III JE. 2006. Review of Effects of PAH  Exposures
on Marine Mammals and a Suggested Approach for Assessing PAH
Levels and Effects in Sotalia. Proceedings of the Workshop on Research
and Conservation of the Genus Sotalia, Rio de Janeiro, Brazil,  19-23
June.

Presentations

Akwesasne Task Force on the Environment. 2004.  lakoti'satstenhserd:wis
Ne Ohon:tsia: They Strengthen The Earth Program Valuation.

Arquette M. 2007. Akwesasne Task Force on the Environment Inc.
Akwesasne Freedom School: A Place to Maintain and Renew
Relationships. Presented at the State University of  New York Potsdam
Campus Festival and International Conference: Connections and
Intersections—Our Changing Landscape, Potsdam, New York, 18-22
April.

Arquette M. 2006. Haudenosaunee Environmental Protection Process
(HEPP): Applying Traditional Teachings to Protect the Natural World and
Promote a Sustainable Society. Presented at the National Forum on
Tribal  Environmental Science, Quinault Indian Nation, Ocean Shores,
Washington, 24-28 September.

Arquette M. 2005. Connecting social and environmental factors to
measure and track environmental health disparities summary  report.
Presented  at the  U.S. Environmental Protection Agency Office of
Children's  Health Protection Meeting, University of  Michigan, Ann Arbor,
Michigan, 24-25 May.

Berner JE. 2012. Human Health Effects  of Persistent Organic
Contaminants in the Arctic: Update of Current  Findings. Presented  to the
U.S. Environmental Protection Agency's National Center for  Environmental
Research, Washington, DC, May.

Berner JE. 2011. Maternal Organics Monitoring (MOM)  Study Data.
Presented  at the  Summer Institute of Circumpolar Health Research,  Oulu
University, Oulu, Finland, June.

Berner JE. 2010. Maternal Organics Monitoring (MOM)  Study Data.
Presented  at the Annual General Meeting of the International  Network for
Circumpolar Health Research, Copenhagen, Denmark, 18-19 May.

Berner JE. 2009. Maternal Organics Monitoring Program and Initial
Findings. Presented at the Annual General Meeting of the International
Network for Circumpolar Health Research, Copenhagen, Denmark, 18-19
May.

Berner JE. 2009. Climate Change and Contaminants  in Subsistence
Foods: A Tribal Program To Monitor the  Health of Alaskan Yupik Woman
and Children. Presented jointly at the Promoting Environmental Health
in Native American Communities Webinar Series and the National EPA-
Tribal  Science Council, 10 December.
                                                                                A Decade of Tribal Environmental  Health  Research:  Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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Appendix B: Outputs From  Tribal Environmental Health Research Program STAR Grants
Berner JE. 2009. Maternal Organics Monitoring Program and Initial
Findings. Presented to the Centers for Disease Control and Prevention/
National Center for Environmental Health, Atlanta, Georgia, July.

Berner JE. 2009. Maternal Organics Monitoring Program and Initial
Findings. Presented to the Yukon  Kusokwim Human Studies Committee,
Bethel, Alaska, December.

Berner JE. 2009. Maternal Organics Monitoring Program and Initial
Findings. Presented at the Northern Contaminants Program and Arctic
Monitoring Assessment Program (AMAP)  Symposium  on Human Health
and Arctic Environmental Contaminants, Iqaluit, Nunavut, Canada, 10-12
June.

Big Man N, Smith Backbone A, Cummins C, Eggers M, and Camper A.
2009. Community-Based Risk Assessment of Exposure to Contaminants
Through Water Sources on the Crow Reservation. Poster presented at the
Western Region COBRE-INBRE Scientific Conference, Big Sky, Montana,
16-18 September.

Burger J, Gochfield  M, and Harper B. 2008. Identifying High-End and
Highly Impacted Fish Consumers: Methods for Assessing  Exposure Risk
for Populations with High Fish Consumption  Rates.  Presented at the
International Society of Exposure Analysis Annual Meeting, Pasadena,
California, 13 October.

Camper AK, Doyle J, Bear Don't Walk U, Lefthand M, Shield M, Cummins
C, Good Luck B, Hamner  S, Broadaway S, and Eggers, M.  2010.
Community-Based  Risk Assessment on the Crow  Reservation. Presented
at the Center for Native  Health Partnerships Webinar, Bozeman, Montana,
20 December.

Cummins C, Bends  A, Young S, and Eggers M. 2010. Crow Water Quality
Project: Using community based participatory research to address
local environmental and  health concerns. Panel presentation at the
Earth Rights: Learning the Language of Indigenous Environmentalism
Conference, Bozeman, Montana,  1-2 April.

Cummins C, Doyle J, Kindness  L, Young SL, Ford TE, and Eggers  MJ.
2010. Community-Based Risk Assessment of Exposure to Contaminants
via Water Sources  on the Crow Reservation in Montana. Panel
presentation at the  2010 National Tribal Science  Forum,Traverse City,
Michigan, 10 June.

Cummins C and Eggers M. 2009. Developing Community Based-
Participatory Research With Little Big Horn College, the Crow Reservation
Community and Montana State University. Presented at the Western
Region COBRE-INBRE Scientific Conference, Big Sky, Montana, 16-18
September.
Cummins C, Ford T, Doyle J, Kindness L, Bear Don't Walk U, and
Eggers M. 2009. Community-Based Risk Assessment of  Exposure to
Contaminants via Water Sources on the Crow Reservation in Montana.
Presented at the Promoting Environmental Health  in Native American
Communities Webinar Series, 18 November.

Groom DB and Lila MA. 2013. Bioexploration Beyond The Field -To the
Laboratory, Curriculum, Clinical, and Commercial. Presented at the U.S.
Department of Agriculture  (USDA) Higher Education Challenge (HEC)
Workshop/United Tribes Technical College Summer Camp, Bismarck,
North Dakota, July.

Groom DB and Lila MA. 2013. Goals and Outcomes for Student
Bioexploration Experiences. Presented at the USDA HEC Finale Workshop,
Kannapolis, North  Carolina, July.

Groom DB and Lila MA. 2013.TEK + STNs + STEM: Measuring  Levels of
Engagement. Presented  at the USDA HEC  Finale Workshop Curriculum
Roundtable, Kannapolis,  North Carolina, July.

Groom DB and Lila MA. 2013. The Science Behind Traditional Knowledge:
An In-Field Plants  Bioassay Method Boosts STEM  Engagement of
American Indian and Alaska  Native High School Students. Presented at
the 59th Annual North American Colleges and Teachers of Agriculture
Conference, Blacksburg, Virginia, 26 June.

Dietrich E, Rao V, Allen C, Doyle JT, Old Coyote TJ, Eggers MJ, and
Camper AK. 2013. Service Learning to Address Drinking Water Quality
through Community-Based Participatory Research on the Crow
Reservation.  Presented at the Montana INBRE Network Research and
Training Symposium, Bozeman, Montana, 17-19, April.

Donatuto J. 2006. The Importance of Fish  Consumption Surveys
for Native Americans. Seminar presented at the University of British
Columbia, Vancouver, British  Columbia, Canada.

Donatuto J. 2006. Swinomish Tribe's Bioaccumulative Toxics and  Native
American Shellfish Project. Presented to the Skagit Marine Resources
Committee, Mt.Vernon, Washington.

Donatuto J. 2006. Swinomish Tribe's Bioaccumulative Toxics and  Native
American Shellfish Project. Presented at the People for Puget Sound's
Toxics Forum, Seattle, Washington.

Donatuto J. 2006. Articulating Sociocultural Health Effects From
Contaminated Subsistence Foods. Presented at the 141st American
Public Health Association Annual Meeting and Exposition, Boston,
Massachusetts, 4-8 November.

Donatuto J. 2006. Fish Consumption and Policy in the Tribal Context.
Presented at the 66th Annual Meeting of the  Society  for Applied
Anthropology, Vancouver, British  Columbia, Canada, 28 March-2 April.
Donatuto J. 2006. Results and Discussion of the Swinomish Tribe's
Toxics in Shellfish Project. Presented at the U.S. Environmental Port
Agency Tribal Leaders Summit, Confederated Tribes of the Umatilla Indian
Reservation, Pendleton, Oregon.

Donatuto J. 2006. Results and Discussion of the Swinomish Tribe's
Toxics in Shellfish Project. Presented at the National Forum  on
Tribal Environmental Science, Quinault Indian Nation, Ocean Shores,
Washington, 24-28 September.

Donatuto J. 2005. Rounding the Home Stretch: Learning Experiences
from the Bioaccumulative Toxics in  Native American Shellfish Project.
Presented at the Puget Sound Georgia Basin  Research Conference,
Seattle, Washington, 29-31  March.

Donatuto J. 2005. Bioaccumulative Toxics in Native American Shellfish.
Presented at the Region  10 U.S. Environmental Protection Agency Tribal
Leaders Summit, Sitka, Alaska.

Donatuto J. 2004. Bioaccumulative Toxics in Native American Shellfish.
Presented at the U.S Environmental Protection Agency Region 10 Tribal
Conference: Collaborating for Success, Bow, Washington, 19 May.

Donatuto J. 2004. Update on the Bioaccumulative Toxics in Native
American Shellfish Project. Poster presented at the National  Institute
for Environmental Health  Sciences Annual Grantees Conference,
Albuquerque, New Mexico, 13-15 June.

Donatuto J. 2004. Swinomish Toxics Trends in Sediment Monitoring
Project Report.  Presented  to the Swinomish Indian Tribal Community, La
Conner, Washington.

Donatuto J. 2004. Bioaccumulative Toxics in Native American Shellfish.
Presented at the National Tribal Environmental Council Meeting,
Marysville, Washington.

Donatuto J. 2004. Developing a Human Health and Cultural Risk
Assessment: Toxics in Shellfish on the Swinomish Reservation. Presented
at the 64th  Annual  Meeting of the Society for Applied Anthropology,
Dallas,Texas, 31 March-4 April.

Donatuto J. 2004. Subsistence Lifeways: Native American Fish
Consumption Rates and Risk. Presented at the Fourth Society of
Toxicology and  Environmental Chemistry World Congress and 25th
Annual Meeting, Portland, Oregon, 14-18  November.

Donatuto J. 2003. Project Design and Implementation: Bioaccumulative
Toxics in Native American Shellfish. Presented at the Georgia Basin/
Puget Sound Research Conference, Vancouver, British Columbia,  Canada,
31 March-3 April.
A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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                                                                                                                           Appendix B: Outputs From Tribal Environmental Health Research Program STAR Grants
Donatuto J. 2003. Project Design and Implementation: Bioaccumulative
Toxics in Native American Shellfish. Presented to the Northwest Indian
Fisheries Commission, La Conner, Washington.

Donatuto J. 2003. Project Design and Implementation: Bioaccumulative
Toxics in Native American Shellfish. Presented at the People for Puget
Sound  Meeting, Bellingham, Washington.

Donatuto J  and Basabe T. 2003. Project Design and Implementation:
Bioaccumulative Toxics in Native American Shellfish. Presented at the
U.S. Environmental Protection Agency Science To Achieve Results Human
Health  Symposium, Washington, DC, 9-10 April.

