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Susitna-Watana Hydroelectric Project Document
ARLIS Uniform Cover Page
Title:
Health impact assessment study, Study plan Section 15.8 : Final study plan
SuWa 200
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Alaska Energy Authority
AEA-identified category, if specified:
Final study plan
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Series (ARLIS-assigned report number):
Susitna-Watana Hydroelectric Project document number 200
Existing numbers on document:
Published by:
[Anchorage : Alaska Energy Authority, 2013]
Date published:
July 2013
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Date or date range of report:
Volume and/or Part numbers:
Study plan Section 15.8
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Document type:
Pagination:
13 p.
Related work(s):
Pages added/changed by ARLIS:
Notes:
All reports in the Susitna-Watana Hydroelectric Project Document series include an ARLIS-
produced cover page and an ARLIS-assigned number for uniformity and citability. All reports
are posted online at http://www.arlis.org/resources/susitna-watana/
Susitna-Watana Hydroelectric Project
(FERC No. 14241)
Health Impact Assessment Study
Study Plan Section 15.8
Final Study Plan
Alaska Energy Authority
July 2013
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15.8. Health Impact Assessment Study
On December 14, 2012, Alaska Energy Authority (AEA) filed with the Federal Energy
Regulatory Commission (FERC or Commission) its Revised Study Plan (RSP), which included
58 individual study plans (AEA 2012). Section 15.8 of the RSP described the Health Impact
Assessment Study. This study focuses on analyzing the potential positive and negative impacts
of programs, projects, and policies on the health of residents in impacted communities. RSP
15.8 provided goals, objectives, and proposed methods for data collection regarding health
impacts.
On February 1, 2013, FERC staff issued its study plan determination (February 1 SPD) for 44 of
the 58 studies, approving 31 studies as filed and 13 with modifications. RSP Section 15.8 was
one of the 31 studies approved with no modifications. As such, in finalizing and issuing Final
Study Plan Section 15.8, AEA has made no modifications to this study from its Revised Study
Plan.
15.8.1. General Description of the Proposed Study
15.8.1.1. Study Goals and Objectives
Health Impact Assessment (HIA) is a structured planning and decision-making process for
analyzing the potential positive and negative impacts of programs, projects, and policies on the
health of residents in impacted communities. In particular, four aspects of the Project may impact
community health:
• The large size of this Project will require a large influx of construction personnel over
several seasons which could impact the residents in various Railbelt communities.
• The development of the Project could lead to increased rail traffic and possibly additional
traffic on the Parks and Denali Highways, potentially impacting communities and
individuals using these transportation resources.
• It is possible that the creation of a large reservoir on the Upper Susitna River could
produce conditions that could lead to changes in subsistence harvest locations or
quantities, possibly leading to changes in nutritional uptake of subsistence users. Also a
new reservoir could increase the bioaccumulation of naturally occurring mercury at a
level that potentially affects public health. If this scenario occurs, it could potentially lead
to consequences for local individuals, and even communities harvesting (and ingesting)
aquatic resources in the Susitna River.
• The Project could lead to potential emission reductions from Railbelt fossil-fuel utility
plants if the Project is operating and this could potentially lead to a reduction in
emissions that affect public health in Railbelt communities.
Potential health considerations for construction and operational staff are not typically evaluated
in HIA as they will be addressed in the occupational medicine and safety component of the
various plans and specifications for construction activities and operational manuals for the
Project.
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The comprehensive HIA will use the methods and guidelines in the Alaska Department of Health
and Human Service’s (DHSS’s) “Technical Guidance for HIA in Alaska,” July 2011
(www.epi.hss.state.ak.us/hia/AlaskaHIAToolkit.pdf).
As part of the goals and objectives of an HIA the following activities are important to undertake:
• Identify potentially affected communities (PACs) and establish a community engagement
plan.
• Through a review of the FERC scoping meetings and ongoing community engagement,
identify public issues and concerns about how community health might be affected
during construction and operation of the Project.
