Snake Fungal Disease in Free-Ranging Northern Pine Snakes (Pituophis melanoleucus melanoleucus) in New Jersey: Lesions, Severity of Sores and Investigator's Perceptions.

Ophidiomyces ophidiicola, the fungus causing snake fungal disease (SFD), has been identified in northern pine snakes (Pituophis melanoleucus) in New Jersey. In this paper, we (1) review the positivity rate of SFD on different locations on snakes' bodies, (2) determine the relationship between the sores and quantitative polymerase chain reaction (qPCR) positivity rates, and (3) explore the relationship between the investigators' clinical evaluation of the severity of sores, their evaluation of the likelihood of the sores being positive, and the qPCR positivity of SFD for the sores. Swabbing the sores was more effective at determining whether the snakes tested positive for O. ophidiicola than ventrum swabbing alone. The perception of the severity of the sores did not relate to qPCR positivity for O. ophidiicola. We suggest that the assessment of the rate of SFD among snakes in the wild needs to include the sampling of snakes with no clinical signs, as well as those with sores, and the swabbing of all the sores collectively. Clear terminology for sores, the identification of clinical signs of SFD, and distinguishing the rates of O. ophidiicola by PCR testing should be adopted. Overall, the pine snakes exhibited a higher rate of sores and positivity of O. ophidiicola swabs by PCR testing compared to the other snakes.

The importance of recognizing Buffer Zones to lands being developed, restored, or remediated: on planning for protection of ecological resources.

Environmental management relies on many types of information before making decisions regarding remediation, restoration, or other land use decisions, including ecological data, such as risks to species, populations, communities, and ecosystems. The aim of this investigation was to describe the ecological information required within the context of making environmental decisions and providing visual communication tools for regulators, conservationists, and the public to understand the risk to ecological resources on- and off-site. It is suggested that ecological information used in environmental decisions is required to be transparent throughout the planning and execution of a project, which needs to include: 1) ecological information and evaluations within development areas or units (in this case, watersheds), and 2) resources in adjacent areas (Buffer Zones) that might be affected. The Melton Valley administrative watershed (Oak Ridge Reservation, TN) is used as a case study because this site still has active facility development and environmental remediation, and there are important ecological resources on and off-site. Data indicate that although there are important resources on Melton Valley administrative watershed, there are also significant resources in the Buffer Zone around the watershed. Compared to the Melton Valley administrative watershed, the Buffer Zone contains more Interior (and Buffer) Forest and greater value resources. The point is made that when remediation, restoration, or development occurs, it is equally important to consider resources that are adjacent to the site in a Buffer Zone, particularly when remediation and development might continue for many years or decades.

Some metals and metalloids in the blood of three species of shorebirds increase while foraging during two-week migratory stopover in Delaware Bay, New Jersey.

Most migratory shorebird species are declining, some are endangered, and some may be vulnerable to contaminants on long distance travel between wintering grounds and high latitude breeding grounds. We examined whether shorebirds accumulated trace elements at the Delaware Bay (New Jersey) stopover by testing the null hypothesis that there was no difference in the levels of arsenic, cadmium, chromium, lead, mercury, and selenium in blood of three species of shorebirds collected early in their stopover compared to levels in blood collected about two weeks later near the end of the stopover, before departing for breeding grounds. There were significantly higher levels of all metals and metalloids in the blood of ruddy turnstone (Arenaria interpres) later in May than earlier. There were seasonal increases in blood levels of arsenic and selenium for all three species. Chromium and lead levels also increased in red knots (Calidris canutus). These increases occurred although the birds were only present for about two weeks. Levels of arsenic, mercury, and lead in knots and selenium in sanderlings (Calidrris alba), exceeded reported effects levels. These results have potential implications for studying the refueling physiology, energetics, and feeding behavior of migratory shorebirds. However, they also suggest cause for concern because the increased contaminant loads occur in a short period, and the high metal level bolus received all in a few days may result in adverse effects.

Comparing land cover and interior forests on contaminated land and the surrounding region: Oak Ridge Reservation as a case study.