Donatuto J  and Campbell  L. 2003. Project Design and Implementation:
Bioaccumulative Toxics in Native American Shellfish. Presented at the
U.S. Environmental Protection Agency Science  Forum, Washington,  DC,
5-7 May.

Donatuto J  and Harper B. 2008. Defining and Evaluating Risks
from Contaminated Food in a Native American Fishing Community
(Swinomish). Presented at the International Society of Exposure Analysis
Annual Meeting, Pasadena, California, 15 October.

Donatuto J  and O'Hara C.  2002.  Project Design and Implementation:
Bioaccumulative Toxics in Native American Shellfish. Presented at the
U.S. Environmental Protection Agency Region  10 Tribal Conference,
Lincoln City, Oregon.

Donatuto J  and Smith K. 2005. Bioaccumulative Toxics in Native
American Shellfish. Poster  presented at the National Institute for
Environmental  Health Sciences Annual Grantees Conference Jalkeetna,
Alaska, 19-22  September.

Doyle JT, Kindness L, Bear  Don't Walk UJ, Realbird J, Eggers MJ, Bends
AL, Crow Environmental Health Steering Committee, and Camper AK.
2012. For As Long As the Grass Shall Grow and the  Rivers  Shall Flow:
Clean Water, a Sovereign Responsibility. Plenary presentation at the
National Congress of American Indians Tribal  Leader and Scholar Forum,
Lincoln, Nebraska, 17-20 June.

Doyle JT, Kindness L, Bear  Don't Walk U, Realbird J, Eggers MJ, Crow
Environmental  Health Steering Committee, Ford TE, and Camper AK.
2013. Addressing Disparities in Safe Drinking Water Access on the  Crow
Reservation, Montana. Presented  at the Environmental Health Disparities
and Environmental Justice Meeting, Raleigh, North Carolina, 29-31  July.

Doyle JT, Kindness L, Bear  Don't Walk U, Realbird J, Eggers MJ, Crow
Environmental  Health Steering Committee, Ford TE, and Camper
AK. 2012. Reducing Tribal Health  Disparities Through Solving Water
Infrastructure Challenges. Presented at the National  Institutes of
Health's National Institute of General Medical Sciences Fourth Biennial
National IDeA Symposium  of  Biomedical Research Excellence (NISBRE),
Washington, DC, 25-27 June.
Doyle JT, Kindness L, Bear Don't Walk U, Realbird J, Eggers MJ, Old
Coyote TJ, Crow Environmental Health Steering Committee, Ford TE, and
Camper AK. 2012. Addressing Disparities in Safe Drinking Water Access
on the Crow Reservation, Montana. Presented at the National Institutes
of Health Summit on the Science of Eliminating Health Disparities,
National Harbor, Maryland, 17-19 December.

Doyle JT, Kindness L, Bends AL, Eggers MJ, Old Coyote TJ, Crow
Environmental Health Steering Committee, and Camper AK. 2012. For As
Long As the Grass Shall Grow and the Rivers Shall Flow: Clean Water, a
Sovereign  Responsibility. Panel presentation at the National Congress of
American Indians Tribal  Leader and Scholar Forum, Lincoln, Nebraska,
17-20 June.

Doyle JT and Young SL. 2013. Understanding and Addressing Disparities
in Safe Drinking Water Access on the Crow Reservation. Presented at the
Third Biennial Western Regional IDeA Scientific Conference, Honolulu,
Hawaii, 6-8 October.

Eggers MJ and Bull Chief E. 2012. Health Risks of Lead Exposure from
Elk and  Deer Meat Consumption. Presented at the Native American
Fish & Wildlife Society 23rd Annual Great Plains Regional Conference,
Bozeman, Montana, 27-29 March.

Eggers MJ, Cummins  C, Crow Environmental Health Steering Committee,
Sigler A, Hamner S, Richards CL,  Big  Man  N,  Ford TE, and Camper AK.
2010. Community-Based Risk Assessment on the  Crow Reservation.
Poster presented at the  Third  Biennial National IDeA Symposium of
Biomedical Research  Excellence, Bethesda, Maryland,  16-18 June.

Eggers M, Cummins C, Richards C, the Crow Environmental Health
Steering Committee,  Hamner S, Broadaway S, Young SL, Ford.T, and
Camper A. 2009. Community-Based  Risk Assessment on the Crow
Reservation. Poster presented at the  Western  Region COBRE-INBRE
Scientific Conference, Big Sky, Montana, 16-18  September.

Eggers MJ, Doyle JT, Lefthand ML, Kindness L, Young SL, Good  Luck
BT, McCormick AKHG, Dietrich E, Felicia DL, Ford TE, Roberts D, and
Camper AK. 2013. Community-Based Risk Assessment  of Exposure to
Waterborne Contaminants, Crow  Reservation, Montana. Presented at the
Environmental Health Disparities  and Environmental Justice  Meeting,
Raleigh, North Carolina, 29-31 July.

Eggers MJ, Doyle JT, Old Coyote TJ, Camper AK, Crow Environmental
Health Steering Committee, Ford  TE.  2012. Addressing  Health Disparities
and Learning Science Through Community-Based  Participatory Research,
Crow Reservation, Montana. Invited panel  presentation at the National
Institutes of Health Summit on the Science of Eliminating Health
Disparities, National Harbor, Maryland, 17-19 December.
Eggers MJ, Moore-Nail AL, Doyle JT, Crow Environmental  Health Steering
Committee, Lageson DR, Roberts D, and Camper AK. 2013. Crow Water
Quality Project: A Community Based  Participatory Approach Finds
Elevated Uranium in Wells on the Crow Indian Reservation, Big Horn
County, Montana. Presented at the Fifth Annual International Conference
on Medical Geology, Arlington, Virginia, 25-29 August.

Eggers MJ, Old Coyote TJ, Doyle JT, Kindness L, Lefthand MJ, Bear Don't
Walk UJ, Young SL,  Bends AL, Good Luck B, Stewart R, Leider A, White
Clay S, Dietrich E, Ford TE, and Camper AK. 2012. Using Community
Based Risk Assessment to Address Health Risks from Waterborne
Contaminants on the Crow Reservation. Presented at the National
Institutes  of Health  Summit on the Science of Eliminating Health
Disparities, National Harbor, Maryland, 17-19 December.

Eggers MJ, Old Coyote TJ, Dietrich E, Doyle JT, Lefthand MJ, Kindness
L, Bear Don't Walk UJ, Young, SL, Bends AL, Good  Luck B, Stewart
R,  Hamner S, Broadaway SC, Ford TE, and Camper AK. 2012. Using
Community-Based Risk Assessment to Reduce Tribal Health Risks from
Water Contamination.  Poster presented at the National Institutes of
Health's National Institute of General  Medical Sciences Fourth Biennial
National IDeA Symposium of  Biomedical Research Excellence (NISBRE),
Washington, DC, 25-27 June.

Eggers M, Old Coyote T, Ford T, Camper A, and Crow  Environmental
Health Steering Committee. 2011. Community-Based Risk Assessment of
Exposure  to Contaminants via Water Sources on the Crow Reservation
in Montana. Presented to the Harvard University Group, Pine Creek,
Montana, 6 June.

Etnier M and Sepez J. 2003.  Ecological, Political, and Cultural
Explanations for Changing Patterns of Sea Mammal Exploitation Among
the  Makah. Presented at the Alaska Anthropological Association Annual
Meeting, Fairbanks, Alaska, March.

Fields N, Wetzel D, Reynolds J, Miller P, Waghiyi V, Kmiecik N, Donatuto
J, Harper  B, Harris S, Waterhous T, and Harding A. 2006. Advancing
Exposure  and Intervention Research to Protect Native American Tribal
Populations. Poster  presented at the  International  Conference on
Environment, Epidemiology, and Exposure, Paris, France, 2-6 September.

Fitch JH. 2009. Sustainability: An  Emerging Substrate for Creativity,
Interdisciplinarity, Integrative  Learning, and Survival. Presented at the
31st Conference of the Association for Integrated Studies, University of
Alabama, Tuscaloosa, Alabama, 8  October.

Flint CG. 2010. Perceptions of Ecosystem Services and Threats to
Well-Being From an Alaska Native Community. Presented at the ACES
(A Community on Ecosystem  Services) Meeting, Gila River Indian
Community, Phoenix, AZ, 6-9 December.
                                                                                A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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Appendix B:  Outputs From Tribal Environmental Health Research Program STAR Grants
Flint C and Lila  MA. 2009. Alaskan Subsistence Resources and
Communities at Risk: Integrating Traditional  Ecological  Knowledge, Risk
Perception Assessment, and Plant Science in Participatory Research.
Presented at the Rural Sociological Society Annual  Meeting, Madison,
Wisconsin, 30 July-2 August.

Flint CG and Lila MA. 2010. Traditional Knowledge and Perceptions
of Ecosystem and Community Well-Being in Three Alaska Native
Communities. Presented at the International Symposium for Society and
Resource Management, Corpus Christi.TX, 6-10 June.

Foran J. 2004. Great Lakes Indian  Fish and  Wildlife Fish Advisory
Program and STAR Grant Plans. Presented at the  Fifth Annual
Environmental and Occupational Health  Conference, Minneapolis,
Minnesota, 11-13 July.

Foran J. 2004. Great Lakes Indian  Fish and  Wildlife Fish Advisory
Program and STAR Grant Plans. Presented at the  Great Lakes Research
Consortium State-National Consumption Advisory Workshop.

Ford TE, Eggers  MJ, Cummins  C, Doyle J, Kindness L, and Young SL.
2010. Translating Community-Based Participatory Research: Lessons
Learned. Panel presentation at the 2010 National Tribal Science  Forum,
Traverse City, Michigan, 6-10 June.

Ford TE, Eggers  MJ, Old Coyote TJ, Good Luck B, Felicia DL, Doyle JT,
Kindness L, Leider A, Moore-Nail A, Dietrich  E, and Camper AK. 2012.
Comprehensive  Community-Based Risk Assessment of Exposure to
Water-Borne Contaminants on the Crow Reservation. Presented at the
EPA Tribal  Environmental Health Research Program Webinar, 17  October.

Hamner S, Broadaway S, Big Man N, Old Elk J, Doyle J, Kindness L,
Pyle B, Eggers M, Camper AK,  and  Ford T. 2012.   Detection of Multiple
Enterohemorrhagic Escherichia coll Serotypes in  the Little Bighorn River,
Montana, USA. Presented at the Society  for  General Microbiology Spring
Conference 2012, Dublin, Ireland, 26-29 March.

Harding A and Harper  B. 2011 .Addressing Tribal Exposures to Polycyclic
Aromatic Hydrocarbons (PAHs) and Building Tribal Capacity Through
a Tribal-University Partnership.  Presented  at the National Institute  of
Environmental Health Sciences and U.S. Environmental Protection Agency
Superfund Research Program  Risk e-Learning Series Webinar, 23 May.

Harding A, Harper B, Harris S, Stone D.Anderson K, Simonich S, Uesugi S,
Forsberg  N, Motorykin  0, Cardenas A, and Waters K. 2012. Working With
a Native American  Community to Characterize (and Define) Their "Risk":
Risk as a Value-Based Decision Based on Important Cultural Practices.
Presented at the 140th American Public Health Association Annual
Meeting and Exposition, San Francisco, California, 30  October.

