To assess the effect of interim clean-up measures on the current health of a community, we conducted a follow-up survey of 193 residents living near the McColl waste disposal site and a comparison area located approximately 5 miles from the site. Results from this survey were compared with results from a similar survey conducted 7 years earlier. Odors were detected at least once per week by 32.7% of "high-exposed" respondents in 1988 compared with 68.5% in 1981, but prevalence odds ratios (PORs) comparing symptom reporting between "high-exposed" and comparison-area respondents were greater than that of the 1981 survey for 89% of symptoms. PORs comparing symptom reporting between these two areas were greater than 2.0 for 64% of symptoms assessed in the current survey. Symptoms reported in excess did not represent a single organ system or suggest a mechanism of response. PORs comparing respondents who were very worried about the environment and those reporting no worry were greater than 2.0 for 86% of symptoms. These finding, along with environmental data from the area, suggest that living near the waste disposal site and being very worried about the environment, rather than a toxicologic effect of chemical from the site, explain excess symptom reporting found in this follow-up study.

To investigate further the possible role of occupational exposures on mortality, an update of a large Texas petroleum refinery cohort was undertaken. Between 1937 and 1987, 6799 deaths were identified among 17,844 employees. Relative to the general population of Texas, the overall standardized mortality ratio (SMR) showed a statistically significant deficit, as did nine other cause-of-death categories. Statistically significant mortality excesses were found for bone cancer (SMR = 207.8: 95% confidence interval [CI], 110.6 to 355.3), acute lymphocytic leukemia (ALL) (SMR = 259.6; 95% CI, 112.1 to 511.5), and benign/unspecified neoplasms (SMR = 194.9; 95% CI, 129.5 to 281.7). However, none of these diseases demonstrated an exposure-response relationship with length of employment. Subcohort mortality analyses by sex and race groups, length of employment, interval since hire, period of hire, and pay status were also performed. Overall, the update findings do not indicate that any excess mortality occurred as a result of employment at the refinery.

Retrospective symptom pralence data, coec from over 2000 adult respondents living near three different hazrds waste sites, were analyzed with respect to both self-reported "environmental worry" and frequency of perceiving environmental (particularly petrochemical) odos Sigifnt positive relationships were observed between the prevalence of several symptoms (headache, nausea, eye and throat irritation) and both frequency of odor perception and degree of worry. Headaches, for example, showed a prevalence odds ratio of 5.0 comparing respondents who reported noticing environmental odors frequently versus those noticing no such odors and 10.8 comparing those who described themselves as "very worried" versus "not iworied" aboute i conditiosin their neighborhood. I tionofrespondents who ascribed their environnmental worry to illness in themselves or in family members did not materially affect the strength ofthe observed associations. In addition to their independent effects, odor perception and environmental worry exhibited positive interaction as determinants of symptom prevalence, as evidenced by a prevalence odds ratio of 38.1 comparing headaches among the high worry/frequent-odor group and the no-worry/no-odor group. In comparison neighborhoods with no nearby waste sites, environmental worry has been found to bea with symptom occurrence as well. Potential explanations for these observations are presented, including the possibility that odors serve as a sensory cue for the manifestation of stress-related illness (or heightened awareness of underlying symptoms) among individuals concerned about the quality of their neighborhood environment.