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In January 1995 the U.S. Environmental Protection Agency declared methyl parathion-contaminated homes in Lorain County, Ohio, as a Superfund cleanup site. During the 2-year cleanup, the Centers for Disease Control and Prevention in collaboration with county and city health officials conducted a study of exposure and health effects among residents. We administered 254 household and 747 individual questionnaires; urine analysis for p-nitrophenol (PNP, a metabolite of methyl parathion) was available for 626 participants. We also reviewed medical records of 49 people who were hospitalized or died after their homes were sprayed. People living in homes sprayed <180 days previously were most likely to have the highest PNP levels (22.9% > 100 ppb PNP), but even people living in homes sprayed more than a year previously appeared to be highly exposed (8.5% > 100 ppb PNP). The National Health and Nutrition Examination Survey reference range is 0-63 ppb. Median detectable PNP levels among children younger than 3 years of age were 93.9 ppb compared with 41.6 ppb among people older than 3 years. Younger children appeared to be at greatest risk of exposure. In none of the medical records that we reviewed did a health care provider consider pesticide poisoning as a potential etiology.

In 1994 officials from the Ohio Department of Health reported that some residents of Lorain County, Ohio, possibly had been exposed to methyl parathion (MP), a highly toxic restricted-use pesticide. The U.S. Centers for Disease Control and Prevention (CDC) assisted in the investigation by providing epidemiologic and laboratory support to the state and local health departments. Although the initial investigation found MP inside the homes, it was unclear if the residents were exposed. CDC used a new biological monitoring method to measure urinary p-nitrophenol (PNP), the metabolite of MP. This biological monitoring measures the internal dose from exposure to toxic chemicals from all routes. Laboratory analyses demonstrated that the urine of residents contained moderate to high levels of PNP, with median, mean, and highest reported concentrations of 28, 240, and 4,800 g/L, respectively, thus confirming exposure of the residents. Almost 80% of the residents had urinary PNP concentrations above the 95th percentile of the reference range concentrations. This information, combined with other analytical results of air and wipe tests, guided public health officials' decisions about the potential risk in each household. In this article we illustrate the laboratory's role in providing information to assist in making these public health decisions. Furthermore, it illustrates how a multidisciplinary team from various governmental agencies worked together to protect the public's health.

A study conducted by the Agency for Toxic Substances and Disease Registry (ATSDR), a US public health agency, evaluated ATSDR's risk communication process, specifically the roles and responsibilities, planning, implementation, and coordination of activities in response to illegal indoor spraying of methyl parathion, a hazardous pesticide, in Pascagoula, MS. Interviews of staff members involved in the intervention were conducted and an analysis revealed strengths and areas in need of improvement in the design and implementation of risk communication strategies. Key recommendations included developing a clear strategy for planning and conducting communication activities; determining staff roles and responsibilities for coordination; and developing clear and consistent health messages, a dissemination strategy, and training in the delivery and evaluation of messages, effects, and outcomes.