Att6D_ASARCO EI_Letter Results Inserts_Oct23_2014

Attachment 6D: Inserts for the Results Letters

Insert A. Blood Lead Level below Investigation Exposure Level (IEL).

Your child’s blood lead level was below the investigation exposure level which indicates that your child’s results are similar to most other children’s results in the United States. Therefore, no additional action is required based on these results.

Although no additional action is required, you should be aware there is no known safe blood lead level for children. ATSDR suggests taking steps to minimize the risk of exposure to lead in the future.

Insert B. Blood Lead Level equal to or above Investigation Exposure Level (IEL).

Your child’s blood lead level was equal to or above the investigation exposure level for blood lead.

As a result, the Arizona Department of Health Services (ADHS) will send you information to help you identify possible sources of exposure. The exposure could be coming from a lot of sources including contaminated soil and dust, hobbies or lead-based paint. ADHS is also available to speak with you about ways to reduce your child’s exposure to lead. You can contact ADHS at XXX-XXX-XXXX.

Your child’s health care provider should evaluate your child and consider appropriate retesting and/or interventions. Blood lead levels equal to or above the investigation exposure level does not mean your child will develop health effects. Health effects depend on the blood lead level, length of exposure, your child's age, and present health status. Potential health effects from lead exposure can include: learning problems such as speech and language delay; problems with attention; decreased intelligence quotient (IQ); anemia (fewer red blood cells than normal).

You should be aware there is no known safe blood lead level for children. This is the reason why we are recommending steps to reduce your family’s exposure to lead.

Insert C. Total Urine Arsenic below Investigation Exposure Level (IEL).

Your child’s total urine arsenic level was below the investigation exposure level for urine arsenic. This indicates that your child’s results are similar to most other people’s results in the United States. Therefore, no additional action is required based on these results.

Although no additional action is required, ATSDR suggests taking steps to minimize the risk of exposure to arsenic in the future.

Insert D. Total Urine Arsenic equal to or above Investigation Exposure Level (IEL) but Inorganic Arsenic normal.

Your child’s total urine arsenic level was equal to or above the investigation exposure level; therefore, we did an additional test to determine the levels of two types of arsenic, organic and inorganic, present in your child’s urine sample. Organic arsenic was, but inorganic arsenic was not, elevated in your child’s urine sample.

Organic arsenic can be increased in urine for a few days after a person eats fish or seafood. This means the increased total arsenic level in your child’s urine may be partly due to organic arsenic and suggests that your child’s diet likely contributed to the elevated level. Organic arsenic is not typically associated with health concerns, so no additional action is required based on these results.

Inorganic arsenic, found in many places in the environment including soil and water, is linked with health concerns when elevated. No additional action is required based on these results.

Insert E. Total Urine Arsenic Level equal to or above the Investigation Exposure Level (IEL), Organic Arsenic normal, Inorganic Arsenic elevated

Your child’s total urine arsenic level was equal to or above the investigation exposure level; therefore, we did an additional test to determine the levels of two types of arsenic, organic and inorganic, present in your child’s urine sample. Inorganic arsenic was, but organic arsenic was not, elevated in your child’s urine sample.

Organic arsenic can be increased in urine for a few days after a person eats fish or seafood. Organic arsenic is not typically associated with health concerns, so no additional action is required based on these results.

Inorganic arsenic, found in many places in the environment including soil and water, is linked with health concerns when elevated.

As a result, the Arizona Department of Health Services (ADHS) will send you information to help you identify the possible sources of exposure. The exposure could be coming from a lot of sources including contaminated soil and dust, elevated arsenic levels in the air or in some foods you may eat. ADHS is also available to speak with you about ways to reduce your child’s exposure to inorganic arsenic. You can contact ADHS at XXX-XXX-XXXX.

Urine inorganic arsenic levels above the level reported in the CDC’s 2009-2010 NHANES do not mean your child will develop health effects. Health effects depend on the urine inorganic arsenic level, length of exposure, your child's age, and present health status. Potential health effects from inorganic arsenic exposure can include: nausea and vomiting, abnormal heart rhythm, damage to blood vessels, a sensation of “pins and needles in the hands and feet, or anemia (fewer red blood cells than normal). Exposure to low levels of inorganic arsenic for a long time can cause a darkening of the skin and the appearance of small “corns” or “warts” on the palms of the hand, soles of the feet and upper body. In addition, there is some evidence that long-term exposure to arsenic in children may result in lower IQ scores and exposure to

arsenic in the womb and early childhood may increase mortality in young adults.  

Your child’s health care provider should evaluate your child and consider appropriate retesting and/or interventions.