Harding AK, Harper BL, and Harris S. 2008. Estimating Environmental
Exposures for Tribes Engaged  in Traditional Subsistence Lifestyles. Poster
presented at the 136th American Public Health Association Annual
Meeting and Exposition, San Diego, California, 25-29 October.
Harper B. 2010. Research Ethics and Informed Tribal Consent. Presented
at the Symposium on Conducting Research in Tribal Communities,
Oregon State University, Corvallis, Oregon, 7 April.

Harper B. 2009. Exposure Scenarios—Fish Consumption Rates Within
the  larger Tribal Exposure Context. Presented at the Tribal Rights and
Fish Consumption Workshop: Issues and Opportunities for the Pacific
Northwest, University of Washington, Seattle, Washington, 12 August.

Harper B. 2008. Bridging Western and Traditional Science in Assessing
Exposure in Subsistence Populations. Presented  at the 18th Annual
International Society of Exposure Analysis Annual Meeting,  Pasadena,
California, 15 October.

Harper B. 2008. Constructing Traditional Tribal Subsistence  Exposure
Scenarios. Presented at the  18th Annual International Society of
Exposure Analysis Annual Meeting, Pasadena, California, 15 October.

Harper B and Harding A. 2008. Tribal  Exposure Analysis  and Scenario
Development. Presented  at the EPA National Risk Assessors Training,
Seattle, Washington, 8 October.

Harper B, Harding A, and Harris S. 2007. A Multidisciplinary Approach
to Developing Tribal Exposure Scenarios. Presented at the International
Society for Exposure Analysis Annual  Meeting, Durham,  North Carolina,
18 October.

Harper B, Harding A, Waterhous T, Harris S, and Fleming  H. 2006.
Estimating Environmental Exposures for Tribes Practicing Traditional
Subsistence  Lifestyles: Part 1: Cross-Cultural Methods and  Part 2:
Research Results for Specific Exposure Pathways. Poster presented at the
National  Forum on Tribal Environmental Science, Quinault Indian Nation,
Ocean Shores, Washington, 24-28 September.

Harper BL, Harding AK, Waterhous TS, Harris SG, Wilcox AR,  McCulley EA,
and Fleming HS. 2005. Regional Tribal Exposure Scenarios  Based  on
Major Ecological Zones and Traditional Subsistence Lifestyles. Poster
presented at the Oregon Public  Health Association Annual  Meeting and
Conference, Corvallis, Oregon, 6  October.

Harper BL, Harding AK, Waterhous TS, Harris SG, Wilcox AR,  McCulley EA,
and Fleming HS. 2005. Regional Tribal Exposure Scenarios  Based  on
Major Ecological Zones and Traditional Subsistence Lifestyles. Poster and
presentation at the Annual Grantee Meeting Sponsored  by  the National
Institute of Environmental Health Sciences, U.S. Environmental Protection
Agency, and  National Institute of Occupational Safety and Health,
Talkeetna, Alaska, 19-22 September.

Harper B, Harding A, Waterhous T, Wilcox A, and  Harris S. 2009. Eco-
Social Cultural Mapping: Tribal Lifestyles and Environmental Risks—
Regional Tribal Exposure Scenarios Based on  Ecological Zones and
Traditional Lifeways. Presented at the Promoting Environmental Health in
Native American Communities Webinar Series, 30  June.
Harper B and Harris S. 2009. Climate, Drought, Adaptation. Invited
presentation at the Workshop on Climate, Drought, and Early Warning on
Western Native Lands, Jackson  Lake  Lodge, Grand Teton National Park,
Wyoming, 9-11  June.

Harper B and Harris S. 2007. Risk Assessment at the USDOE
Hanford Nuclear Site With an Ecologically Based Tribal Human
Health Subsistence Exposure Scenario. Presented at the Society for
Environmental Toxicology and Chemistry Annual Meeting, Milwaukee,
Wisconsin, 15 November.

Harper B and Harris S. 2005.Tribal Perspectives on Exposure Assessment
Presentation and Panel Discussion on Updating EPA's Guidance on
Exposure Assessment. Presented at the International  Society for Exposure
Assessment Annual  Meeting, Tucson,  Arizona, 2 November.

Harris S, Harper B, Donatuto J, and Harding  A. 2006.  Impacts to Tribal
Health and Culture of  Mercury and Other Contaminants in Columbia
Basin Fish. Presentation at the Conference on Mercury as a  Global
Pollutant: Toward Integration of Science, Policy, and Socioeconomics,
Madison, Wisconsin, 6-11 August.

Harris SG, Harper BL, and  Harding AK. 2004. Risks  From Tribal
Subsistence Lifeways in the  Columbia Basin. Presentation at the  Fourth
Society for Environmental Toxicology  and Chemistry World Congress,
Portland, Oregon, 14-18 November.

Kellogg J, Flint C, Ferguson G, Raskin I, and  Lila MA. 2010. Phytochemical
Composition and Bioactivity of Wild Alaskan Berries. Presented at the
2010 Joint Annual  Meeting  of the American Society  of Pharmacognosy
and the Phytochemical Society of North America, St. Petersburg Beach,
Florida, 10-14 July.

Kellogg J, Flint C, Ferguson G, Raskin Land  Lila MA. 2010. Partnering
With Alaska Native  Communities to Link Science and Traditional
Ecological Knowledge of Wild Berry Resources. Presented at the  2010
National Tribal Science Forum, Traverse City, Michigan, 6-10 June.

Kellogg J.YousefGG, Grace  MH, Flint C, Raskin Land Lila. 2009.
Partnering With Alaskan Communities to Examine  Health Benefits of
Traditional Wild Berries. Presented at  Experimental Biology 2009, New
Orleans, Louisiana, 18-22 April.

Kellogg J, Yousef GG, Grace  MH, Flint C, Raskin I, and Lila MA. 2009.
Partnering With Alaskan Communities to Examine  Health Benefits of
Traditional Wild Berries. Presented at  the National  Science Teachers
Association National Conference on Science Education, New Orleans,
Louisiana, 19-22 March.

Kellogg J, Wang J, Ribnicky D, Kuhn P, Raskin I, and Lila MA.  2010.
Phytochemical Composition and Bioactivity  of Wild Alaskan Berries.
Presented at the 33rd Meeting of the American Society of Primatologists,
Louisville, Kentucky, 16-19 June.
A Decade of Tribal Environmental  Health  Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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                                                                                                                           Appendix B: Outputs From Tribal Environmental Health Research Program STAR Grants
King J. 2007. lakotisa'tstentsera:wis Ne Ohontsia. Reducing  Risk by
Restoring Relationships. Workshop presentation at the Haudenosaunee
Environmental Youth Conference.

Kmiecik N. 2008. Intervention research and Probabilities of Risk in
Walleye-Harvesting  Ojibwe Communities. Presented at the International
Society of Environmental Epidemiology and International Society of
Exposure Analysis Joint Annual Meeting, Pasadena, California, 12-16
October.

Kmiecik N. 2008. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented  at the Joint Conference of the National Tribal Forum
and National Tribal  Air Association, Las Vegas, Nevada, 3-5 June.

Kmiecik N. 2008. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Final report presented to the Voigt Intertribal Task Force, Mole
Lake, Wisconsin.

Kmiecik N. 2008. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Final report presented to Great Lakes Indian Fish and Wildlife
Commission Board  of Commissioners, Mole Lake, Wisconsin.

Kmiecik N. 2007. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented  at the Society for  Risk Analysis Annual Meeting, San
Antonio, Texas, 9-12 December.

Kmiecik N. 2007. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented  at the 135th American Public Health Association
Annual Meeting and Exposition, Washington,  DC, 3-7 November.

Kmiecik N. 2007. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Poster presented at the  National  Forum on Contaminants in
Fish, Portland, Maine, 23-26 July.

Kmiecik N. 2007. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented  at the Native  American Fish and Wildlife Society
Annual Meeting, Reno, Nevada, 20-24 May.

Kmiecik N. 2007. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented  at the Native  American Fish and Wildlife Society,
Great Lakes Region, Lac du Flambeau, Wisconsin.

Kmiecik N. 2007. Reducing Health Risks to the Anishinaabe From
Methyl Mercury. Presented at the Multi-State Workgroup Annual Meeting,
Madison, Wisconsin.

Kmiecik N. 2006. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented  at the Boys and Girls Club Meeting of the Bad River
Tribe, Odanah, Wisconsin, 23 October.

Kmiecik N. 2006. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented  at the National Forum on  Tribal Environmental
Science, Quinault Indian Nation,  Ocean Shores, Washington, 27
September.
Kmiecik N. 2006. STAR Grant Project Progress to Date. Poster presented
at the National Forum on Tribal Environmental Science, Quinault Indian
Nation, Ocean Shores, Washington, 27 September.

Kmiecik N. 2006. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Poster presented at the National Forum on Tribal Environmental
Science, Quinault Indian Nation, Ocean Shores, Washington, 25
September.

Kmiecik N. 2006. Mercury as a Global Pollutant. Poster presented at the
National Forum on Tribal Environmental Science, Quinault Indian Nation,
Ocean Shores, Washington, 25 September.

Kmiecik N. 2006. Fish Consumption  Rates of Select Anishinaabe Tribal
Members. Presented at the  Eighth International Conference  on Mercury
as a Global Pollutant, Madison, Wisconsin, 8 August.

Kmiecik N. 2006. Mercury as a Global Pollutant. Presented at the Eighth
International Conference on Mercury as a Global Pollutant, Madison,
Wisconsin, 8 August.

Kmiecik N. 2006. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented at the Boys and Girls Club Meeting of the  Lac Courte
Oreilles Tribe, Hayward, Wisconsin, 20 July.

Kmiecik N. 2006. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented at the Bad  River  Community Meeting, Odanah,
Wisconsin, 5 June.

Kmiecik N. 2006. Mercury, Chippewa Flowage Mercury Concentrations,
and Great Lakes Indian Fish and Wildlife Fish Advisory Program.
Presented at Lac Courte Oreilles Ojibwe Community College, Hayward,
Wisconsin, 24 April.

Kmiecik N. 2006. Reducing Health Risks to the Anishinaabe From
Methyl Mercury. Presented at the Bad River Spearer's Meeting, Odanah,
Wisconsin, 22 March.

Kmiecik N. 2006. Fish Consumption  Rates of Select Anishinaabe Tribal
Members. Presented at the  14th Annual Midwest Chapter Meeting of
Society of  Environmental Toxicology and Chemistry, St. Cloud, Minnesota,
21 March.

Kmiecik N. 2006. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented at the 14th Annual Midwest Chapter Meeting of the
Society of  Environmental Toxicology and Chemistry, St. Cloud, Minnesota,
21 March.

Kmiecik N. 2006. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented at the Great Lakes Native American Elders Meeting,
Oneida, Wisconsin, 3 February.
Kmiecik N. 2006. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented at the Foster Grandparents/Senior Companions
Meetings, Mole Lake Foster Reservation, Mole Lake, Wisconsin, 24
January.

Kmiecik N. 2006. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented at the Foster Grandparents/Senior Companions
Meeting, St. Croix Reservation, Webster, Wisconsin, 24 January.

Kmiecik N. 2006. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented at the Foster Grandparents/Senior Companions
Meeting, Lac Courte  Oreilles Reservation, Hayward, Wisconsin, 18
January.

