Public health investigations of hazardous organic chemical waste disposal in the United States.

Despite marked national concern, the number of published public health investigations of organic chemical hazardous wastes is small. Moreover, the extant literature provides little or no convincing evidence, either positive or negative, as to the question whether waste sites are harmful to human health. In this review, available literature is characterized as to time, place, and person. The majority of studies began 2 years or more after the end of exposure and 10 years after the start of exposure. Vast geographic areas of exposure have never been investigated. The number of study subjects evaluated has generally been too small to detect rare but important effects. The most common determinant of sites chosen for investigation has been the concern of local citizen groups. Several hypotheses are advanced to explain this pattern: methodologic and logistic difficulties; extensive litigation surrounding many waste sites; governmental reorganization which transferred environmental health from public health authority in the 1970s; and the presence of forces which have worked to block active community diagnosis.