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Carter County, Tennessee: environmental and disease records

Cancer mortality in Carter County is 163.8 deaths per 100,000 people per year against a U.S. rate of 143.2, a statistically significant excess. The strongest disease signals are Lung & bronchus deaths at 1.6 times the U.S. rate. Federal databases place 200 regulated facilities, sites and hazards inside the county, led by NPDES wastewater discharge permit (112), Gas station (mapped facility) (24), Air permit holder (minor source) (17). One correctional facility operates in the county. EPA AirToxScreen estimates a lifetime cancer risk from outdoor air toxics of 20 in a million, driven mainly by formaldehyde.

Rates are age-adjusted per 100,000 people. A cancer signal is marked significant when the lower bound of its 95 percent confidence interval is above the U.S. rate. Facility counts use active federal records located inside the county boundary. Approximate county center: 36.3073, -82.1558.

How this county ranks in Tennessee

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Cancer deaths and new cases versus the United States

Source: NCI and CDC State Cancer Profiles, both sexes, all ages. Sorted by the ratio of the county rate to the U.S. rate.

Cancer rates for Carter County compared with the United States
Cancer	Measure	County rate	U.S. rate	Times U.S.	95% interval	Years
Lung & bronchus	Deaths	48.1	30.2	1.59xSignificant	41.8 to 55.2	2020-2024
Bladder	Deaths	5.8	4.1	1.41x	3.8 to 8.7	2020-2024
Lung & bronchus	New cases	73.2	51.8	1.41xSignificant	65.4 to 81.8	2019-2023
Thyroid	New cases	16.2	13	1.25x	12 to 21.5	2019-2023
Kidney & renal pelvis	Deaths	4.2	3.4	1.24x	2.5 to 6.8	2020-2024
Leukemia	Deaths	6.7	5.7	1.18x	4.5 to 9.9	2020-2024
All cancer	Deaths	163.8	143.2	1.14xSignificant	152 to 176.4	2020-2024
Bladder	New cases	20.5	18.7	1.1x	16.6 to 25.3	2019-2023
Melanoma of the skin	New cases	26	23.8	1.09x	21.2 to 31.8	2019-2023
Liver & bile duct	New cases	9.4	8.7	1.08x	6.7 to 12.9	2019-2023
Liver & bile duct	Deaths	7.1	6.6	1.08x	5 to 10.1	2020-2024
Brain & nervous system	New cases	6.6	6.2	1.06x	4 to 10.3	2019-2023
Esophagus	New cases	4.7	4.6	1.02x	2.9 to 7.5	2019-2023
Kidney & renal pelvis	New cases	18.2	17.9	1.02x	14 to 23.3	2019-2023
Brain & nervous system	Deaths	4.4	4.4	1x	2.6 to 7.3	2020-2024
All cancer	New cases	427.1	453.4	0.94x	406.9 to 448.2	2019-2023
Pancreas	Deaths	9.9	11.3	0.88x	7.1 to 13.6	2020-2024
Pancreas	New cases	11.5	13.9	0.83x	8.5 to 15.4	2019-2023
Leukemia	New cases	11.6	14.5	0.8x	8.4 to 15.8	2019-2023
Non-Hodgkin lymphoma	Deaths	3.8	4.8	0.79x	2.2 to 6.3	2020-2024
Non-Hodgkin lymphoma	New cases	12.7	18.5	0.69x	9.2 to 17	2019-2023

Mortality measures versus the U.S. county median

Source: County Health Rankings, built from CDC National Vital Statistics System death records. The comparison value is the median of all U.S. counties.

Mortality measures for Carter County
Measure	County	U.S. median	Difference	Unit
Premature death	12,615.6	9,842.6	+28%	years of life lost before age 75 per 100,000
Life expectancy	72.7	75.3	-3%	years
Child mortality	79.1	59.8	+32%	deaths under age 18 per 100,000
Infant mortality	6.4	6.2	+3%	deaths under age 1 per 1,000 live births
Injury deaths	129.2	96.9	+33%	deaths per 100,000
Drug overdose deaths	44.4	28.6	+55%	deaths per 100,000

Air toxics and air quality

EPA AirToxScreen 2020

Lifetime cancer risk from outdoor air toxics: 20 in a million. EPA treats 100 in a million as the upper end of acceptable risk and 1 in a million as the goal.

