The Alaska Community Action on Toxics asked BDRC to participate in a conference call with Dr. Ted Schettler, Alaska Native community representatives and others concerned about a report from the health department that birth defects in Alaska were double the rate of other states. There was also an increase in certain birth defects in Alaska Native communities near open waste dumps. One problem identified during the call was that Alaska has required reporting of birth defects by health care facilities and providers for children up to age six. Birth defect reporting systems that have required monitoring out to six years will usually show double the rate of birth defects found in systems that use hospital discharge data. Despite this, there was a four-fold increase in the rate of other congenital defects in infants born to Alaska Native mothers residing in villages with high hazard dumpsite contents.