The Agency for Toxic Substances and Disease Registry (ATSDR) has faced concerns related to the quality of some of the public health products it publishes. ATSDR investigates community exposures related to certain hazardous chemical sites and releases; assesses associated health effects; and recommends actions to stop, prevent, or minimize harmful effects. ATSDR publishes many types of products, including public health assessments, health consultations, exposure investigations, and health study reports. GAO was asked to examine the extent to which ATSDR's policies and procedures for product preparation, including work initiation, product development, and review and clearance, provide reasonable assurance of product quality. GAO reviewed ATSDR policies and procedures and interviewed agency officials and employees. GAO recommends that ATSDR develop policies and procedures that direct management to assess the risk level of work when it is initiated and reevaluate the risk level throughout product preparation to ensure it remains appropriate, and that ATSDR revise its policies and procedures to include guidance about management's roles and responsibilities in monitoring product development.