Insert F. Total Urine Arsenic Level equal to or above the Investigation Exposure Level (IEL), both Organic Arsenic and Inorganic Arsenic elevated

Your child’s total urine arsenic level was equal to or above the investigation exposure level; therefore, we did an additional test to determine the levels of two types of arsenic, organic and inorganic, present in your child’s urine sample. Both organic and inorganic arsenic were elevated in your child’s urine sample.

Organic arsenic can be increased in urine for a few days after a person eats fish or seafood. This means the increased total arsenic level in your child’s urine may be partly due to organic arsenic and suggests that your child’s diet likely contributed to the elevated level. Organic arsenic is not typically associated with health concerns, so no additional action is required based on these results.

Inorganic arsenic, found in many places in the environment including soil and water, is linked with health concerns when elevated.

As a result, the Arizona Department of Health Services (ADHS) will send you information to help you identify the possible sources of exposure. The exposure could be coming from a lot of sources including contaminated soil and dust, elevated arsenic levels in the air or in some foods you may eat. ADHS is also available to speak with you about ways to reduce your child’s exposure to inorganic arsenic. You can contact ADHS at XXX-XXX-XXXX.

Urine inorganic arsenic levels above the level reported in the CDC’s 2009-2010 NHANES do not mean your child will develop health effects. Health effects depend on the urine inorganic arsenic level, length of exposure, your child's age, and present health status. Potential health effects from inorganic arsenic exposure can include: nausea and vomiting, abnormal heart rhythm, damage to blood vessels, a sensation of “pins and needles in the hands and feet, or anemia (fewer red blood cells than normal). Exposure to low levels of inorganic arsenic for a long time can cause a darkening of the skin and the appearance of small “corns” or “warts” on the palms of the hand, soles of the feet and upper body. In addition, there is some evidence that long-term exposure to arsenic in children may result in lower IQ scores and exposure to

arsenic in the womb and early childhood may increase mortality in young adults.  

Your child’s health care provider should evaluate your child and consider appropriate retesting and/or interventions.

Insert G. Blood Lead Level below Investigation Exposure Level (IEL)

Your blood lead level was below the investigation exposure level in your blood sample which indicates that your results are similar to most other people’s results in the United States. Therefore, no additional action is required based on these results.

Although no additional action is required, you should be aware there is no known safe blood lead level for pregnant women or for women of childbearing age. ATSDR suggests taking steps to minimize the risk of exposure to lead in the future.

Insert H. Blood Lead Level equal to or above Investigation Exposure Level (IEL)

Your blood lead level was equal to or above the investigation exposure level for blood lead.

As a result, the Arizona Department of Health Services (ADHS) will send you information to help you identify possible sources of exposure. The exposure could be coming from a lot of sources including, hobbies, contaminated soil and dust, or lead-based paint. ADHS is also available to speak with you about ways to reduce your exposure to lead. You can contact ADHS at XXX-XXX-XXXX.

The U.S. Centers for Disease Control and Prevention (CDC) has set a reference value of 5 µg/dL for blood lead for children under the age of 6 years. Lead can pass from a mother to her unborn baby and no safe blood lead for children, including infants, has been identified. As a result, blood lead levels in women who are pregnant or may become pregnant should be kept as low as possible and below the level of 5 µg /dL. ATSDR uses 5 µg/dL as the investigation exposure level to identify pregnant women with an elevated blood lead level who should be advised to take steps to reduce their lead exposure.

Your health care provider should evaluate you and consider appropriate retesting and/or interventions. Blood lead levels equal to or above the investigation exposure level do not mean that you (or your baby, if you are pregnant) will develop health effects. Health effects depend on the blood lead level, length of exposure, your age, and present health status. Potential health effects for pregnant women include increased risk of miscarriage, low birth weight, or premature birth. Potential health effects for a baby from lead exposure can include: learning problems such as speech and language delay; problems with attention; decreased intelligence quotient (IQ); anemia (fewer red blood cells than normal).

As a woman who is, or may become, pregnant, you should be aware there is no known safe blood lead level for children. This is the reason why we are recommending steps to reduce your family’s exposure to lead.

Insert I. Total Urine Arsenic Level below the Investigation Exposure Level (IEL)

Your total urine arsenic level was below the investigation exposure level for urine arsenic. This indicates that your results are similar to most other people’s results in the United States. Therefore, no additional action is required based on these results.

Although no additional action is required ATSDR suggests taking steps to minimize the risk of exposure to arsenic in the future.

Insert J. Total Urine Arsenic Level equal to or above the Investigation Exposure Level (IEL), Organic Arsenic elevated, Inorganic Arsenic normal

Your total urine arsenic level was equal to or above the investigation exposure level; therefore, we did an additional test to determine the levels of two types of arsenic, organic and inorganic, present in your urine sample. Organic arsenic was, but inorganic arsenic was not, elevated in your urine sample.