Pressure from expanding populations has resulted in a need for protection, reclamation, and restoration of damaged land to productive, beneficial health uses. The objective of this investigation was to 1) compare land cover on the Department of Energy (DOE) Oak Ridge Reservation (ORR) with the surrounding region, 2) select an indicator to evaluate ORR's protection of ecological resources, and 3) develop and implement a method to compare the amount of the indicator on ORR with the regions using National Land Cover Database (NLCD). Data demonstrated that ORR has a higher % of forests (deciduous, coniferous, mixed) than the 10 km and 30 km areas surrounding ORR, suggesting that obligations are being met to protect the ecology and environment. The findings also indicate that the interior forest at ORR is fragmented more than is the interior forest in the 30 km buffer zone, suggesting a need for DOE and managers of other lands to take into consideration the importance of intact interior forest when developing land or planning roads. The study describes the basis for specific ecological parameters such as interior forest that are important to consider when planning and executing remediation, restoration, and other management actions.

Prevalence of Ophidiomyces ophidiicola and epizootiology of snake fungal disease in free-ranging Northern Pine Snakes (Pituophis melanoleucus melanoleucus) in New Jersey.

Snake fungal disease, caused by Ophidiomyces ophidiicola, is recognized as a potential concern for North American snakes. We tested skin swabs from Northern Pine Snakes (Pituophis melanoleucus melanoleucus) in the New Jersey pinelands for the presence of O. ophidiicola before emergence from hibernation. We used qPCR to test the collected swabs for the presence of O. ophidiicola, then determined pathogen prevalence as a function of sampling year, sampling location (skin lesion, healthy ventral skin, healthy head skin) sex, and age. There were no temporal trends in O. ophidiicola detection percentages on snakes, which varied from 58 to 83% in different years. Ophidiomyces ophidiicola detection on snakes was highest in swabs of skin lesions (71%) and lowest in head swabs (29%). Males had higher prevalence than females (82% versus 62%). The fungus was not detected in hatchling snakes (age 0) in the fall, but 75% of juveniles tested positive at the end of hibernation (age 1 year). We also screened hibernacula soil samples for the presence of O. ophidiicola. Where snakes hibernated, 69% of soil samples were positive for O. ophidiicola, and 85% of snakes lying on positive soil samples also tested positive for the pathogen. Although a high proportion of snakes (73%) tested positive for O. ophidiicola during our 4-year study, the snakes appeared healthy except for small skin lesions. We conclude that O. ophidiicola prevalence is high on hibernating Northern Pine Snakes and in the hibernacula soil, with a strong association between snakes and positive adjacent soil. This is the first demonstration that snakes likely become infected during hibernation.

Response to Toshihide Tsuda, Yumiko Miyano and Eiji Yamamoto [1].

BACKGROUND: In August 2021, we published in Environmental Health a Toolkit for detecting misused epidemiological methods with the goal of providing an organizational framework for transparently evaluating epidemiological studies, a body of evidence, and resultant conclusions. Tsuda et al., the first group to utilize the Toolkit in a systematic fashion, have offered suggestions for its modification. MAIN BODY: Among the suggested modifications made by Tsuda et al., we agree that rearrangement of Part A of the Toolkit to reflect the sequence of the epidemiological study process would facilitate its usefulness. Expansion or adaptation of the Toolkit to other disciplines would be valuable but would require the input of discipline-specific expertise. We caution against using the sections of the Toolkit to produce a tally or cumulative score, because none of the items are weighted as to importance or impact. Rather, we suggest a visual representation of how a study meets the Toolkit items, such as the heat maps used to present risk of bias criteria for studies included in Cochrane reviews. We suggest that the Toolkit be incorporated in the sub-specialty known as "forensic epidemiology," as well as in graduate training curricula, continuing education programs, and conferences, with the recognition that it is an extension of widely accepted ethics guidelines for epidemiological research. CONCLUSION: We welcome feedback from the research community about ways to strengthen the Toolkit as it is applied to a broader assemblage of research studies and disciplines, contributing to its value as a living tool/instrument. The application of the Toolkit by Tsuda et al. exemplifies the usefulness of this framework for transparently evaluating, in a systematic way, epidemiological research, conclusions relating to causation, and policy decisions. POSTSCRIPT: We note that our Toolkit has, most recently, inspired authors with discipline-specific expertise in the field of Conservation Biology to adapt it for use in the Biological Sciences.