Kmiecik N. 2006. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented at the Foster Grandparents/Senior Companions
Meeting, Red Cliff Reservation, Red Cliff, Wisconsin, 17 January.

Kmiecik N. 2006. Reducing Health Risks to the Anishinaabe From Methyl
Mercury. Presented at the Foster Grandparents/Senior Companions
Meeting, Bad River Reservation, Odanah, Wisconsin, 17 January.

Kmiecik N. 2006. Updated Geographic Information System Maps,
Including Walleye Advice and the STAR Grant. Presented at the  Bad River
Community Meeting, Odanah, Wisconsin.

Kmiecik N. 2006. Updated Geographic Information System Maps,
Including Walleye Advice and the STAR Grant. Presented at the  Great
Lakes Native American Elders Meeting, Oneida, Wisconsin.

Kmiecik N. 2005. STAR Grant Project Progress. Presented at the
Environmental Justice/Community-Based Participatory Research and
Tribal Research Programs Annual Grantee Meeting, Talkeetna, Alaska,
19-22 September.

Kmiecik N. 2005. Updated Geographic Information System Maps,
Including Walleye Advice and the STAR Grant. Presented at the  U.S.
Environmental Protection Agency Fish  Forum, Baltimore, Maryland,  18-21
September.

Kmiecik N. 2005. Updated Geographic Information System Maps,
Including Walleye Advice and the STAR Grant. Presented at the American
Fisheries Society 135th Annual  Meeting, Anchorage, Alaska, 10-15
September.

Kmiecik N. 2005. Updated Geographic Information System Maps,
Including Walleye Advice and the STAR Grant. Presented at the  Great
Lakes Indian Fish and Wildlife All Staff Meeting, Odanah, Wisconsin.

Kmiecik N. 2005. Updated Geographic Information System Maps,
Including Walleye Advice and the STAR Grant. Presented at the  Great
Lakes Indian Fish and Wildlife Board of Commissioners Meeting, Lac du
Flambeau, Wisconsin.
                                                                                A Decade of Tribal Environmental Health Research:  Results and Impacts from EPA's Extramural Grants and Fellowship Programs

-------
Appendix B: Outputs From Tribal Environmental Health Research Program STAR Grants
Kmiecik N. 2005. Updated Geographic Information System Maps,
Including Walleye Advice and the STAR Grant. Presented at the Bad River
Spearer's Meeting, Odanah, Wisconsin.

Kmiecik N. 2005. Updated Geographic Information System Maps,
Including Walleye Advice and the STAR Grant. Presented at the Mole
Lake Spearer's Meeting, Mole Lake, Wisconsin.

Kmiecik N. 2005. Updated Geographic Information System Maps,
Including Walleye Advice and the STAR Grant. Presented at the Voigt
Intertribal Task Force Meeting, Lac du Flambeau, Wisconsin.

Kmiecik N. 2005. Updated Geographic Information System Maps,
Including Walleye Advice and the STAR Grant. Presented at the Honor
Our Children and Maternal Child Health Staff Meeting, Lac du Flambeau,
Wisconsin.

Kmiecik N. 2005. Updated Geographic Information System Maps,
Including Walleye Advice and the STAR Grant. Presented at the
Consolidated  Childhood Programs Staff Meeting, Hayward, Wisconsin.

Kmiecik N. 2005. Updated Geographic Information System Maps,
Including Walleye Advice and the STAR Grant. Presented at the Midwest
Environmental Advocates Forum, Lac du Flambeau, Wisconsin.

Kmiecik N. 2004. Great Lakes Indian Fish  and Wildlife Fish Advisory
Program and  STAR Grant Plans. Presented at the Wisconsin
Environmental Health Conference, Wisconsin, October.

Kmiecik N. 2004. Great Lakes Indian Fish  and Wildlife Fish Advisory
Program and  STAR Grant Plans. Presented at the Great Lakes Consortium
State-National Fish Consumption Advisory Workshop.

Lefthand MJ,  Eggers MJ, Old Coyote TJ, Doyle JT, Kindness L, Bear Don't
Walk UJ, Young SL, Bends AL, Good  Luck B, Stewart R, Leider A, White
Clay S, Dietrich E, Ford TE, and Camper AK. 2012. Holistic Community
Based Risk Assessment of Exposure to Contaminants via Water Sources.
Presented at the 140th American Public Health Association Annual
Meeting and  Exposition, San Francisco, California, 27-31  October.

Lila MA. 2013. Stressed for Success: Why Plants from Arctic Extremes are
Extremely Health-Protective. Presented  at the Alaska Plants as Food and
Medicine Symposium, Girdwood, Alaska, May.

Lila MA. 2013. The Science and the Traditional Knowledge Behind Halth-
Protective Plant Foods. Presented at the Washington State University
Molecular Plant Sciences  Seminar, Pullman, Washington, April.

Lila MA. 2013. Culturally Acceptable Strategies for  Boosting Protein and
Phytoactive Delivery  in Rural Villages. Seminar presented at the University
of Alaska Fairbanks,  Fairbanks, Alaska,  March.
Lila MA. 2013. Stressed for Success: Berry Wild Origins' Impact on
Health-Relevant Properties. Seminar presented at the University of Alaska
Fairbanks, Fairbanks, Alaska, March.

Lila MA. 2012. Stressed for Success: How the Berry's Wild Origins Result
in Multifaceted Health  Protections.  Presented at the 10th  International
Symposium on Vaccinium and Other Superfruits, in conjunction with
ISHS-IFU, MECC Maastricht, The Netherlands, 17-22 June.

Lila MA. 2012. Capitalizing on the  Health Benefits of Berryfruits: Science
Versus the Marketplace. Presented  at BiotechFruit 2012, Nelson, South
Island, New Zealand, 20 March.

Lila MA. 2012. Berry Health Benefits. Presented at the Swedish University
of Agricultural Sciences (SLU) Symposium—Bioactive Components in
Plant  Foods, Uppsala, Sweden, 15-16 March.

Lila MA. 2011. Stressed for Success: Berry Crops, Environmental Stress,
and Human  Health Benefits. Keynote  presentation at the North American
Raspberry and Blackberry Association Conference,  Savannah, Georgia,
5-7 January.

Lila MA. 2011. Berryfruits and Human Health:The Chemistry Behind the
Bioactivity. Presented at the American Chemical  Society (North Carolina
Section) North Carolina Research Campus Meeting, Kannapolis, North
Carolina.

Lila MA. 2011. Environmental Stress, Wild Berry Fruits, and Human Health
Benefits. Presented at the University of Alaska  Fairbanks Department of
Neurosciences Summer Seminar Series, Fairbanks, Alaska.

Lila MA. 2009. Alaska Tribal Berry Resources and Human  Health Under
the Cloud of Climate Change. Presented at the Promoting Environmental
Health in Native American Communities Webinar Series, 14  October.

Lila MA. 2009. Berry Resources and Human Health....Under the Cloud
of Climate Change. Presented at the  International Berry Health Benefits
Symposium, Monterey, California, 22-23 June.

Lila MA and  Ferguson  G. 2011 .The Store Outside Your Door: Research
Supporting Berries as a Valuable Traditional Food Resource in Diabetes
Prevention. Presented at the Annual Alaska Native Diabetes Conference,
Anchorage, Alaska, 30  November-December 2.

Lila MA, Kellogg J, Flint C, and Raskin 1.2010. Arctic Berries: Stressed
for Success.  Presented at the Seventh Natural Health Product Research
Conference: The Next Wave, Halifax, Nova Scotia, Canada, 24 May.

McCormick AKHG, Pease B, Lefthand MJ, Eggers  MJ, McClearyT, Felicia
D, and Camper AK. 2012. Water, A  Resource for Health: Understanding
Impacts of Water Contamination in a Native American Community.
Roundtable presentation at the  140th American Public Health
Association Annual Meeting and Exposition, San Francisco,  California,
27-31 October.
Miller PK, Carpenter DO, Eckstein L, Wellfinger-Smith G, and Waghiyi V
2010. Contaminants in the Traditional Foods of the Yupik People of St.
Lawrence Island, Alaska—Exposure Pathways, Collaborative Interventions,
and Prevention. Presented at the Strengthening Environmental Justice
Research and Decision Making: A Symposium on the  Science of
Disproportionate Environmental Health Impacts, Washington DC, 17-19
March.

Miller PK, Carpenter DO, Eckstein L, Wellfinger-Smith G, and Waghiyi V
2009. Environmental Contaminants in Foodstuffs  of Siberian Yu'piks from
St. Lawrence Island, Alaska. Presented at the 15th Annual Alaska Tribal
Conference for Environmental  Management, Anchorage, Alaska,  16-20
November.

Miller PK, Carpenter DO, Eckstein L, Wellfinger-Smith G, and Waghiyi V
2009. Environmental Contaminants in Foodstuffs  of Siberian Yu'piks
from St. Lawrence Island, Alaska. Presented  at the University of Alaska
Community-Based Research Institute, Nome, Alaska, July.

Miller PK, Carpenter DO, Eckstein L, Wellfinger-Smith G, and Waghiyi V
2009. Environmental Contaminants in Foodstuffs  of Siberian Yu'piks
from St. Lawrence Island, Alaska. Presented  at the Arctic Monitoring and
Assessment Programme and Northern Contaminants Programme Human
Health and Arctic Environmental Contaminants Conference, Iqaluit,
Nunavut, Canada, 10-12 June.

Miller PK, Carpenter DO, Eckstein L, Wellfinger-Smith G, and Waghiyi V
2009. Environmental Contaminants in Foodstuffs  of Siberian Yu'piks
from St. Lawrence Island, Alaska. Presented  at the Fourth Meeting of the
Conference of the Parties of the Stockholm  Convention  on  Persistent
Organic Pollutants, Geneva, Switzerland, 4-8 May.

Miller PK, Carpenter DO, Eckstein L, Wellfinger-Smith G, and Waghiyi V
2009. Environmental Contaminants in Foodstuffs  of Siberian Yu'piks from
St. Lawrence Island, Alaska. Presented at the American Association for
the Advancement of Science Meeting, Chicago, Illinois, 12-16 February.

Miller PK, Carpenter DO, Eckstein L, Wellfinger-Smith G, and Waghiyi V
2009. Environmental Contaminants in Foodstuffs  of Siberian Yu'piks
from St. Lawrence Island, Alaska. Presented  at the Alaska Forum on the
Environment, Anchorage, Alaska, 2-6  February.

Miller PK, Carpenter DO, Eckstein L, Wellfinger-Smith G, and Waghiyi V
2009. Environmental Contaminants in Foodstuffs  of Siberian Yu'piks from
St. Lawrence Island, Alaska. Presented at the Kawerak  Regional Health
Conference, Nome, Alaska, February.

Miller PK, Carpenter DO, Eckstein L, Wellfinger-Smith G, and Waghiyi V
2008. Environmental Contaminants in Foodstuffs  of Siberian Yu'piks
from St. Lawrence Island, Alaska. Presented  at the 2008 Joint Annual
Conference of the International Society for Environmental Epidemiology
and the International Society of Exposure Analysis, Pasadena, California,
12-16 October.
A Decade of Tribal Environmental Health  Research:  Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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                                                                                                                            Appendix B: Outputs From Tribal Environmental Health Research Program STAR Grants
Miller PK, Carpenter DO, Eckstein L, Wellfinger-Smith G, and Waghiyi V.
2006. Environmental Contaminants  in Foodstuffs of Siberian Yu'piks
from St. Lawrence Island, Alaska. Presented at the National Tribal Forum
on Environmental Science, Quinault Indian Nation, Ocean Shores,
Washington, 24-28 September.

