2016-09-16_PERMIT FILE - M2016009

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V COLORADO Department of Public Health b Environment Dedicated to protecting and improving the health and environment of the people of Colorado Jodi Schreiber Fremont Paving and Redi Mix Canon City, CO 81212 September 14, 2016 Dear Ms. Schreiber: Thank you for contacting the Colorado Department of Public Health and Environment with your concern of potential worker exposure to anthrax during excavation work. Human anthrax is extremely rare in the United States. There are less than 100 cases of human anthrax that occur each year in the world. The most recent reported human case in the United States was 2011. In the 2014 Zoonotic Disease in Colorado Annual Report, no cases of anthrax were reported between 2009 and 2014. There is a very low risk to humans of contracting anthrax from soil being disturbed, even if naturally occurring anthrax spores are present in the soil. Anthrax in humans can be acquired in three ways: cutaneous, ingestion, or inhalation. Cutaneous, or skin, anthrax can occur when the bacterial anthrax spores enter an open wound and infect the wound. Ingestion, or gastrointestinal, anthrax occurs in poorer parts of the world where persons may eat animals that have died from anthrax. Inhalational anthrax develops when anthrax spores enter the lungs through the airways. Most inhalational anthrax cases in the US occurred in the early 1900s and were in factory or mill workers who were regularly exposed to spores while they directly processed animal hides or hair. In 2001, eleven cases of inhalational anthrax occurred in workers at the US Postal Service. This was deemed an act of terrorism. The human case in 2011, was a single inhalational anthrax case and no specific exposure was identified in the investigation. There has not been a case report to date that has linked even a single case of human anthrax to soil disruption activities such as excavation. Because of the concentration of spores needed, human acquisition of anthrax directly from soil is very unlikely. Rather, host animals are required for spore germination and anthrax is naturally acquired from infected meat and animal products. In addition, unlike anthrax spores that have been manipulated for terrorism to improve their ability to stay aloft in the air, naturally occurring anthrax spores have an affinity to quickly fall to the ground and remain there. I hope that you find this information helpful. We appreciate your concern for your employee's health and safety. Should you have any additional questions, you may contact me at (303)692-2791. Sincerely, Roberta Smith, RN, MSPH, CIH Occupational Health Program Manager Colorado Department of Public Health and Environment 4300 Cherry Creek Drive S., Denver, CO 80246-1530 P 303-692-2000 www.cotorado.gov/cdphe John W. Hickenlooper, Governor I Larry Wolk,MD,MSPH, Executive Director and Chief Medical Officer i876_