Information needs, approaches, and case studies in human health risk communication.

This article uses ten case studies to illustrate the information needs, various communication approaches, and the communicator's role in explaining environmental health risks from a variety of hazards, to a variety of audiences, over time frames from days to years, using in person consultation, lectures, zooms, and email formats. Events often had a long history before the communication began and may have had a long tail afterward. Audiences may be public officials, companies, workers, communities, or individuals. Each individual may have their own understanding or mental model regarding the hazard, exposure, and risk. The communicator's role or intention may be to reassure an audience that has unrealistic exaggerated concerns or fears or to protect a client if the fears are realistic. Or it may be altruistic to inform a complacent audience to take the risks it faces more seriously. Although risk assessment research has advanced the techniques for communicating abstruse probabilities to audiences with low numeracy, in my experience, audiences are unimpressed by precise-sounding probability numbers, and are more interested in whether exposure is occurring or may occur and how to stop it. Often audiences have reason to be outraged and may be more concerned about punishing wrong doers than about the hazard itself, particularly when the exposure is past and cannot be undone. Thus, there is a difference between discussing the riskiness of a situation (risk communication) and what you are going to do about the situation (risk management). Risk communication is successful when the audience responds as intended, calming down or taking action. These case studies are drawn from a large number of risk communication experiences that I and my Rutgers colleagues have engaged in over the past four decades. Through the 20th century, New Jersey was the most densely industrialized State in United States. New Jersey experienced growth of the chemical and petrochemical industries and the unfortunately profligate disposal of toxic wastes. Having the most Superfund sites of any state is a dubious distinction, but New Jersey also has the most experience in evaluating and responding to these hazards.

Progressive multifocal fibrosing neuropathy: description of a novel disease.

Entrapment peripheral neuropathies are clinically characterized by sensory impairment and motor deficits. They are usually caused by mechanical injuries, but they are also a frequent manifestation of metabolic diseases, toxic agent exposure, or systemic fibrotic disorders. Here we describe the clinical, radiological, and histopathological features of a novel progressive fibrotic disorder characterized by progressive multifocal fibrosing neuropathy. We identified two patients who presented with severe and progressive peripheral neuropathic symptoms sequentially affecting multiple sites. These patients presented with severe and progressive multifocal, sequentially additive peripheral neuropathic symptoms. Extensive nerve conduction and radiological studies showed the sequential development of multifocal motor and sensory peripheral neuropathy in the absence of any exposure to known infectious, inflammatory, or fibrotic triggers and the lack of family history of compression neuropathies. Extensive clinical and laboratory test evaluation failed to support the diagnosis of any primary inflammatory or genetic peripheral neuropathy and there was no evidence of any systemic fibrosing disorder including Systemic Sclerosis, lacking cutaneous fibrotic changes and cardiopulmonary abnormalities. The clinical course was progressive with sequential development of motor and sensory deficits of upper and lower extremities displaying proximal predominance. Histopathological study of tissues obtained during nerve release surgeries showed severe perineural fibrosis with marked accumulation of thick collagen bundles encroaching the peripheral nerves. There was no evidence of vasculitic, inflammatory, or vascular fibroproliferative lesions. We suggest that the clinical findings described here represent a previously undescribed fibrotic disorder affecting peripheral nerves, and we propose the descriptive term "Progressive Multifocal Fibrosing Neuropathy" to refer to this novel disorder. Despite the inherent limitations of this early description, we hope this is would contribute to the identification of additional cases.

Combining ecological, eco-cultural, and environmental justice parameters to create Eco-EJ indicators to monitor cultural and environmental justices for diverse communities around contaminated sites.