• Collect baseline health data at the state level, borough, or census area level, tribal level,
and at the potentially affected community level, as possible.
• Identify data gaps and determine the most efficient method to fill those gaps, through
community consultation and coordination with other studies, such as subsistence (Section
14.5), socioeconomics (Sections 15.5 and 15.6), and recreation (Section 12.5).
• Evaluate the baseline data against the Project description to initially determine the nature
and extent of potential impact pathways, both positive and negative.
• Prepare an HIA baseline data report document which is transparent, scientifically
rigorous, and understandable to the public.
15.8.2. Existing Information and Need for Additional Information
A variety of existing information sources is available and potentially useful to the HIA analysis.
These information sources include reports from various Alaska state agencies including:
• Alaska Department of Health and Social Services
̶ Bureau of Vital Statistics
̶ Alaska Behavioral Risk Factor Surveillance Survey (BRFSS)
̶ Youth Risk Behavior Study (YRBS)
̶ Section of Epidemiology bulletins
̶ Alaska Trauma Registry (ATR)
̶ Cancer Registry
• State of Alaska Department of Labor and Work Force Development
̶ Employment reports
• Alaska Department of Transportation and Public Facilities
̶ Highway traffic statistics, particularly on large loads vehicles
̶ Alaska State Trooper annual reports
• Alaska Department of Fish & Game
̶ Harvest studies
̶ Community Information System
The Alaska Native Tribal Health Consortium (ANTHC) prepares health status reports on a
statewide and regional basis. The AEA HIA team will use these reports as baseline data:
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• Alaska Native Health Status Report, August 2009
• Regional Health Profile for Interior Alaska, July 2011
• Regional Health Profile for Anchorage and Matanuska-Susitna, December 2011
In addition, pertinent reports from the U.S. Centers for Disease Control and Prevention and
annual reports, such as County Health Rankings, prepared by the University of Wisconsin, are
important resources that will be reviewed.
Review of the above data sources allows identification of data gaps which require additional
information.
15.8.3. Study Area
The proposed HIA study area includes those communities potentially affected by construction
and operation of the Project, such as Cantwell and communities along the Alaska Railroad
corridor, as well as those communities further away but potentially affected by the movement of
workers, materials, and supplies by using the criteria available in the Technical Guidance for
HIA in Alaska (DHSS 2011). The study would also include communities identified in the
Regional Economic and Air Quality studies that would experience changes in emissions resulting
from reductions in fossil-fuel utility plant outputs as a result of the Project. In addition to the
communities along transportation corridors and those identified in the Regional Economic and
Air Quality studies, the HIA study will initially consider all the communities being studied in the
Subsistence Study. Together all these communities have been initially identified as PACs for the
Project analysis to help facilitate collecting baseline information that could be used in the
analysis of Project effects. Some sample analysis factors that could be used to evaluate a
communities possible nexus to the Project effects the following criteria are examined:
• Close geographic proximity to the Project,
• High likelihood for worker influx,
• Intense work force recruitment potential,
• High likelihood for change in key subsistence resources,
• High likelihood for change in transportation infrastructure,
• Potential for economic change including regional staging centers, and
• Existing high level of exposure to an environmental hazard that would be potentially
exacerbated or improved by Project development.
15.8.4. Study Methods
The HIA will be divided into the following phases to systematically address data gaps identified
during the overview process.
15.8.4.1. Project Overview and Issues Summary
The Project overview process will:
• develop Project-specific criteria for establishing the PAC’s analysis framework (PACs
for health may not be the same as for other social sciences and must be established);
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• coordinate through community engagement, other social study areas, and other AEA
licensing participant engagement programs to gather enough of the appropriate
information to meet HIA needs; and,
• identify potential health concerns and issues related to the Project.