Moore-Nail A and Eggers MJ. 2012. Elevated Uranium and Lead  in
Wells on the Crow Reservation, Big  Horn County—A Potential Problem.
Presented at the 2012 Geological Society of America Annual Meeting
and Exposition, Charlotte, North Carolina, 4-7 November.

Moore-Nail A and Eggers MJ. 2012. Elevated Uranium and Lead  in
Wells on the Crow Reservation, Big  Horn County—A Potential Problem.
Presented at the 2012 Annual Meeting of the Montana Section of the
American Water Resources Association, Butte, Montana, 11-12 October.

Moore-Nail A, Eggers MJ, Camper AK, and Lageson D. 2013.
Elevated Uranium and  Lead in Wells on  the Crow Reservation, Big
Horn County—A Potential  Problem.  Presented at the Earth Science
Colloquium,  Bozeman, Montana, 12-13 April.

Ramirez N and Steinberg SJ. 2010.  Modeling Ecotoxicological Stressors
Using Geographic Information Systems. Presented at Humboldt State
University, Arcata, California.

Ranco D and Borsuk M.201 l.The Clean Air  Mercury Rule and Indian
Tribes: Consultation, Subsistence, and  Cost-Benefit Analysis. Presented at
the College of the Holy Cross, Worcester, Massachusetts,  1  March.

Ranco D and Borsuk M. 2010.The Clean Air  Mercury Rule and Indian
Tribes: Sovereignty, Subsistence, and Participation. Presented at Bates
College, Lewiston, Maine, 17  November.

Reynolds III JE and O'Hara TM. 2004.  Goals and Objectives of the
Risks to Northern Alaskan  Inupiat: Assessing Potential  Effects of Oil
Contamination on Subsistence Lifestyles, Health, and Nutrition Project.
Presented to the City of Wainwright, Alaska, July.

Reynolds III JE and Wetzel  DL. 2005. Bowhead Whales, Bearded  Seals,
and Alaska Native Health.  Invited presentation to the Alaska Forum on
the Environment, Anchorage, Alaska, 7-11 February.

Reynolds III JE and Wetzel  DL. 2005. Bowhead Whales, Bearded  Seals,
and Alaska Native Health.  Invited presentation to the Barrow Arctic
Science Consortium's Outreach Series, Inupiat Heritage Center, Barrow,
Alaska, February.
Reynolds III JE, Wetzel DL, Hanns C, Mercuric P, and O'Hara TM. 2005.
Analyses of Polycyclic Aromatic Hydrocarbons in Sediments, Fish and
Marine Mammals From the North Slope of Alaska. Presented at the
International Symposium on Oil and Gas Activities in the Arctic, St.
Petersburg, Russia, 13-15 September.

Richards C, Eggers M, Pyle  B, Camper A, and Ford T. 2009. Detection of
Opportunistic Pathogens in Drinking Water and Associated Biofilms in
Rural Montana. Poster presented at the Eurobiofilms Conference, Rome,
Italy, 2-5 September.

Sepez J. 2003. Anthropological and Historical Contexts of Makah
Whaling. Invited lecture presented at the GreenLAW Environmental Law
Lecture  Series, University of Washington Law School, Seattle, Washington.

Sepez, J. 2002. Makah Whaling and Sealing Into the Twenty-First
Century. Invited  lecture  presented at the University of Washington
Sociocultural Anthropology  Colloquium  Series: Indigenous Rights,
Indigenous Resources, Indigenous Futures, Seattle, Washington, 18
November.

Sepez J. 2002. If Middens Could Talk: Comparing Ancient, Historic,
and Contemporary Makah Foraging Patterns. Presented at the  Ninth
International Conference on Hunting and Gathering Societies, Edinburgh,
Scotland, 12 September.

Sepez J. 2000. The Right to Culture in  International Wildlife
Management. Presented at the Society  For Applied Anthropology
Conference, San  Francisco, California, 25 March.

Sloan K. 2012. Preliminary  Findings of  Pacific Lamprey Tissue Testing.
Presented at the South  Coast  Lamprey  Summit, North Bend, Oregon,
22-24  May.

Sloan K and Fluharty S. 2012. Cumulative Risk and Yurok Tribal  Lifeway.
Presented at the U.S. EPA STAR Tribal  Environmental Health Research
Program Webinar, November 7.

Sloan K and Fluharty S. 2011 .Yurok Tribe Environmental Justice and
Climate  Change Prioritization Project. Presented at the  19th Annual
Region 9 Tribal EPA Conference, Pala, California, 20 October.

Sloan K and Fluharty S. 2010. Understanding the Cumulative Effects of
Environmental and Psycho-Social Stressors That Threaten the Pohlik-lah
and Ner-er-ner Lifeway: The Yurok Tribe's Approach. Presented at the
2010 National Tribal Science Forum,Traverse City, Michigan, 7  June.
Uesugi S, Harding A, Harper B, Harris S, Schure M, Kile M, and Coins
T. 2012. Environment and Health Connections: Perspectives From
Community Members of the Confederated Tribes of the Umatilla Indian
Reservation. Poster  presented at the 25th Annual Meeting of the
Superfund Research Program, Raleigh, North Carolina, 21-24 October.

Uesugi S, Harding A, Harris S, Harper B, Simonich S.Anderson K, Stone D,
Jia Y, Hirsch  N, Cardenas A, and Sudakin D.  2011. Walking in Two Worlds:
Tribal-University Partnerships, Capacity Building, Technology Transfer, and
Developing Cultural Sensitivity in Toxicology and Environmental Health
Research.  Presented at  Pacific Northwest Association of Toxicologists
Annual Regional Chapter Meeting: The Art and Science of Research
Translation in Toxicology, North  Bonneville, Washington, 7 October.

Wetzel DL and Reynolds III JE. 2007. Bowhead Whales and Bearded
Seals  of Alaska's North  Slope: Contaminant  Analysis and  Nutritional
Assessment. Presented to the citizens of Barrow, Alaska, at the Inupiat
Heritage Museum, Barrows, Alaska, October.

Wetzel DL and Reynolds III JE. 2007. Bowhead Whales and Bearded
Seals  of Alaska's North  Slope: Contaminant  Analysis and  Nutritional
Assessment. Presented to the Tribal  Council leaders in the Native Village
of Wainwright, Alaska, October.

Wetzel DL, Reynolds III JE,  Hanns  C, and Mercuric P. 2006. Analysis of
Polycyclic Aromatic Hydrocarbons in Marine Mammals From the North
Slope of Alaska. Presented  at the  National Forum on Tribal Environmental
Science, Quinault Indian Nation, Ocean Shores, Washington, 24-28
September.

Young SL (moderator), Lefthand MJ, Good Luck BT, Kindness L, Stewart
R, Doyle JT, McCormick  AKHG. 2013. Finding Answers in  Contrary
Lessons. Presented  at the National EPA-Tribal Science Council Traditional
Ecological Knowledge Pre-Workshop Webinar Series Traditional
Ecological Knowledge Webinar #2,28 May.
                                                                                 A Decade of Tribal Environmental Health Research:  Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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Appendix C-. Outputs From Tribal Environmental Health Research Program STAR Grants
Appendix C:  Tribal Environmental Health
Research Program Presentations
Staff members from EPA's Tribal Environmental Health Research Program have given a number of presentations about the research conducted within the program at national and international  meetings. A representative list of
these presentations is provided below.
Breville M. 2011. NCER Tribal Programs: An Overview. Presented to the
EPA Office of International and Tribal Affairs, Washington, DC, 3 August.

Breville M. 2011. NCER Tribal Programs: An Overview. Presentation
provided to the National EPA-Tribal Science Council, June.

Breville M. 2010. NCER Tribal Environmental Health Overview. Presented
at the 20th Annual International Society of Exposure Science Conference
(joint with International Society for Environmental Epidemiology), Seoul,
Korea, 30 August.

Breville M. 2010. Tribal Environmental Health  Research Program Grants.
Presented at the Tribal Environmental Health  RFA Strategy Session, 2010
National Tribal Science Forum,Traverse  City, Michigan, 9 June.
Breville M.2010. NCER Tribal Environmental Health Overview. Presented
at the 2010 National Tribal Science Forum, Traverse City, Michigan, 7
June.

Breville M. 2009. Educational Opportunities at EPA's National Center
for Environmental Research. Presented at the Fifth  Biennial National
Association of Fellowships Advisors Conference, Seattle, Washington, 16
July.

McOliver C, O'Fallon L, and Finn S. 2013. Role of Federal Funding of
Environmental Research  in Building Capacity in Indigenous  Communities.
Poster presented during the Creating Healthy Native Communities-
Infrastructure, Capacity, and Equality in Indigenous Public Health
Endeavors Poster Session at the American  Public  Health Association
141st Annual Meeting and Exposition, Boston, Massachusetts, 3
November.
McOliver C. 2012.Tribal Science: NCER STAR Program. Presented to EPA's
NCER, Washington, DC, 1 November.

McOliver C. 2012.Tribal Science: NCER STAR Program. Presented
at the EPA Office of International and Tribal Affairs American Indian
Environmental Office Tribal  ecoAmbassadors Meeting, Washington, DC,
October.

McOliver C. 2012.Tribal Science: NCER STAR Program. Presented to the
EPA Office of International and Tribal Affairs, Washington, DC, Washington,
DC, 5 September.
A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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                                                                        Appendix D-. Overview of Tribal Environmental Health Research Program Grantee Webinars
Appendix D: Overview of Tribal
Environmental Health Research
Program Grantee Webinars
In 2009,  the Tribal Environmental Health Research
Program,  in coordination with the National EPA-
Tribal Science Council, sponsored a series of webinars
highlighting Science To Achieve Results (STAR)
research focused on tribal environmental health and
exposure concerns. Another series was held during the
fall of 2012. This appendix provides an overview
of the 2009 webinars and information about the
2012 webinars.
 Promoting Environmental  Health
 in Native American Communities:
 A webinar Series Addressing the Environmental
Health and Exposure Concerns of North American
        Native Subsistence Populations
                                                                          &ER&
                  United States
                  Environmental Protection
                  Agency
                                                                                       Sponsored by the
                                                                     EPA's STAR Research Grants Program and the National EPA-Tribal Science Council
                                                                       with additional support from EPA Office of Children's Health Protection and
                                                                         Environmental Education and the Human Health Research Program
                                               A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

-------
Appendix D-. Overview of Tribal Environmental Health Research Program  Grantee  Webinars
                       United States
                       Environmental Protection
                       Agency
                                Executive  Summary
     The Environmental Protection Agency's (EPA) STAR
     Research Grants Program, in partnership with the National
     EPA-Tribal Science Council, conducted a webinar series
     designed to translate and disseminate recent findings of
     previous and current STAR-funded research addressing
     the environmental health and exposure concerns of North
     American Native subsistence populations. Additional
     support for the project was provided by the EPA Office of
     Children's Health Protection and Environmental Education
     and the Human Health Research Program.