Formaldehyde16.89 per million
Carbon Tetrachloride2.77 per million
Acetaldehyde1.51 per million
Benzene0.86 per million

EPA Air Quality Index

No EPA air quality monitor reports daily AQI for this county.

Regulated facilities, sites and hazards by type

200 active records inside the county from EPA ECHO, TRI, Superfund, Brownfields, NPDES, EIA, FAA, FRA and corrections data.

NPDES wastewater discharge permit112
Gas station (mapped facility)24
Air permit holder (minor source)17
Auto repair or body shop (mapped facility)13
Rail grade crossing9
TRI reporting facility5
Toxic chemical release facility (TRI)5
Small hazardous waste generator4
Brownfield property3
Large hazardous waste generator3
Hydroelectric plant2
Public airport1
Correctional facility (prison or jail)1
Scrapyard (mapped facility)1

Highest-severity records

The 25 records with the highest Envyrofax severity in the county, with the agency identifier to cite in a records request.

Snap-On Tools Co, Elizabethton
Toxic chemical release facility (TRI). Chemicals: Nickel, Chromium, Nitrate compounds (water dissociable; reportable only when in aqueous solution), Zinc compounds and 4 more. Reports carcinogens. 31,010 lbs released over 5 years.
TRI facility ID 37644SNPNTSTATE (U.S. EPA Toxics Release Inventory)
Severity 7.9
Colorworks Division, Elizabethton
TRI reporting facility. Penalties $1,500.
EPA FRS registry ID 110004973002 (U.S. EPA ECHO) Agency record
Severity 7.3
Borla Performance Industries Inc, Johnson City
Toxic chemical release facility (TRI). Chemicals: Chromium, Manganese, Nickel, Diisocyanates. Reports carcinogens. 2,599 lbs released over 5 years.
TRI facility ID 37604SMNSN3000B (U.S. EPA Toxics Release Inventory)
Severity 7.1
Aym Inc - Tennessee Distribution Center, Elizabethton
Toxic chemical release facility (TRI). Chemicals: Copper, Lead, Nickel. Reports carcinogens. 578 lbs released over 5 years.
TRI facility ID 37643YMNCT100MC (U.S. EPA Toxics Release Inventory)
Severity 6.6
Colorworks Inc, Elizabethton
Toxic chemical release facility (TRI). Chemicals: Ammonia. 41,576 lbs released over 5 years.
TRI facility ID 3764WCLRWR151ID (U.S. EPA Toxics Release Inventory)
Severity 6.5
Snap On Tools, Elizabethton
TRI reporting facility.
EPA FRS registry ID 110000372212 (U.S. EPA ECHO) Agency record
Severity 5.8
Elizabethton Wwtp, Elizabethton
NPDES wastewater discharge permit.
EPA FRS registry ID 110039849037 (U.S. EPA ECHO) Agency record
Severity 5.5
Aym Inc - Tennessee Distribution Center, Elizabethton
TRI reporting facility.
EPA FRS registry ID 110012706107 (U.S. EPA ECHO) Agency record
Severity 5.3
Borla Performance Industries Inc, Johnson City
TRI reporting facility.
EPA FRS registry ID 110001994423 (U.S. EPA ECHO) Agency record
Severity 5.1
Siam Utility District-Wells, Elizabethton
NPDES wastewater discharge permit.
EPA FRS registry ID 110006688995 (U.S. EPA ECHO) Agency record
Severity 4.5
Mapes Piano String Co, Elizabethton
Toxic chemical release facility (TRI). Chemicals: Nickel, Lead, Ammonia, Manganese and 1 more. Reports carcinogens.
TRI facility ID 37643MPSPN408NO (U.S. EPA Toxics Release Inventory)
Severity 4.5
The Mapes Piano String Company, Elizabethton
TRI reporting facility.
EPA FRS registry ID 110000372203 (U.S. EPA ECHO) Agency record
Severity 4.3
Chemical Technologies Llc, Elizabethton
Large hazardous waste generator.
EPA FRS registry ID 110008134269 (U.S. EPA ECHO) Agency record
Severity 4