Assessing environmental quality often requires selection of indicators that can be employed over large spatial scales and over long-time periods to assess the health and well-being of species, natural communities, and ecosystems, and to detect changes warranting intervention. Typically, the ecologic environment and the human environment are evaluated separately and selection of indicators and monitoring approaches are not integrated even though ecological indicators may also provide information on risk to human consumers from contaminants (e.g., eco-cultural indicators) or because of disease levels. This paper is a call for ecologists and managers to consider diverse cultural and environmental injustice disparities and health issues when selecting indicators for environmental assessment and monitoring. There is an opportunity for managers and community members to work together to preserve ecological and cultural resources and heritages. We propose a paradigm that selects indicators and monitoring approaches that lend themselves to the integration of human-diversity and uniqueness in the same manner that the selection of ecological indicators and monitoring approaches consider biological species diversity and uniqueness. The proposed paradigm builds on ecological risk assessment techniques, developing analogous endpoints for neighboring communities. For example, identification and protection of human communities, particularly culturally diverse and environmental justice communities, identification of contaminant corridors (e.g., through water or green corridors) into communities, and eco-monitoring of vulnerable communities are not routine at contaminated sites. Green corridors refers to a width of wild habitat (forest, grasslands) that connects other similar habitat paths (usually a corridor runs through an urban or suburban habitat). We coin the term Eco-EJ indicators for these endpoints, including examination of (1) unique cultural relationships to resources; (2) connectedness of on-site and off-site resources and habitats; (3) health of threatened, rare, and unique cultures and communities; and (4) linkages between ecological, eco-cultural, and public health for monitoring and assessment. We also propose that assessment and monitoring include these Eco-EJ indicators, especially for communities near facilities that have extensive chemical or radiological contamination.Developing these indicators to assess risk to culturally diverse and environmental justice communities would be an equivalent goal to reducing risk for significant ecological resources (e.g., endangered species, species of special concern). These Eco-EJ indicators are complementary to the usual human health-risk assessments, would include surveys of neighboring vulnerable communities, and require time and re-organization of current data and additional data collection at site boundaries and in adjacent communities, as well as rethinking the human component of indicators. This approach lends itself to addressing some diverse cultural and environmental justice issues with current indicator selection and biomonitoring, and helps identify specific hotspots of unique ecosystem risk and environmental justice community risk. We briefly discuss ecological and eco-cultural monitoring already on-going at three Department of Energy sites to illustrate how the addition of these indicators might work and add value to environmental management and to their relationships with surrounding communities. We recommend that managers of contaminated sites convene people from culturally diverse communities, environmental justice communities, local and federal government, Tribes, resource trustees, managers, and other stakeholders to develop appropriate site-specific indicators to address environmental inequities around contaminated facilities.

Toolkit for detecting misused epidemiological methods.

BACKGROUND: Critical knowledge of what we know about health and disease, risk factors, causation, prevention, and treatment, derives from epidemiology. Unfortunately, its methods and language can be misused and improperly applied. A repertoire of methods, techniques, arguments, and tactics are used by some people to manipulate science, usually in the service of powerful interests, and particularly those with a financial stake related to toxic agents. Such interests work to foment uncertainty, cast doubt, and mislead decision makers by seeding confusion about cause-and-effect relating to population health. We have compiled a toolkit of the methods used by those whose interests are not aligned with the public health sciences. Professional epidemiologists, as well as those who rely on their work, will thereby be more readily equipped to detect bias and flaws resulting from financial conflict-of-interest, improper study design, data collection, analysis, or interpretation, bringing greater clarity-not only to the advancement of knowledge, but, more immediately, to policy debates. METHODS: The summary of techniques used to manipulate epidemiological findings, compiled as part of the 2020 Position Statement of the International Network for Epidemiology in Policy (INEP) entitled Conflict-of-Interest and Disclosure in Epidemiology, has been expanded and further elucidated in this commentary. RESULTS: Some level of uncertainty is inherent in science. However, corrupted and incomplete literature contributes to confuse, foment further uncertainty, and cast doubt about the evidence under consideration. Confusion delays scientific advancement and leads to the inability of policymakers to make changes that, if enacted, would-supported by the body of valid evidence-protect, maintain, and improve public health. An accessible toolkit is provided that brings attention to the misuse of the methods of epidemiology. Its usefulness is as a compendium of what those trained in epidemiology, as well as those reviewing epidemiological studies, should identify methodologically when assessing the transparency and validity of any epidemiological inquiry, evaluation, or argument. The problems resulting from financial conflicting interests and the misuse of scientific methods, in conjunction with the strategies that can be used to safeguard public health against them, apply not only to epidemiologists, but also to other public health professionals. CONCLUSIONS: This novel toolkit is for use in protecting the public. It is provided to assist public health professionals as gatekeepers of their respective specialty and subspecialty disciplines whose mission includes protecting, maintaining, and improving the public's health. It is intended to serve our roles as educators, reviewers, and researchers.