     The series highlighted research goals and preliminary
     findings of newly awarded projects focused on cumulative
     risk and climate change. These projects may particularly
     appeal to those interested in novel risk assessment methods
     or the potential direct and indirect impacts of global
     warming on the health outcomes to Alaska Natives. The
     results discussed in these webinars may be of particular
     interest to Agency risk assessors, Tribal environmental
     managers, and Tribal health care practitioners.

     The series consisted of four webinars conducted from
     June 30, 2009 to December 10, 2009:

                  "Eco-social Cultural Mapping: Tribal
                  Lifestyles and Environmental Risks,"
                  June 30, 2009.
                  "Alaska Tribal Berry Resources and
                  Human Health Under the Cloud of
                  Climate Change," October 14, 2009.


                  "Community-Based Risk Assessment
                  of Exposure to Contaminants via Water
                  Sources on the Crow Reservation in
                  Montana," November 18, 2009.

                  "Climate Change and Contaminants
                  in Subsistence Foods: A Tribal Program
                  to Monitor the Health of Alaska
                  Yupik Women and Children,"
                  December 10,2009.
Overview of the Research
Many traditional North American Native Tribal Populations
maintain intricate and ecologically interdependent
relationships with the natural environment. Though many
of these relationships developed over centuries, with
knowledge and skills accumulated and passed across scores
of generations, the rapid emergence of industrial chemical
pollution; the availability of refined, processed foods; and
social and political isolation have severely threatened the
health, wellness, and way of life of individuals and entire
Tribal communities in the United States.

Recently, there has been increased emphasis on
encouraging traditional diets, religious practices, and
customs to restore and protect the health and knowledge
base of Tribal  communities,  while concomitantly
addressing issues of environmental pollution, social
justice, and sovereignty. This seminar series featured
Tribal communities and their research partners conducting
dietary exposure, cumulative risk, climate change health
effects, and risk reduction research that aimed to quantify
and reduce environmental risks and to encourage or restore
traditional, healthy ways of life for American Native
communities.

Specific objectives of the Webinar Series included:

1.  Understanding and reviewing research findings.

2.  Exploring new strategies, methods, and tools for
   assessing environmental  health exposure among
   Tribal populations.

3.  Identifying research opportunities for advancing
   health protection and maintaining traditional
   Tribal ways of life.

The following pages provide one-page summaries of
each webinar.  To read a complete summary or to view the
webinars, visit I-         -".pa.gov/osp/tribes/events.htm.
                                                                                  United States
                                                                                  Environmental Protection
                                                                                  Agency
                                                                                                                                                                  Webinar Series
        Promoting Environmental  Health  in
              Native American  Communities

                Eco-social Cultural Mapping: Tribal Lifestyles and Environmental Risks —
          Regional Tribal Exposure Scenarios Based on Ecological Zones and Traditional Lifeways
           Barbara Harper,1'2 Anna Harding,1 Therese Waterhous,1 Anthony Wilcox,1 and Stuart Harris2
                                             June 30, 2009
                   This project systematically described
                   how Tribal people interact with
                   the environment and how they
                   might be exposed to environmental
                   contaminants. The initial driver was
                   the lack of exposure scenarios and
                   exposure factors for use in Superfund
                   risk assessments where Tribes and
                   Tribal resources are affected.
Tribal communities engage in active, outdoor lifestyles in
all climates, with greater environmental contact rates in
comparison to members of the suburban community. Diets
of each Tribe are based on the natural resources present and
the unique cultural uses. Consequently, most Tribal exposure
factors are higher than EPA default rates.

Exposures occur through food and medicine intake as well
as through cultural, ceremonial, and occupational practices
of Tribal members. Data were taken in consideration of the
whole-life scenario—that is, data from full-time residents, not
those with recreational status—and analyses were conducted
assuming nutritionally complete diets for accurate statistical
plotting.

Researchers operated under the basic concepts of ecology,
cultural quality of life, a broader definition of health,
contemporary suppression of resource use, and reconstruction
of traditional lifeways. Researchers considered the
biodiversity, landscapes, critical habitat, and human use of
the local  environment to determine food chain concentrations
and socio-cultural exposures for evaluating eco-risk to the
population.

The researchers recognized that contemporary suppression
of resource use would have to be considered when collecting
data. Local fish advisories, contaminated sites, and rights
of access issues could restrict  use and consumption and
associated exposures, so real-time subsistence lifestyles and
diets were measured for risk assessment. The outcomes would
help target restoration efforts of the natural resources.
To reconstruct traditional lifeways and natural resources,
researchers conducted culturally competent interviews and
reviewed anthropological literature that included traditional
ecological knowledge, physiology, culture, ecology, ethno-
botany, language and oral tradition, and exposure science.
Major food groups were used to categorize caloric intake,
and consumption and exposure rates were estimated based
on cultural activities. This holistic overview approach to data
collection was used, versus simple food consumption surveys
to attain precise and accurate study results, and these multiple
lines of evidence were peer-reviewed for a more robust and
confident conclusion.

This research was conducted solely for the benefit of the
Tribe, so it was critical to ensure their willing participation.
An advisory board consisting of Tribal and technical members
ensured that the communities were involved, informed
(informed consent) and in control of the data (intellectual
property). True informed consent was obtained after members
were apprised of how the data would be used and potential
misuse of the data was explained fully.
1 Oregon State University
2 Confederated Tribes of the Umatilla Indian Reservatior

To read a complete summary or to
view and/or listen to the webinar, visit
http://www.epa.gov/osp/tribes/events.htm.
A  Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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                                                                                                                             Appendix D-. Overview of Tribal Environmental Health Research Program Grantee  Webinars
   wEFA
United States
Environmental Protection
Agency
                                       Webinar Series
        Promoting  Environmental  Health  in
             Native American  Communities

          Alaska Tribal Berry Resources and Human Health Under the Cloud of Climate Change
                   Mary Ann Lila, Ph.D.,1 Courtney G. Flint, Ph.D.,2 Gary Ferguson, N.D.3
                                          October 14, 2009
                  This project investigated the potential
                  health and medical benefits of
                  wild berries to Alaska Natives in
                  three coastal communities. Wild
                  Alaska Berries (salmonberries, bog
                  blueberries, blue huckleberries, and
                  blackberries/crowberries/mossberries)
                  are a rich part of many Alaska Native
                  people's Tribal resources, and they
produce beneficial biological compounds in response to the
stresses they undergo during growth in the harsh climate. The
research team worked with students and community members
to look at the role berries play in the lives, lifestyle, and
culture of Native Americans in each community.

The participating communities—Seldova, Akutan,  and Point
Hope—are located along three distinctive coastal areas of
Alaska. Each one has a complement of berries keyed to the
                                 Field screening of the berries was conducted under the
                                 Screens-to-Nature (STN) program to measure health benefits
                                 and help students and elders learn first-hand how the
                                 chemistry of wild berries makes them healthy for humans.
                                 The STN technology tested for amylases and amylase
                                 inhibitors; proteases and protease inhibitors; and antioxidants.
                                 Scientific analyses of the berries indicated that the amylase-
                                 inhibiting activity of berries slows down the process of
                                 turning starch into sugar (i.e., it has an important impact
                                 on diabetes); berries contain varying levels of antioxidants;
                                 and protease inhibitors in berries may help fight HIV/AIDS,
                                 parasitic diseases, and metabolic disorders.

                                 Alaska Natives were engaged to assess their overall opinions
                                 and perspectives on their communities, including the risks
                                 and challenges they face from climate change, environmental
                                 contamination, threats to subsistence resources,  as well as
                                 their concerns about their health and the vitality of their local
health and economic benefits of the community. Berries are
important for food, physical activity, sharing with family
and friends, and keeping traditions alive. They are eaten in a
variety of ways and stored for winter. Berries generally are
considered healthy, but specific benefits are not very well
known in the communities. Berries produced under stress
offer enhanced health benefits to humans.

The project was conducted within a Community Based
Participatory Research (CBPR) framework. CBPR involves
collaboration that equitably includes community members,
organizational representatives, and researchers in the project.
The research team combined biological and social sciences,
community participation, and integrated inquiry.
                                 economies. Each community has concerns about diabetes,
                                 cancer, and unhealthy diets.
                                 In all three communities, Tribal health issues were linked to
                                 the loss of a traditional way of life and a decreased emphasis
                                 on subsistence resources and foods. Many factors prevent
                                 the subsistence lifestyle. The influence of Western culture on
                                 Alaska Native youth and the high cost of fuel are also altering
                                 the cultural landscape.
                                 -1 Alaska Native Tribal Health Consortium

                                 To read a complete summary or to
                                 view and/or listen to the webinar, visit
                                 http://www.epa.gov/osp/tribes/events.htm.
                 United States
                 Environmental Protection
                 Agency
                                                                                                                                     Webinar Series
        Promoting  Environmental  Health  in

             Native American  Communities

                    Community Based Risk Assessment of Exposure to Contaminants
                        via Water Sources on the Crow Reservation in Montana
                        Crescentia Cummins,1'2Timothy Ford, Ph.D.,3 John Doyle,2'4'5
                        Larry Kindness,1'2'4 Urban Bear Don't Walk,2'4'6 Mari Eggers1-7
                                        November 18, 2009
                 This research project developed a risk
                 assessment program focusing on the
                 contamination of water sources on
                 the Crow Reservation in Montana.
                 Water, wastewater, and aquatic
                 subsistence foods were collected and
                 analyzed, and contamination from
                 toxic substances in drinking water
and surface water sources were evaluated. These data are
being combined with an investigation into contemporary and
traditional uses of water in the Crow community.

LifeLine Tribal risk assessment modeling software will
be used to assess the overall risks to the community from
contaminated water sources. Potential outcomes from this
research include a better understanding of the environmental
risks of water sources associated with a subsistence-based
lifestyle of Tribal populations. Also, through community-
based participation, this research may help improve Tribal
capacity to manage and protect environment and health
through health education and other risk communication
measures.

The Crow Indian Reservation, located in south-central
Montana, encompasses 2.8 million acres and has a
population of about 8,000 people. Although much of the
Reservation is rangeland, it does include a significant
amount of agricultural land.

Water has  always been a treasured resource in the Crow
community, and traditions and history surrounding water
are still honored and practiced today. Rivers and springs
continue to be used in many ceremonial practices and
recreational purposes, including in  the Native American
Church, the Sun Dance, and Sweat Lodge ceremonies.
However, water quality on the Reservation has deteriorated
over the past 50 years, and, today, degradation of water
quality is the community's top environmental health
concern.
This research project employed a Community-Based
Participatory Research (CBPR) model, which is defined
as " [a] collaborative approach to research that equitably
involves, for example, community members, organizational
representatives, and researchers in all aspects of the research
process."