The result of this effort will be a “Project Overview and Issues Summary” that will be included
in the Initial Study Report and will include a set of the geographical, time scale, and population
boundaries of the assessment. The report will generally follow the overall strategies and
methodologies presented in the “Technical Guidance for HIA in Alaska.” For example, the State
of Alaska HIA Program has identified the following eight health effect categories (HECs) that
should be used to categorize the issues and concerns:
1. Social Determinants of Health (SDH),
2. Accidents and Injuries,
3. Exposure to Potentially Hazardous Materials,
4. Food, Nutrition, and Subsistence Activity,
5. Infectious Disease,
6. Water and Sanitation,
7. Non-communicable and Chronic Diseases, and
8. Health Services Infrastructure and Capacity.
These HECs are fully described in the “Technical Guidance for HIA in Alaska.” In addition,
there may be community-level health concerns that are expressed holistically and do not fit this
analytic structure. In addition, positive health benefits of a new renewable energy resource to the
region will be identified. An HIA, however, cannot address every conceivable health effect or
effects that are primarily nuisance impacts and rarely observed. Instead, the initial Project review
process highlights health effects that have the possibility of producing intense impacts with
persistent duration and broad geographical scope that are highly likely to occur. There must also
be a clearly defined causal link between the Project and the anticipated health effect.
15.8.4.2. Phase 2: Baseline Data Collection
After the Project overview process is complete, it will be necessary to perform an analysis of
available federal/state/regional/tribal/community/household level health data starting in the
second half of 2013 and proceeding through 2014. Data collected by other Project studies will be
included where such studies will produce baseline data that may be useful to the HIA. For
example, AEA will use information from the Air Quality study concerning existing and future air
quality levels, and from the socioeconomic studies for population projections and household
characteristics, which have been shown to be key determinants of health. Coordination between
studies will avoid unnecessary duplication of effort and community ‘survey fatigue.’
Subsistence issues and existing available community / household consumption and nutritional
data are often critical for local communities. AEA HIA team will integrate some efforts with the
Subsistence Resources Study (Section 14.5) to address how subsistence issues interact with the
proposed Project location, size, linear features, and PACs. Community input and baseline harvest
data and traditional and local knowledge (TLK) documented in the Subsistence Resources Study
(Section 14.5) will be used to identify those subsistence foods and practices that are vital to
residents of the area. This information will be used to identify potential impacts to the quality
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and quantity of, and access to, subsistence resources. Direct, indirect, and cumulative impacts to
subsistence will be considered throughout HIA study.
Field studies are designed to fill data gaps. For example, 1) AEA will document community food
sources in PACs during/in conjunction with the subsistence household harvest surveys 2) the
AEA HIA practitioners will work alongside the AEA Subsistence Resource Study (Section 14.5)
practitioners to document traditional and local knowledge regarding health in the subsistence
TLK workshops. The AEA HIA team may conduct follow-up interviews regarding health with
key respondents identified during TLK workshops and make observations on critical community
services, such as water, sanitation, and health care facilities, including medical emergency
services capabilities. Understanding capabilities and functionality of these services provides
input to determining potential effects related to influx, construction activities, and roadway
traffic. Field studies and community visits will be coordinated with Subsistence Resource Study
efforts (Section 14.5) to provide the information in an efficient manner.
The Subsistence Resources Study (Section 14.5) will document TLK. The AEA HIA team will
conduct follow-up interviews regarding health with key respondents identified during TLK
workshops.
The AEA HIA team will perform data collection tasks within the “subsistence resource study
communities” according to identified data gaps. The Subsistence Resources Study (Section 14.5)
includes a list of study communities designed to adequately address potential impacts to those
who use the study area for subsistence activities. This includes communities that are located
outside the study area but have documented use within the study area. The Subsistence
Resources Study (Section 14.5) developed these criteria for inclusion as a study community:
• the community is located within the Susitna River watershed;
• the community is located outside of the Susitna River watershed but has previously
documented subsistence use areas that extend into the watershed; or
• the community is one of the communities preliminarily identified by ADF&G as needing
updated harvest information.
Based on the above criteria, the Subsistence Resources Study (Section 14.5) has identified 37
study communities whose subsistence uses could potentially be affected by the proposed Project.