Roan Mountain State Park, Roan Mountain
NPDES wastewater discharge permit.
EPA FRS registry ID 110006664369 (U.S. EPA ECHO) Agency record
Severity 3.5
The Mapes Piano String Company, Elizabethton
Large hazardous waste generator.
EPA FRS registry ID 110000372203 (U.S. EPA ECHO) Agency record
Severity 3.3
Hampton Stone, Hampton
NPDES wastewater discharge permit.
EPA FRS registry ID 110071363705 (U.S. EPA ECHO) Agency record
Severity 3.3
Cherokee Industrial Park, Elizabethton
Brownfield property.
EPA FRS registry ID 110038753649 (U.S. EPA Brownfields (ACRES)) Agency record
Severity 3
Big G Market, Elizabethton
Brownfield property.
EPA FRS registry ID 110043638506 (U.S. EPA Brownfields (ACRES)) Agency record
Severity 3
Danny'S Auto Glass, Elizabethton
Brownfield property.
EPA FRS registry ID 110060856140 (U.S. EPA Brownfields (ACRES)) Agency record
Severity 3
Snap On Tools, Elizabethton
Large hazardous waste generator.
EPA FRS registry ID 110000372212 (U.S. EPA ECHO) Agency record
Severity 3
Colorworks Division, Elizabethton
NPDES wastewater discharge permit. Penalties $1,500.
EPA FRS registry ID 110004973002 (U.S. EPA ECHO) Agency record
Severity 3
Hampton Elementary School, Hampton
NPDES wastewater discharge permit.
EPA FRS registry ID 110006690697 (U.S. EPA ECHO) Agency record
Severity 3
Carter County, Elizabethton
NPDES wastewater discharge permit. Penalties $1,600.
EPA FRS registry ID 110069994733 (U.S. EPA ECHO) Agency record
Severity 3
Carter County Work Camp, Mountain City
NPDES wastewater discharge permit.
EPA FRS registry ID 110010947663 (U.S. EPA ECHO) Agency record
Severity 2.8
Colorworks Division, Elizabethton
Air permit holder (minor source). Penalties $1,500.
EPA FRS registry ID 110004973002 (U.S. EPA ECHO) Agency record
Severity 2.5

Correctional facilities

Prisons, jails and corrections operations with an EPA facility record, and the drinking water and wastewater compliance attached to them.

Carter County Work Camp, Mountain City
EPA FRS registry ID
110010947663
Wastewater permit
Yes, 5 quarters in noncompliance
EPA detailed facility report

Discovery / public records

Records to request for Carter County

Tennessee state cancer registry
Cancer incidence counts by census tract or ZIP code, by cancer type and year (de-identified). Any cancer cluster inquiries or investigations in Carter County, and their findings.
Tennessee vital statistics office
Death certificate counts by cause of death and residence tract or ZIP code, and the years behind the mortality measures above.
Tennessee health department, environmental epidemiology
Health consultations or assessments by ATSDR or the state health department covering the county, and any exposure investigations.
Tennessee environmental agency and the U.S. EPA regional office
Compliance history, inspection reports, notices of violation, penalties and enforcement actions for each facility above, cited by EPA FRS registry ID.
Tennessee drinking water program
Violation notices, sampling results and sanitary surveys for the public water systems serving the county, including any system serving a correctional facility.
Department of corrections or county sheriff
Water testing, grievances and environmental health inspections for the correctional facilities listed above.

Each Envyrofax address report includes a printable records request worksheet with the custodian and the exact request wording per finding.

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