The data from this project has helped the Apsaalooke Water
and Wastewater Authority move into the next phase of its
work, replacing wastewater lagoons and repairing water lines.
The Authority is in the process of raising funds for Phase 3,
which will include funds for drilling new drinking water wells
and expansion of Little Big Horn College's health education
facility.
'Little Big Horn College
2 Crow Tribal member
^University of New England
"Apsaalooke Water and Wastewater Authority; Crow Environmental Health
 Steering Committee
                                                                                                                                                            the
                                                                                                                                                                 To read a complete summary or to view and/or listen to the
                                                                                                                                                                 webinar, visit http://www.epa.gov/osp/tribes/events.htm.
                                                                                 A Decade of Tribal  Environmental Health  Research:  Results and Impacts  from EPA's Extramural Grants and Fellowship Programs

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Appendix D-. Overview of Tribal Environmental Health Research Program Grantee Webinars
       &EPA
United States
Environmental Protection
Agency
                                         Webinar Series
           Promoting  Environmental  Health  in
                 Native American  Communities

                 Climate Change and Contaminants in Subsistence Foods: A Tribal Program to
                          Monitor the Health of Alaska Yupik Women and Children
                                         James E. Berner, M.D.1
                                          December 10, 2009
                 Dr. James E. Berner directs the
                 Alaska Native Traditional Food Safety
              _  Monitoring Program, which assesses
    JH      I  contaminant and micronutrient levels
         1^     in pregnant Alaska Native women and
                 evaluates health effects in mothers
                 and newborn infants. In this webinar,
                 Dr. Berner describes the climate
                 changes taking place in Alaska and
the contaminants these changes are bringing to Alaska. He
discusses the impacts climate change and contaminants are
having on the health of pregnant Alaska Yupik women and on
subsistence food safety.

Health impact mechanisms on the Native Alaska people
because of climate change and contaminants in the Arctic
include;
  The effect of contaminant transport on subsistence foods.
  The spread of zoonotic disease (diseases animals can give
  to people).
  Damage to permafrost-dependent infrastructure.
  Unintentional injury.
  Extreme weather events.

Subsistence food safety is essential to the Alaska Native
population in the following ways:
*  Rural Alaska Natives are the most subsistence dependent
  population in the United States.
•  Accumulation of organic contaminants in the food web
  biomagnifies and bioaccumulates, and the developing fetus
  and pregnant women are most sensitive to the toxicologic
  effects of contaminants and heavy metals.
•  Traditional food has public health and culture benefits.
•  Transport of contaminants by ocean, river, and atmospheric
  mechanisms may be increased by a warming climate.

Food safety issues surrounding contaminants include
persistent organic pollutants and heavy metals that are
present and threaten food safety, including mercury, lead,
arsenic, and cadmium.
                                                   This research attempted to discover the human toxicological
                                                   effects of climate change and contaminants in the Arctic on
                                                   subsistence food safety, including negative effects on Native
                                                   people in terms of growth, neurologic development; endocrine
                                                   disruption; immunologic effects; and adult chronic disease,
                                                   which might turn out to be the most common effect of all.

                                                   In a comparison of women in the Yukon-Kuskokwim Delta to
                                                   other populations along the Arctic coast, the blood levels of
                                                   persistent organic compounds in circumpolar pregnant women
                                                   were less than or about average for the group. However, the
                                                   Yupik population had substantially higher omega-3 fatty acid
                                                   levels than any other pregnant Inupiat women on Alaska's
                                                   Arctic Ocean coast, and future studies will consider the risk
                                                   and balance of these levels of fatty
                                                   acids in the diet of pregnant women.
                                                   1 Division of Community Health Services, Alaska
                                                   Native Tribal Health Consortium, Anchorage, AK
                                                   To read a complete summary or to view
                                                   the webinar, visit http://www.epa.gov/osp/tribes/events.htm.
                                                                                                                                               Or. Jim Berner
                                                                                                                             2007 Tribal Environmental Health Star Grantee

                                                                                                        A Conversation on Climate Change, POPs, Subsistence Food and Alaskan Communities
                                                                                        Bio: Dr, James E. Berner has practiced medicine in the Alaska Native health system since 1974, and
                                                                                        is certified in Internal Medicine and Pediatrics. He is the Senior Director for Science in the Division
                                                                                        of Community Health, of the Alaska Native Tribal  Health Consortium.

                                                                                        Research: Dr. Berner's current grant (R833705) focuses on the Yupik Alaskan Native (AN) residents
                                                                                        in the Yukon-Kuskokwim River Delta (YKD) of Southwestern Alaska. Salmon and seals are the
                                                                                        largest component of the subsistence diet for AN in the YKD and climate change has increased the
                                                                                        concentration  of POPs in these animals. Pregnant Yupik women have POPs levels similar to other
                                                                                        Arctic women, with higher toxaphene, brominated flame retardants (PBDEs) and Hg levels than
                                                                                        most other Arctic pregnant women. The goal of Dr. Berner's grant is to evaluate whether climate
                                                                                        change is affecting the health of the Yupik AN people through its impact on their subsistence
                                                                                        lifestyle.
A Decade of Tribal Environmental Health Research:  Results and Impacts from EPA's Extramural Grants and Fellowship Programs

-------
Appendix  E: Summary Tables of EPA Tribal  Research
Projects  Discussed  Within  the  Report
 STAR Grants Discussed in this Report and Funded Under the EPA Tribal  Environmental  Health Research Program (TEHRP)
         Project Title (Grant Number)
                        RFA Needs Addressed by Grant
   Principal
Investigator(s)/      Institution(s)
   Fellow(s)
 Issues in Tribal Environmental Research and Health Promotion: Novel Approaches for Assessing and Managing Cumulative Risks and Impacts of Global Climate Change (2007 RFA)
 An Epidemiologic Study ofTimeTrendsand Health
 Effects of Persistent Organic Pollutants, Mercury
 and Micronutrients (R833705)


 Community-Based Risk Assessment of Exposure
 to Contaminants via Water Sources on the Crow
 Reservation in Montana (R833706)


 Impacts of Climate Change on Health Benefits of
 a Tribal Alaskan Resource: Integrating Traditional
 Ecological Knowledge with Risk Assessment
 Through Local Monitoring (R833707)


 Understanding the Cumulative Effects of Environ-
 mental and Psycho-Social Stressors that Threaten
 the Pohlik-lah and Ner-er-ner Lifeway:The Yurok
 Tribe's Approach (R833708)
> Addressed tribal cumulative exposures^ multiple environmental stressor in rural Yupik
 Alaska Native people.
i Evaluated the affect of global climate change on contaminants in the Bering Sea to ad-
 dress impacts on the cultural and physical health on Yupik Alaska Native people.

i Provided a comprehensive assessment of tribal cumulative exposures of the Crow resi-
 dents from their water sources.
> Developed culturally appropriate risk communication specific to the Crow Nation to reduce
 subsistence-based risk.

' Provided a baseline assessment of sustenance berry bioactivity as influenced by global
 climate change and its impact on the cultural and physical health of three Alaska com-
 munities.
> Integrated this information with biophysical findings for informed local health-related
 decision-making to reduce subsistence-based risk.

' Collected and evaluated health data on the Yurok Tribe with a focus on health problems
 associated with tribal cumulative exposures^ target contaminants.
> Determined with the tribe how the findings could reduce subsistence-based risk and
 preserve Yurok subsistence resources.
 Lifestyle and Cultural Practices of Tribal Populations and Risks From Toxic Substances in the Environment (2002 RFA)
 Environmental Contaminants in Foodstuffs of
 Siberian Yupiks from St. Lawrence Island,Alaska
 (R831043)
 lakotisa'tstentsera:wis Ne Ohontsia: Reducing Risk
 by Restoring Relationships (R831044)
 Risks to Northern Alaskan Inupiat: Assessing Poten-
 tial Effects of Oil Contamination on Subsistence
 Lifestyles, Health and Nutrition (R831045)
 Lifestyle and Cultural Practices ofTribal Popula-
 tions and Risks From Toxic Substances in the
 Environment (R831046)
i Examined Yupik traditional foods and subsistence activities to determine food safety and
 ascertain the cumulative exposure profile of the tribe.
> Discussed the project implications with the Yupik in a culturally sensitive manner in an
 effort to reduce subsistence-based risk without compromising lifestyles to a significant
 extent because traditional foods are vital to Yupik well-being and culture.

> Developed educational and intervention materials for the Mohawk community that
 promote traditional cultural and subsistence practices to reduce subsistence-based risk
 without compromising lifestyles to a significant exten/while restoring healthy relation-
 ships with the natural world.
> Identified  culturally sensitive strategies^ decrease the health risk associated with expo-
 sure to persistent toxic substances and reduce subsistence-based risk.

• Analyzed Inupiat subsistence marine mammals to quantify subsistence-based exposures
 that occur primarily through food, cultural/ceremonial and occupational practices.
> Presented study information and outcomes to the Inupiat in a culturally sensitive manner
 in an effort to reduce risk in subsistence groups without compromising lifestyles to a
 significant extent.

' Prepared a set of regional traditional tribal subsistence exposure scenarios to reduce risk
 in subsistence groups without compromising lifestyles to a significant extent.
> Developed a culturally sensitive publication, the Tribal Exposure Scenario Guidance
 Manual.
James Berner
Timothy Ford
Mary Ann Lila
Kathleen Sloan
Pamela K. Miller
MaryArquette
Dana L.Wetzel
Barbara Harper
Alaska Native Tribal
Health Consortium
Montana State
University and
University of New
England

University of Illinois at
Urbana-Champaign
Yurok Tribe Environ-
mental Program
Alaska Community
Action on Toxics
Akwesasne Task Force
on the Environment/
Haudenosaunee
Environmental Task
Force
Mote Marine Labora-
tory
Oregon State
University
                            Project Period
June 1,2009through May31,
2013 (Extended to May 21,
2014)


June 1,2009, through May 31,
2012 (Extended to May 31,
2013)


January 1,2008, through
December 31,2011
July 1,2008, through Decem-
ber31,2012
December 1,2003, through
November 30,2006
April 1,2004,through March
31,2007
August 1,2003, through July
1,2006
August 1,2003 through July
31,2006
                                                                            A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

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Appendix E: Summary Tables of EPA Tribal Research Projects Discussed Within the Report
Summary of  Grants Discussed in This Report and Funded Under the  EPA Tribal Environmental Health  Research  Program  (TEHRP) continued
         Project Title (Grant Number)
                                                                      RFA Needs Addressed by Grant
 Reducing Risks of the Anishinaabe From Methyl
 Mercury (R831047)
                                             > Analyzed Anishinaabe walleye consumption data and collected walleye mercury data to
                                              quantify subsistence-based exposures and predict the cumulative exposure profile of
                                              the Anishinaabe.
                                             • Developed a culturally sensitive intervention program, including fish advisory maps, to  re-
                                              duce subsistence-based risks from consumption of methylmercury-contaminated walleye
                                              without compromising lifestyles to a significant extent.
Environmental Justice: Partnerships for Communication (2000 RFA)
Bioaccumulative Toxics in Native American Shell-    • Established effective input from an underserved community affected by an environmen-
fish (R829476)                                 tal tor/cant the Swinomish Indian Tribal Community, by administering a community survey
                                              and conducting individual interviews of tribal citizens.
                                             • Developed community-based, culturally sensitive educational materials, including a
                                              Swinomish traditional food book, coloring book, documentary and posters, to mitigate
                                              adverse health effects from environmental toxicants in the Swinomish community.
                                                                            Principal
                                                                         Investigator(s)/
                                                                            Fellow(s)
                                                                         Jeffrey Foran
                                                                                                                               Jamie Donatuto
                                   Institution(s)
                                Great Lakes Indian
                                Fish and Wildlife
                                Commission
                                                                                          Swinomish Tribal
                                                                                          Community
                                         Project Period
                                  July 1,2003, through June 30,
                                  2006 (Extended to October 31,
                                  2007)
                                                     March 15,2002, through
                                                     March 14,2006 (Extended to
                                                     August 28,2006)
Summary of  Non-TEHRP EPA-Funded Tribal  Projects Discussed in This Report
      Project Title (Grant Number)
 Tribal Environmental Public Health
 Indicators (R834791)