The HIA study will work through the subsistence data collection efforts to gather information
from a food security/nutrition perspective. As part of the subsistence household surveys,
ADF&G survey tools include a food security/nutrition section to help identify potential nutrition
related considerations most of the communities being surveyed. The survey tool to be
administered can be found in the Draft Household Harvest Survey Instrument of the Subsistence
Resource study plan. Depending on results from the baseline studies in 2013, some additional
communities that have not been surveyed specifically for the food security/nutrition aspects may
need to be surveyed in 2014. If that is the case, then the ISR will include the rationale and
methods to gather additional information to supplement the baseline study information and this
will be discussed with Licensing Participants in 2013-2014 TWG meetings.
The output of the baseline data review, data gaps analysis, and field studies will be a “Baseline
Community Health Data Assessment” chapter in the HIA which will be included in the Updated
Study Report.
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15.8.4.3. Phase 3: Identification of Potential Impact Mechanisms and Effects
The specific health impacts for the Project will be identified when all components of the Project
have been defined as AEAs proposal in its License Application to FERC. The HIA analysis in
2013 and 2014 therefore will not necessarily serve as a final HIA for the Project; however the
analysis, as needed, can be updated and included in the FERC License Application once the
AEA Project proposal is finalized. For this study, the AEA HIA team will rate and rank the
health impacts using a semi-quantitative model described in detail in the HIA Toolkit. The
purpose of rating and ranking impacts is to enable interested parties to construct a health impact
management framework.
The HIA will consider impacts that have beneficial or detrimental consequences to communities
or individuals. Each health impact has several different dimensions, listed below.
• Significance
• Nature
• Timing and duration
• Extent
• Magnitude (intensity)
• Frequency
The HIA process may include the following components:
• In-depth review of available state, regional, tribal, and local health data;
• Comparison of study area data to state and regional health data;
• Analysis of special at-risk subpopulations (such as children under the age of five years,
pregnant women, elderly, or other previously defined vulnerable groups);
• Consideration of key Project-specific toxicology issues, e.g., mercury loading associated
with reservoir development and impacts on subsistence resources;
• Field survey visit and consultation with local health representatives, particularly from
tribal organizations, if present;
• Seasonality considerations, i.e., summer versus winter differences in subsistence
practices, water use, and associated disease-transmission dynamics;
• Variability of existing health care infrastructure across different affected areas;
• Coordination and alignment with existing State disease-control programs and strategies
(e.g., TB, HIV/AIDS, hypertension, diabetes, substance abuse, etc.); and
• Detailed consideration of impacts to tribal peoples through the presentation of tribal
health data and inclusion of the results of tribal health consultations in the HIA.
The information developed in this study is intended to be sufficient to be able to prepare a Health
Management Plan (HMP), if needed in the licensing process, which may include:
• Types of health protection processes that may be needed;
• Traditional knowledge, perspectives, and activities that may represent uniquely tribal
approaches to human wellness;
• Strategies available to lessen impacts and the timescales relating to health impacts;
• Temporary measures which can be put in place; and
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• Local capacity to put the proposed strategies into practice.
15.8.4.4. Phase 4: HIA Document Preparation
An HIA document, with technical appendices as needed, written in accordance with the DHHS
HIA guidelines will be issued in the Updated Study Report. The HIA will be updated to include
relevant results from 2014 field studies as reported in the Initial Study Reports.
15.8.5. Consistency with Generally Accepted Scientific Practice
The HIA will follow the ADHHS technical guidance for HIAs (ADHSS 2011). These guidelines
are the standard to which HIA is performed in the State of Alaska.
15.8.6. Schedule
An Initial Study Report for the HIA will be completed by Q1 2014. This initial report will
document the project overview, issues summary, and baseline data collected. Results from other
studies (Subsistence (Section 14.5), Air Quality (Section 15.9), Social Conditions and Public
Goods and Services (Section 15.6) and any additional information and analysis conducted in
2014 will be summarized in the Updated Study Report in Q1 2015 (see Table 15.8-1).
