{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T08:32:35Z","timestamp":1758961955183},"reference-count":27,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2014,7,24]],"date-time":"2014-07-24T00:00:00Z","timestamp":1406160000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disaster med. public health prep."],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1935789314000603_abs1\" sec-type=\"general\"><jats:title>Objective<\/jats:title><jats:p>To assess the health of community residents following a coal fly ash spill at the Tennessee Valley Authority Kingston Fossil Plant in Harriman, Tennessee, on December 22, 2008.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789314000603_abs2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>A uniform health assessment was developed by epidemiologists at Oak Ridge Associated Universities and medical toxicologists at Vanderbilt University Medical Center. Residents who believed that their health may have been affected by the coal fly ash spill were invited to participate in the medical screening program.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789314000603_abs3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Among the 214 individuals who participated in the screening program, the most commonly reported symptoms were related to upper airway irritation. No evidence of heavy metal toxicity was found.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789314000603_abs4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>This is the first report, to our knowledge, regarding the comprehensive health evaluation of a community after a coal fly ash spill. Because this evaluation was voluntary, the majority of residents screened represented those with a high percentage of symptoms and concerns about the potential for toxic exposure. Based on known toxicity of the constituents present in the coal fly ash, health complaints did not appear to be related to the fly ash. This screening model could be used to assess immediate or baseline toxicity concerns after other disasters. (<jats:italic>Disaster Med Public Health Preparedness<\/jats:italic>. 2014;0:1\u20138)<\/jats:p><\/jats:sec>","DOI":"10.1017\/dmp.2014.60","type":"journal-article","created":{"date-parts":[[2014,7,24]],"date-time":"2014-07-24T10:08:53Z","timestamp":1406196533000},"page":"341-348","source":"Crossref","is-referenced-by-count":3,"title":["Medical Screening After a Coal Fly Ash Spill in Roane County, Tennessee"],"prefix":"10.1017","volume":"8","author":[{"given":"Gregory P.","family":"Nichols","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna L.","family":"Cragle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John G.","family":"Benitez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2014,7,24]]},"reference":[{"key":"S1935789314000603_ref27","unstructured":"Agency for Toxic Substances and Disease Registry. US Department of Health and Human Services. Coal fly ash landslide Forward Township, Allegheny County, Pennsylvania: health consultation; June 2006."},{"key":"S1935789314000603_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtemb.2010.11.004"},{"key":"S1935789314000603_ref12","unstructured":"Kingston ash slide: air quality information; December 5, 2013. Tennessee Valley Authority website. http:\/\/www.tva.com\/kingston\/air\/index.htm. Accessed August 2013."},{"key":"S1935789314000603_ref21","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03540350054033"},{"key":"S1935789314000603_ref2","unstructured":"Ash slide at TVA Kingston Fossil Plant: metals and polynuclear aromatic hydrocarbons results; January 6-7, 2009. Tennessee Department of Environment and Conservation website. http:\/\/tn.gov\/environment\/kingston\/metals.shtml. 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Tennessee Valley Authority Kingston Fossil Plant coal ash release: public health assessment; September 7, 2010. https:\/\/health.state.tn.us\/environmental\/PDFs\/pha-e-TVA_Kingston_Fossil_Plant_Final.pdf."},{"key":"S1935789314000603_ref3","unstructured":"Agency for Toxic Substances and Disease Registry. US Department of Health and Human Services. Toxicological profile for selenium; September 2003. http:\/\/www.atsdr.cdc.gov\/toxprofiles\/tp92.pdf."},{"key":"S1935789314000603_ref20","doi-asserted-by":"publisher","DOI":"10.1580\/1080-6032(1997)008[0177:LTTE]2.3.CO;2"},{"key":"S1935789314000603_ref4","unstructured":"Agency for Toxic Substances and Disease Registry. Toxicological profile for thallium. 1992. usa.gov website. http:\/\/www.atsdr.cdc.gov\/toxprofiles\/tp.asp?id=309&tid=49."},{"key":"S1935789314000603_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-6445(03)00055-X"},{"key":"S1935789314000603_ref5","first-page":"725","article-title":"Changes in the normal maximal expiratory flow-volume curve with growth and aging","volume":"127","author":"Knudson","year":"1983","journal-title":"Am Rev Respir Dis"},{"key":"S1935789314000603_ref7","unstructured":"SAS version 9.2 [computer program]. Cary, North Carolina: SAS Institute Inc., 2009."},{"key":"S1935789314000603_ref13","unstructured":"Tennessee Valley Authority. Kingston ash recovery project non-time-critical removal action embayment\/dredge cell engineering evaluation\/cost analysis (EE\/CA); January 15, 2010."},{"key":"S1935789314000603_ref14","unstructured":"AECOM. 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