 Midwest Hazardous Substance Research
 Center (R828770)
 Space-Time Aquatic Resources Modeling
 and Analysis  Program (R829095)
 Rocky Mountain Training and Technical
 Assistance to Brownfields Communities
 Program (TR831579)

 Linking Traditional Knowledge and
 Environmental Policy in the Cherokee
 Nation of Oklahoma (F5C30541)

 Dine Bikeyah: Environment, Cultural
 Identity and Gender in Navajo Country
 (U915164)
 Makah Traditional Environmental
 Knowledge and Gray Whale Conservation
 (U914970)
 Use of Bone  Char for the Removal of
 Arsenic and Uranium from Groundwater
 at the Pine Ridge Reservation (SU834713
 and SU835069)
                                         Funding
                                         Program
                                       NCER STAR
                                       Grant

                                       STAR-Funded
                                       Center
                                       STAR-Funded
                                       Center
                                       STAR Training
                                       Grant
                                       STAR Graduate
                                       Fellowship
                 Request for Application
Exploring Linkages Between Health Outcomes and Environmental
Hazards, Exposures, and Interventions for Public Health Tracking
and Risk Management (2009 NCER RFA)
Hazardous  Substance Research Centers—HSRC (2001 NCER RFA)

Research Program on Statistical Survey Design and Analysis for
Aquatic Resources (2001 NCER RFA)
HSRC—TTAB Brownfields (2003 NCER RFA)
STAR Graduate Fellowships (2005)
                                       STAR Graduate  STAR Graduate Fellowships (1997)
                                       Fellowship

                                       STAR Graduate  STAR Graduate Fellowships (1996)
                                       Fellowship
    Principal
 Investigators)/                Institution(s)
    Fellow(s)
Jamie Donatuto     Swinomish Tribal Community
M. Katherine        Kansas State University (in partnership
Banks             with Haskell Indian Nations University)
N. Scott Urquhart    Colorado State University

Charles D.          Colorado State University and Montana
Shackelford and     Tech of the University of Montana (in
Karl Burgher        partnership with Aaniih Nakoda  College
                  [formerly Fort  Belknap College])
Clinton R. Carroll    University of California, Berkeley
                                                           Marsha L.Weisiger   University of Wisconsin-Madison
                                                           Jennifer Sepez      University of Washington
                                       P3
Phase I (SU834713): P3 Awards: A National Student Design
Competition for Sustainability Focusing on People, Prosperity and
the Planet (2010)

Phase II: (SU835069): P3 Awards: A National Student Design
Competition for Sustainability Focusing on People, Prosperity and
the Planet - Phase 2  (2011)
Charles J.Werth
(Faculty Advisor),
Jacob Becraft et
al. (Student Team)
University of Illinois at Urbana-Champaign
(in partnership with Oglala Lakota
College)
                                           Project Period
July 1,2011, through
June 30,2013

October 1, 2001, through
September 30, 2006
October 1, 2001, through
September 30, 2006
April  1,2004, through
March 30, 2007
(Extended to March 30,
2008)
September 1,2005,
through August 31,2007


September 1,1997,
through December 31,
2000
January 1,1996, through
August 16,1999

Phasel(SU834713):
August 15,2010, through
August 14,2011

Phase II: (SU835069):
August 15,2011, through
August 14,2013
A Decade of Tribal Environmental  Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

-------
Appendix F:  Practical  Applications of
EPA Tribal Research
It is important that AI/AN communities, the larger public, researchers,
health departments, practitioners, state and local regulators, and other
stakeholders understand how tribal research conducted within the STAR
Tribal Environmental Health Research  Program and other EPA initiatives
can provide them with  practical applications and tools, methods and
approaches that may be replicated in their own communities as they
confront real-world environmental  health issues.

Theme: Cultural Practices, Language and Traditional Ecological
       Knowledge

•  Understand and integrate the cultural aspects of the community into
   research and develop culturally relevant educational materials, such
   as a booklet on wild plant knowledge in the Cherokee language, to
   explain  risks and how to mitigate them  to more effectively reduce
   exposures of sensitive populations  as they engage in traditional
   practices.

Theme: Subsistence Foods and Water Resources

•  Utilize community-based research to develop wellness plans, such  as
   those being developed by the Alaska  Native Tribal  Health Consortium
   around  sustenance berry use, that  preserve traditional diets while
   managing risk and protecting public health.

•  Use quantitative data on contaminant levels, such as those used by
   the St. Lawrence Island Yupik people to  assess the contaminants in
   rendered oils and organ  meat that  are part of their traditional diet, to
   help communities avoid or reduce  the risks associated with traditional
   diets.
Theme: Community-Based Participatory Research and Community
       Outreach and Education

• Develop strong partnerships with the community and enlist community
  representatives to guide the research design and implementation, as
  was done for the research project on the Crow Reservation that was
  guided by the Crow Environmental Health Steering  Committee. This
  approach  ensures that the research  is informed by the local culture
  and relevant to the communities' needs, and ultimately, the results will
  be  more  readily accepted and used to protect community health and
  natural resources.

• Communicate research results to community members in a culturally
  sensitive  manner, as was done, for example, during the town council
  meetings of the Northern Alaskan Inupiat, and provide personal
  followup  in the native language, such as the in-home followup in the
  Crow language provided to Crow residents, to increase the community
  members' understanding of the results and how to use them to
  reduce their exposures to environmental contaminants.

Theme: Risk Assessment and Sensitive Populations

• Incorporate risk assessment methodologies to create exposure
  scenarios that can be applied at the national, regional and local
  levels, such as those detailed in the Traditional Tribal  Subsistence
  Exposure Scenario and  Risk Assessment Guidance  Manual, ultimately
  helping sensitive populations  to reduce exposures and protect
  community and  environmental health.

• Use the knowledge obtained from environmental public health
  indicators that are reflective of communities' health views and
  priorities, such as the Tribal Environmental Public Health Indicators
  that were developed for Salish Sea tribes, to assess and improve the
  health status  of these communities and their members.
Theme: Impacts on  Regulations and Management Plans

• Develop and use quantitative data to establish environmental quality
  standards that more accurately reflect the unique exposures of special
  populations, such  as the stricter water quality standards established
  by the Makah Nation  based on STAR  grant data, to ultimately reduce
  their risks and protect their health and culturally important resources.

• Assist communities in developing resource management and
  monitoring  plans, such as the tribal aquatic water quality  monitoring
  plans developed by several tribes to monitor cultural uses of tribal
  water, that protect environmental resources and community health.
                                                                               A Decade of Tribal Environmental Health Research: Results and Impacts from EPA's Extramural Grants and Fellowship Programs

-------
Appendix G: Additional  Resources
NCER Program Websites
NCER Home Page: http://Www.epa.gov/ncer
Events and Webinars: http://epa.gov/ncer/events
Fellowships Programs: http://www.epa.gov/ncer/fellow
People, Prosperity and the Planet Student Design Competition for
Sustainability: http://www.epa.gov/P3
Requests for Applications/Funding Announcements: http://www.epa.gov/
ncer/rfa
Small Business Innovation Research: http://www.epa.gov/ncer/sbir
Tribal Environmental Health Research Program: http://www.epa.gov/ncer/
tribalresearch
EPA Tribal Websites
American Indian  Environmental Office: http://www.epa.gov/aieo/index.htm
American Indian  Environmental Office Tribal Portal: http://www.epa.gov/
Indian/
Indoor Air Quality Tribal Partners Program: http://www.epa.gov/iaqtribal/
index.html
Region 1 Tribal Program in  New England Portal: http://www.epa.gov/
region 1/govt/tribes/i ndex.html
Region 2 Indian  Nations: http://www.epa.gov/region02/nations/index.html
Region 4 Indian  Program: http://www.epa.gov/region4/indian/index.htm
Region 5 Indian  Environmental Office: http://epa.gov/region5/tribes/
Region 6 Tribal Affairs: http://www.epa.gov/earthlr6/6dra/oejta/
tribalaffairs/index.html
Region 7 Tribal Program: http://www.epa.gov/region07Aribal/index.htm
Region 8 Tribal Assistance Program: http://www.epa.gov/region8/tribes/
Region 9 Tribal Program: http://www.epa.gov/region09Aribal/
Region lOTribal  Programs:  http://yosemite.epa.gov/rlOAribal.NSF
Science in  Indian Country: http://www.epa.gov/ospAribes/Who.htm
A Decade of Tribal Environmental Health Research:  Results and Impacts from EPA's Extramural Grants and Fellowship Programs
Grantee Websites
EPA is not affiliated with the content of these websites.
Regional Tribal Exposure Scenarios Based on Major Ecological Zones
and Traditional Subsistence Lifestyles Grant: http://health.oregonstate.
edu/research/featu red-projects/tribal-grant
Space-Time Aquatic  Resources Modeling and Analysis Program:
http://www.stat.colostate.edu/~nsu/starmap/program.html
Swinomish Indian Tribal Community Bioaccumulate Toxics in Native
American Shellfish: http://www.swinomish-nsn.gov/Resources/
Environment/Shellfish/Bioaccumulate-Toxics-ln-Native-American-Shellfish.
aspx
Technical Outreach Services for Native American Communities:
http://www.engg.ksu.edu/chsr/outreach/tosnac/
Yurok Tribal Environmental Program: http://www.yuroktribe.org/
departments/ytep/ytep.htm
Federal Tribal  Websites
EPA is not affiliated with the content of these websites.
Agency for Toxic Substances & Disease Registry: http://www.atsdr.cdc.
govAribal/
Indian Health Service: http://www.ihs.gov
U.S. Department of Agriculture: http://www.usda.gov/wps/portal/usda/
usdahome?navid=OTR
U.S. Department of the Interior Bureau of Reclamation: http://www.usbr.
gov/native/
U.S. Fish & Wildlife Service: http://www.fws.gov/nativeamerican/
U.S. Forest Service: http://www.fs.fed.us/spfAribalrelations/index.shtml
U.S. Geological Survey: http://www.usgs.gov/indian/
Grants Training: EPA-Supported Programs and Contacts
htt p ://www. p etet ri ba I. o rg/
http://www.epa.gov/ogdAraining/recipJrain.htm
http://www.epa.govAp/contactinfo/regcontacts.htm
Region 9 Current Contact: Laura Ebbert (ebbert.laura@epa.gov)
Region 10 Current Contact: Sally Thomas (thomas.sally@epa.gov)
gov/tribal/
Grants Training: Non-EPA Programs
EPA is not affiliated with the content of this website.
The Administration for Native Americans has been  hosting grant writing
training across the country, including Alaska and Hawaii, on an annual
basis for  more than 15 years. There is no fee for tribes to attend;
however,  they must cover transportation-related expenses. The schedule
can be found at:
http://www.acf.hhs.gov/programs/ana/assistance/applicant-training-
technical-assistance
                                                                     These website links were current at the time of publication, but they are
                                                                     subject to change.

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