Role of uncertainties in protecting ecological resources during remediation and restoration.

Cleanup of contaminated waste sites is a National priority to protect human health and the environment, while restoring land to productive uses. While there are uncertainties with understanding risk to individuals from exposure, the aim of this study was to focus on uncertainties and complexities for ecological systems, complicated by hundreds of species occupying any remediation site which participate in multiple-interacting food webs. The ability to better predict the effectiveness of remediation in fostering future ecosystems might facilitate remedy selection and improve strategic environmental management. This investigation examined (1) uncertainties in ecosystem processes, (2) uncertainties in exposure from contamination before remediation, and (3) uncertainties during remediation. Two Department of Energy sites Hanford Site and Savannah River Site were used as case studies to illustrate how the uncertainties affect eco-receptors. Several types of ecological, physical, and human dimension uncertainties are defined. Ecological uncertainties include temporal, spatial, individual, developmental, and exogenous types. Physical uncertainties are weather-related, watershed variations, slope/aspect, soil/sediment structure and form, unforeseen events, and temporal patterns. Human dimension uncertainties include current land use, future land use, extractive and non-extractive recreation. The effects of remedial strategies varied between the two sites because Hanford is a primarily arid shrub-steppe ecotype, while Savannah River is a wet forest ecotype. Defining the associated ecological sensitivities and uncertainties and providing examples might help policy-makers, managers, planners, and contractors to be aware of issues to consider throughout planning, remediation, and restoration. Adding ecological uncertainty analysis to risk evaluations and remediation planning is analogous to using safety factors in human health risk assessment.

Biomonitoring selenium, mercury, and selenium:mercury molar ratios in selected species in Northeastern US estuaries: risk to biota and humans.

The mutual mitigation of selenium and mercury toxicity is particularly interesting, especially for humans. Mercury is widely recognized as a pantoxic element; all forms are toxic to all organisms. Less well known is that selenium in excess is toxic as well. The high affinity between these elements influences their bioavailability and toxicity. In this paper, we use selected species from Barnegat and Delaware Bays in New Jersey to examine variations in levels of selenium and mercury, and selenium:mercury molar ratios between and within species. We report on species ranging from horseshoe crab eggs (Limulus polyphemus), a keystone species of the food chain, to several fish species, to fish-eating birds. Sampling began in the 1970s for some species and in the 1990s for others. We found no clear time trends in mercury levels in horseshoe crab eggs, but selenium levels declined at first, then remained steady after the mid1990s. Concentrations of mercury and selenium in blood of migrant shorebirds directly reflected levels in horseshoe crab eggs (their food at stopover). Levels of mercury in eggs of common terns (Sterna hirundo) varied over time, and may have declined slightly since the mid2000s; selenium levels also varied temporally, and declined somewhat. There were variations in mercury and selenium levels in commercial, recreational, and subsistence fish as a function of species, season, and size (a surrogate for age). Selenium:mercury molar ratios also varied as a function of species, year, season, and size in fish. While mercury levels increased with size within individual fish species, selenium levels remained the same or declined. Thus selenium:mercury molar ratios declined with size in fish, reducing the potential of selenium to ameliorate mercury toxicity in consumers. Mercury levels in fish examined were higher in early summer and late fall, and lower in the summer, while selenium stayed relatively similar; thus selenium:mercury molar ratios were lower in early summer and late fall than in midsummer. We discuss the importance of temporal trends in biomonitoring projects, variations in levels of mercury, selenium, and the molar ratios as a function of several variables, and the influence of these on risks to predators and humans eating the fish, and the eggs of gulls, terns. Our data suggests that variability limits the utility of the selenium:mercury molar ratio for fish consumption advisories and for risk management.

Mercury interactions with selenium and sulfur and the relevance of the Se:Hg molar ratio to fish consumption advice.