Organic arsenic can be increased in urine for a few days after a person eats fish or seafood. This means the increased total arsenic level in your urine may be partly due to organic arsenic and suggests that your diet likely contributed to the elevated level. Organic arsenic is not typically associated with health concerns, so no additional action is required based on these results.

Inorganic arsenic, found in many places in the environment including soil and water, is linked with health concerns when elevated. No additional action is required based on these results.

Insert K. Total Urine Arsenic Level equal to or above the Investigation Exposure Level (IEL), Organic Arsenic normal, Inorganic Arsenic elevated

Your total urine arsenic level was equal to or above the investigation exposure level; therefore, we did an additional test to determine the levels of two types of arsenic, organic and inorganic, present in your urine sample. Inorganic arsenic was, but organic arsenic was not, elevated in your urine sample.

Organic arsenic can be increased in urine for a few days after a person eats fish or seafood. Organic arsenic is not typically associated with health concerns, so no additional action is required based on these results.

Inorganic arsenic, found in many places in the environment including soil and water, is linked with health concerns when elevated.

As a result, the Arizona Department of Health Services (ADHS) will send you information to help you identify the possible sources of exposure. The exposure could be coming from a lot of sources including contaminated soil and dust, elevated arsenic levels in the air or in some foods you may eat. ADHS is also available to speak with you about ways to reduce your exposure to arsenic. You can contact ADHS at XXX-XXX-XXXX.

Urine inorganic arsenic levels above the level reported in the CDC’s 2009-2010 NHANES do not mean you will develop health effects. Health effects depend on the urine inorganic arsenic level, length of exposure, your age, and present health status. Potential health effects from inorganic arsenic exposure can include: nausea and vomiting, abnormal heart rhythm, damage to blood vessels, a sensation of “pins and needles in the hands and feet, or anemia (fewer red blood cells than normal). Exposure to low levels of inorganic arsenic for a long time can cause a darkening of the skin and the appearance of small “corns” or “warts” on the palms of the hand, soles of the feet and upper body.

There is some evidence that inhaled or ingested arsenic can injure pregnant women or their unborn babies, although the studies are not definitive. Studies in animals show that large doses of arsenic that cause illness in pregnant females, can also cause low birth weight, fetal malformations, and even fetal death. Arsenic can cross the placenta and has been found in fetal tissues. Arsenic is found at low levels in breast milk. There is also some evidence that exposure to arsenic in the womb and early childhood may increase mortality in young adults.  

Your health care provider should evaluate you and consider appropriate retesting and/or interventions.

Insert L. Total Urine Arsenic equal to or above Investigation Exposure Level (IEL), both Organic and Inorganic Arsenic elevated.

Your total urine arsenic level was equal to or above the investigation exposure level; therefore, we did an additional test to determine the levels of two types of arsenic, organic and inorganic, present in your child’s urine sample. Both organic and inorganic arsenic were elevated in your urine sample.

Organic arsenic can be increased in urine for a few days after a person eats fish or seafood. This means the increased total arsenic level in your urine may be partly due to organic arsenic and suggests that your diet likely contributed to the elevated level. Organic arsenic is not typically associated with health concerns, so no additional action is required based on these results.

Inorganic arsenic, found in many places in the environment including soil and water, is linked with health concerns when elevated.

As a result, the Arizona Department of Health Services (ADHS) will send you information to help you identify the possible sources of exposure. The exposure could be coming from a lot of sources including contaminated soil and dust, elevated arsenic levels in the air or in some foods you may eat. ADHS is also available to speak with you about ways to reduce your exposure to inorganic arsenic. You can contact ADHS at XXX-XXX-XXXX.

Urine inorganic arsenic levels above the level reported in the CDC’s 2009-2010 NHANES do not mean you will develop health effects. Health effects depend on the urine inorganic arsenic level, length of exposure, your age, and present health status. Potential health effects from inorganic arsenic exposure can include: nausea and vomiting, abnormal heart rhythm, damage to blood vessels, a sensation of “pins and needles in the hands and feet, or anemia (fewer red blood cells than normal). Exposure to low levels of inorganic arsenic for a long time can cause a darkening of the skin and the appearance of small “corns” or “warts” on the palms of the hand, soles of the feet and upper body.

There is some evidence that inhaled or ingested arsenic can injure pregnant women or their unborn babies, although the studies are not definitive. Studies in animals show that large doses of arsenic that cause illness in pregnant females, can also cause low birth weight, fetal malformations, and even fetal death. Arsenic can cross the placenta and has been found in fetal tissues. Arsenic is found at low levels in breast milk. There is also some evidence that exposure to arsenic in the womb and early childhood may increase mortality in young adults.  

Your health care provider should evaluate you and consider appropriate retesting and/or interventions.