Approximately 16,000 municipal waste water treatment plants in the US produce over seven million tons (dry weight) of residual sludge each year;most is applied to agricultural lands as free fertilizer. This sludge, also known as biosolids, consists of sediments resulting from the treatment of waste water from homes, streets, schools, hospitals, and industries. In addition to nutrients useful for agriculture sludges contain pathogens, allergens, metals, industrial chemicals and Pharmaceuticals. As land application of sludges has increased, neighboring rural residents have reported health problems and impaired quality of life. Residents whose concerns have been dismissed by government officials have low trust in authorities and in health research conducted by government agencies and university researchers who have ties with sludge generators and industries that profit from sludge disposal. Many affected communities are in low income, rural areas, making land application of sludge an environmental justice issue. Since the 1990's community members from across the country have organized through conferences and the internet to seek assistance in conducting research into health problems that may be caused by land application of sewage sludge, and to educate citizens and government officials. Using CBPR methods developed in prior research on human exposure to hog waste, and building on community and research partnerships solidified at a recent participatory workshop, we propose to conduct an assessment of off-site migration of sludge constituents linked to an epidemiologic study of neighbors of sites permitted for land application of sludges. We will recruit neighbors of sites permitted for sludge application in North Carolina and Virginia to participate in a one-year longitudinal study of environmental exposures, symptoms, physiological functioning, and health- related quality of life. Neighbors in two types of areas will participate: areas where permits have been issued but no land application has yet occurred;and areas where sludges have been recently applied. Recruitment will be accompanied by environmental health and environmental justice education conducted under the leadership of experienced community based organizations.
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