Eating fish is often recommended as part of a healthful diet. However, fish, particularly large predatory fish, can contain significant levels of the highly toxic methylmercury (MeHg). Ocean fish in general also contain high levels of selenium (Se), which is reported to confer protection against toxicity of various metals including mercury (Hg). Se and Hg have a high mutual binding affinity, and each can reduce the toxicity of the other. This is an evolving area of extensive research and controversy with variable results in the animal and epidemiologic literature. MeHg is toxic to many organ systems through high affinity for -SH (thiol) ligands on enzymes and microtubules. Hg toxicity also causes oxidative damage particularly to neurons in the brain. Hg is a potent and apparently irreversible inhibitor of the selenoenzymes, glutathione peroxidases (GPX), and thioredoxin reductases (TXNRD) that are important antioxidants, each with a selenocysteine (SeCys) at the active site. Hg binding to the SeCys inhibits these enzymes, accounting in part for the oxidative damage that is an important manifestation of Hg toxicity, particularly if there is not a pool of excess Se to synthesize new enzymes. A molar excess of Se reflected in an Se:Hg molar ratio > 1 is often invoked as evidence that the Hg content can be discounted. Some recent papers now suggest that if the Se:Hg molar ratio exceeds 1:1, the fish is safe and the mercury concentration can be ignored. Such papers suggested that the molar ratio rather than the Hg concentration should be emphasized in fish advisories. This paper examines some of the limitations of current understanding of the Se:Hg molar ratio in guiding fish consumption advice; Se is certainly an important part of the Hg toxicity story, but it is not the whole story. We examine how Hg toxicity relates also to thiol binding. We suggest that a 1:1 molar ratio cannot be relied on because not all of the Se in fish or in the fish eater is available to interact with Hg. Moreover, in some fish, Se levels are sufficiently high to warrant concern about Se toxicity.

A template of information needs for decision-making about delaying remediation on contaminated lands to protect human health.

The contamination legacy of industrialization, militarization, and nuclear arms race poses current or future risks to populations and the environment. Responsible parties and regulators make decisions regarding which sites to clean up, how, how much, and when. This study aimed to provide an information needs template to evaluate and reduce risks to human health when considering whether to initiate or delay remediation. This investigation focused on four aspects of timing and prioritization: 1) management, planning and implementation, 2) source terms, pathways, and exposures, 3) risks and receptors, and 4) external drivers. Within each type, issues were identified and described. Management class included personnel, health and safety data, funding, equipment, and structural integrity. Source term included contaminant sources, pathways, initiating events, and barriers to exposure. Risk included types and exposures to workers and general public. External drivers included regulatory framework, stakeholders, Congressional mandates, and economic and social contexts. Risk may increase over time as contamination spreads, enters aquifers, and reaches receptors, and may decline as radionuclides decay, and plumes dissipate. The overall objective was to provide a template of information that is useful to managers and regulators, and might be used by the public to understand the risks and benefits of re-prioritization cleanup.

Risk to ecological resources following remediation can be due mainly to increased resource value of successful restoration: A case study from the Department of Energy's Hanford Site.