15.8.7. Relationship with Other Studies
The HIA is dependent upon results from several other studies and will require input from several
other studies as shown in Figures 15.8-1 through 15.8-5, below. As shown in Figure 15.8-1, the
HIA HEC3 Exposure to Potentially Hazardous Materials will use baseline data collected via the
Mercury Assessment and potential for Bioaccumulation Study (Section 5.7) to establish a
baseline of current levels of contaminants of human health concern present in fish and in water.
These data will be compared to human health risk based screening levels. Similarly, the HIA will
use data generated by the modeling exercise portion of these studies in order to assess potential
project impacts on contaminant levels in fish and water. Mercury will be a specific area of focus
for this HEC given its potential for: adverse effects on human health; its bioaccumulative
properties; and given that reservoir construction can elevate levels of mercury in fish through the
release of natural and anthropogenic-sourced inorganic mercury from flooded vegetation and
soils.
As shown in Figure 15.8-2, the HIA HEC3 Exposure to Potentially Hazardous Materials will
also utilize baseline emissions data collected by the Air Quality and Transportation Studies as a
resource for determining baseline air quality in the PACs. Data generated by the modeling of
future air emissions portion of the by Air Quality Study will inform the assessment of Project
driven risks to human health due to potential change in air quality.
As shown in Figure 15.8-3, the HIA HEC2 Accidents and Injuries will utilize traffic levels data
(Road, Air, Rail, River) generated by the Transportation Study as a resource for establishing a
traffic safety baseline in the PACs. Data generated by the traffic forecasting portion of the study
will inform the assessment of project driven accidents and injury risk posed by changes in
baseline traffic.
As shown in Figure 15.8-4, the HIA HEC1 Social Determinants of Health will use the Social
Goods and Public Services Study as a resource for establishing baseline social determinants of
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health. Data regarding: hiring practices, cultural change; housing availability/inflation; economy,
employment, and education; generated by the Engineering and Social Goods and Public Services
Studies will be used inform the assessment of potential project driven changes in SDH.
As shown in Figure 15.8-5, the HIA HEC4 Food, Nutrition, and Subsistence section will use the
Subsistence Resources Study to identify subsistence resources currently used in project area and
as a resource to evaluate potential project impacts on identified subsistence uses in the PACs.
15.8.8. Level of Effort and Cost
Based on past HIA experiences in Alaska, the HIA study program is expected to cost
approximately $200,000.
15.8.9. Literature Cited
AEA 2011. Railbelt Large Hydroelectric, Presentation to the Alaska Senate Resources
Committee and the House Energy Committee, by the Alaska Energy Authority, January
25, 2011.
DHSS 2011. Technical Guidance for Health Impact Assessment in Alaska, Alaska Department
of Health and Human Services, Section of Epidemiology, Health Impact Assessment
Program, July 2011.
15.8.10. Tables
Table 15.8-1. Schedule for implementation of the HIA.
Activity 2012 2013 2014 2015
1 Q 2 Q 3 Q 4 Q 1 Q 2 Q 3 Q 4 Q 1 Q 2 Q 3 Q 4 Q 1 Q
Project Overview and Issues Summary
Baseline Data Collection -----
Initial Study Report Δ
Potential Impact Mechanisms & Effects
Updated Study Report ▲
Legend:
Planned Activity
----- Follow up activity (as needed)
Δ Initial Study Report
▲ Updated Study Report
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15.8.11. Figures
Figure 15.8-1. HIA Interdependencies for Baseline Water Quality and Mercury Bioaccumulation Studies.
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Figure 15.8-2. HIA Interdependencies with Air Quality and associated Transportation Study components.
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Figure 15.8-3. HIA Interdependencies with the Transportation Study.
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Figure 15.8-4. HIA Interdependencies with Social Conditions and Public Services Study.
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Figure 15.8-5. HIA Interdependencies with Subsistence Study.