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In 1971, waste oil containing 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) was sprayed for dust control on a number of residential, recreational, and work areas in Missouri. In several of them, the level and extent of environmental contamination were not known until late 1982 or 1983. Extrapolation from existing toxicological data indicated the potential for substantial adverse health effects in highly exposed populations. As a result, the Missouri Division of Health and the Centers for Disease Control initiated close collaboration with the Environmental Protection Agency (EPA) on review and evaluation of environmental data, the development of health advisories to EPA on the need for remedial or preventive actions at specific contaminated sites, a health education effort for the medical community and general public, establishment of a dermatological screening clinic, establishment of a central listing of potentially exposed persons through administration of a health effects survey questionnaire, and a pilot medical study of a "highest risk" cohort. Strategies for additional interventions will continue to be based on findings derived from this first phase of the investigation.
P A Stehr, and
D Forney, and
G Stein, and
H D Donnell, and
H Falk, and
R Hotchkiss, and
W A Spratlin, and
E Sampson, and
S J Smith
January 1987,
American journal of industrial medicine,
P A Stehr, and
D Forney, and
G Stein, and
H D Donnell, and
H Falk, and
R Hotchkiss, and
W A Spratlin, and
E Sampson, and
S J Smith
January 1987,
Archives of environmental health,
P A Stehr, and
D Forney, and
G Stein, and
H D Donnell, and
H Falk, and
R Hotchkiss, and
W A Spratlin, and
E Sampson, and
S J Smith
January 1984,
Journal of toxicology and environmental health,
P A Stehr, and
D Forney, and
G Stein, and
H D Donnell, and
H Falk, and
R Hotchkiss, and
W A Spratlin, and
E Sampson, and
S J Smith
February 1984,
MMWR. Morbidity and mortality weekly report,
P A Stehr, and
D Forney, and
G Stein, and
H D Donnell, and
H Falk, and
R Hotchkiss, and
W A Spratlin, and
E Sampson, and
S J Smith
April 2000,
Food additives and contaminants,
P A Stehr, and
D Forney, and
G Stein, and
H D Donnell, and
H Falk, and
R Hotchkiss, and
W A Spratlin, and
E Sampson, and
S J Smith
March 1977,
Science (New York, N.Y.),
P A Stehr, and
D Forney, and
G Stein, and
H D Donnell, and
H Falk, and
R Hotchkiss, and
W A Spratlin, and
E Sampson, and
S J Smith
July 1990,
American journal of epidemiology,
P A Stehr, and
D Forney, and
G Stein, and
H D Donnell, and
H Falk, and
R Hotchkiss, and
W A Spratlin, and
E Sampson, and
S J Smith
March 1984,
JAMA,
P A Stehr, and
D Forney, and
G Stein, and
H D Donnell, and
H Falk, and
R Hotchkiss, and
W A Spratlin, and
E Sampson, and
S J Smith
January 1993,
Critical reviews in toxicology,
P A Stehr, and
D Forney, and
G Stein, and
H D Donnell, and
H Falk, and
R Hotchkiss, and
W A Spratlin, and
E Sampson, and
S J Smith
January 2006,
Reviews on environmental health,
