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Public Health Assessment Guidance Manual (PHAGM)
Public Health Assessment Guidance Manual (PHAGM)
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Page last reviewed:
April 14, 2022
Content source:
Agency for Toxic Substances and Disease Registry
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ATSDR PHAGM
About
Understanding the PHA Process
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ATSDR’s Mission and Goals
Mandates
Purpose of This Guidance
Steps and Components of the PHA Process
Factors to Consider in the PHA Process
Who’s Involved?
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ATSDR’s Role
Players in the PHA Process
Getting Familiar with the Site
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Gain A Basic Understanding of the Site
Identify the Community
Use Appropriate Information Sources
The Site Visit
Identify Information Gaps
Compile and Organize Information
Engaging the Community
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Community Engagement Goals and Phases in the PHA Process
Roles in Community Engagement
Understanding the Community
Effective Communication
Choosing Community Engagement Strategies
Community Engagement Actions, Tools, and Activities
Selecting Sampling Data
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Types of Sampling Data
Evaluating Sampling Data
Identifying and Filling Data Gaps
Evaluating Modeled Data
Considering Background Concentrations
Conducting Scientific Evaluations
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Exposure Pathways
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Overview of the Exposure Pathway Evaluation
Exposure Pathway Categories
Element 1: Contamination Sources
Element 2: Environmental Fate and Transport
Element 3: Exposure Points
Element 4: Exposure Routes
Element 5: Potentially Exposed Populations
Tips for Conducting the Exposure Pathway Evaluation
Screening Analysis
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Screening Analysis Overview
Screening Levels Used by ATSDR
Screening Analysis Steps
Screening Analysis Example
EPCs and Exposure Calculations
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Exposure Point Concentrations and Exposure Calculations Overview
Estimating Exposure Point Concentrations
Performing Exposure Calculations
Estimating Site-Specific Ingestion and Dermal Exposure Doses
Estimating Site-Specific Inhalation Exposures
Calculating Hazard Quotients and Cancer Risk Estimates
Other Factors to Consider
Drawing Conclusions
In-Depth Toxicological Effects Analysis
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In-Depth Toxicological Effects Analysis and E-Manual Section Overview
Identify Data from Studies Used to Develop
Non-Cancer
Health Guidelines
Review the Original Journal Article(s) that Served as the Basis for the
Non-Cancer
Health Guidelines, If Warranted
Examine More Recent
Non-Cancer
Studies, If Warranted
Evaluate the Evidence to Examine
Non-Cancer
Effects
Evaluate the Evidence to Examine
Cancer
Effects
Review Tox Data for Other Health Effects with Doses or Air Concentrations Similar to Those for Your Site
Review Other Contaminant-Specific Toxicological Information
Examine Radiation Exposures
Evaluate Site-Specific Health Effects Data
Putting It All Together
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Overview of Limitations, Conclusions, and Recommendations for Public Health Actions
Evaluating Limitations
Developing Conclusions
Determining Recommendations and Developing a Public Health Action Plan
Developing Your Documents
Tips for Preparing Written Documents
Releasing Documents
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Resources
Disclaimer
SAS
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