Many nations are faced with the need to remediate large contaminated sites following World War II, the Cold War, and abandoned industrial sites, and to return them to productive land uses. In the United States, the Department of Energy (DOE) has the largest cleanup challenge, and its Hanford Site in the state of Washington has the most extensive and most expensive cleanup task. Ideally, the risk to ecological resources on remediation sites is evaluated before, during, and after remediation, and the risk from, or damage to, ecological resources from contaminants should be lower following remediation. In this paper, we report the risk to ecological resources before, during, and as a consequence of remediation on contaminated units requiring cleanup, and then examine the causes for changes in risk by evaluating 56 cleanup evaluation units (EUs) at the Hanford Site. In this case, remediation includes a restoration phase. In general, the risk to ecological and eco-cultural resources is currently not discernible or low at most contaminated units, increases during remediation, and decreases thereafter. Remediation often causes physical disruption to ecosystems as it reduces the risk from exposure to contaminants. Most new remediation projects at the Hanford Site include ecological restoration. Ecological restoration results in the potential for the presence of higher quality resources after remediation than currently exists on these contaminated lands and facilities. Although counter-intuitive, our evaluation of the risk to ecological resources following remediation indicated that a significant percentage of units (61%) will be at increased risk in the post-remediation period. This increased risk is due to DOE's successful remediation and restoration that results in a higher percent of native vegetation and higher ecological value on the sites in the post-remediation period than before. These newly-created resources can then be at risk from post-remediation activities. Risks to these new higher quality resources include the potential for spread of invasive species and of noxious grasses used in previous cleanup actions, disruption of ecosystems (including those with state or federally listed species and unique ecosystems), compaction of soil, use of pesticides to control invasive species, and the eventual need for continued monitoring activities. Thus, by greatly improving the existing habitat and health of eco-receptors, and maintaining habitat corridors between high quality habitats, the ecological resources in the post-remediated units are at risk unless care is taken to protect them. Many of the negative effects of both remediation and future monitoring (or other future land uses) can be avoided by planning and management early in the remediation process. We suggest DOE and other agencies convene a panel of managers, remediation scientists, regulators, environmental and ecological scientists, Native Americans, economists, and the public to develop a generic list of performance metrics for the restoration phase of remediation, including evaluation of success, which could be applied across the DOE complex.

The management of embedded metal fragment patients and the role of chelation Therapy: A workshop of the Department of Veterans Affairs-Walter Reed National Medical Center.

Exposure to retained metal fragments from war-related injuries can result in increased systemic metal concentrations, thereby posing potential health risks to target organs far from the site of injury. Given the large number of veterans who have retained fragments and the lack of clear guidance on how to medically manage these individuals, the Department of Veterans Affairs (VA) convened a meeting of chelation experts and clinicians who care for embedded fragment patients to discuss current practices and provide medical management guidance. Based on this group's clinical expertise and review of published literature, the evidence presented suggests that, at least in the case of lead fragments, short-term chelation therapy may be beneficial for embedded fragment patients experiencing acute symptoms associated with metal toxicity; however, in the absence of clinical symptoms or significantly elevated blood lead concentrations (greater than 80 µg/dL), chelation therapy may offer little to no benefit for individuals with retained fragments and pose greater risks due to remobilization of metals stored in bone and other soft tissues. The combination of periodic biomonitoring to assess metal body burden, longitudinal fragment imaging, and selective fragment removal when metal concentrations approach critical injury thresholds offers a more conservative management approach to caring for patients with embedded fragments.

A paradigm for protecting ecological resources following remediation as a function of future land use designations: a case study for the Department of Energy's Hanford Site.

Since the late 1980s, there has been a US federal mandate to clean up contaminated sites remaining from the Second World War, the Cold War, and abandoned industries. One determinant of cleanup standards for remediation is future land use-how will the land be used and by whom? Land use decisions may be consensus documents developed by site owners, state and federal agencies, and local stakeholders. Often there are competing views and/or claims on how remediated sites should be used, including as open or green space. Large sites are likely to have more ecological heterogeneity within similar land use designations because of differences in climate, geology, topography, and history of human use. This paper uses the Department of Energy's (DOE) Hanford Site as a case study to examine how and whether future land use designations will protect species, species diversity, heterogeneity, and ecosystems once remediation is complete. The objective of this paper is to describe "future land use designations" on a large, complex site (DOE's Hanford Site) and to examine the following: (1) how future land use designations were made and have changed over time, (2) how land use designations included the value of ecological resources, (3) how risk evaluations of ecological resources from remediation were made, and (4) how future land use may affect the health and well-being of ecological resources on site in the post-remediation period. The paper provides a paradigm for integrating ecological protection into future land use designations such that rare and sensitive resources are protected throughout the process. The paradigm includes the following: (1) developing future land use designations, (2) defining resource levels (values), (3) relating resource levels to land use designations and management, (4) defining risk evaluations, (5) determining the likelihood that valuable resources will occur on each land use type after remediation, and (6) evaluating the potential risk to those resources that results from activities allowed under future land use designations. The paper discusses the importance of each step, the implications for protection of ecological resources, and the importance of land use designations in the assessment of risk to ecological resources from both continued monitoring and maintenance by DOE (or other land owners) and the activities permitted by the established future land use designations.