Boston Globe, The (MA) – Sunday, May 22, 2005
Author: Beth Daley, GLOBE STAFF

Every year, Department of Public Health officials receive more than a thousand calls from worried residents who are convinced that something in the air, water, or soil is making them and their neighbors sick.

But the reports of cancer clusters or tainted drinking water that the small staff of the Bureau of Environmental Health Assessment ultimately pursues often have more to do with politics than health priority.

Since 1998, close to two-thirds of the more than $9 million that has been budgeted for studies by the office has been spent on projects initiated at the direction of the Legislature, rather than selected by the agency’s professional staff, according to a Globe analysis of legislative records and budget figures provided by DPH officials.

“Investigations should be based on science, not politics,” said former state public health commissioner David H. Mulligan. “Choosing investigations this way undermines public trust.”

The studies called for by lawmakers have yielded few meaningful results, and some of the initiatives have little to do with investigating links between the environment and disease. Legislators set aside $50,000 in 2000 for health officials to examine, among other things, lactose intolerance in children who participate in school breakfast programs. This year’s budget awarded a $150,000 grant to the ALS Therapy Development Foundation in Cambridge, which deals with the disease amyotrophic lateral sclerosis.

The earmarking of funds allocated for environmental health investigations has contributed to an enormous backlog of cases in the department, delays that have deeply frustrated community activists who say the bureau is no longer effective.

“They are just not responsive anymore,” said Matt Wilson, the former director of the Toxics Action Center who stepped down last month. “We don’t trust them to do the right thing.”

The bureau’s 17 staff members dedicated to environmental health assessment have about 200 ongoing community investigations and another 40 on a waiting list, according to state health officials. Grafton residents have been waiting 15 years to find out if a cluster of cancer illnesses is unusually high. Lowell residents have been waiting since 1993 for a disease analysis near a former industrial area.

Health officials have faced increasing community concerns about environment pollutants in recent years. The book and movie “A Civil Action,” based on a childhood leukemia study in Woburn in the 1980s, helped spark a rise in citizen demand for answers about links between diseases and environmental contaminants.

Public outcry about disease clusters and environmental toxins often attracts news coverage and the attention of politicians. Public health specialists say this politicizes what should be an objective system that chooses investigations based on need.

“The money they have is not being apportioned in a rational way,” said David Ozonoff, professor of environmental health at Boston University. “It’s been allocated through political pressure.”

Items earmarked

In 2002, state health officials complained privately to legislators about the earmarking of money in the DPH budget, including those for disease investigations. Today, earmarks still eat up half of the bureau’s budget for studies.

“It’s a tough balance for competing interests,” said Suzanne Condon, the assistant commissioner of public health who oversees environmental health. Although legislators earmark funds in a much larger line item in the DPH budget, Condon says virtually all of the earmarks come from her environmental health budget, because most other costs within the line item are fixed.

Condon said the earmarks sometimes parallel the agency’s own concerns. She said the earmarks have “not deterred us from getting to what we consider to be the highest priority.”

An examination of the funds earmarked by the Legislature shows a hodgepodge of projects, some of which don’t appear to be directly related to environmental health.

The $150,000 grant to the ALS foundation was inserted with the help of former speaker of the House Thomas M. Finneran before he left office last year. The foundation, which publicly honored Finneran for securing the grant, is a member of the Massachusetts Biotechnology Council, which Finneran now heads. He declined to comment.

Legislators allotted $30,000 for nutritional supplements for people affected by renal disease in the last two budgets. Hundreds of thousands of dollars have been set aside to develop disease registries that specialists say would cost more than the state’s entire environmental health budget to properly develop and maintain.

“When you don’t manage your resources and prioritize, the folks who control your funds move into the void,” said Brent Baeslack of the Haverhill Environmental League, which has been waiting more than five years for a study on asthma cases near incinerators in the Merrimack Valley.

Political help

In the late 1990s, two public health inquiries by citizens took divergent paths.

In Walpole, health agent Robin Chapell became concerned by the number of phone calls from residents complaining about cancer rates near a landfill piled high with discarded shingles that used to emit clouds of chalky dust. She called the Department of Public Health for an investigation in 1997 and was put on a waiting list.

Two years later, Winthrop residents and town officials began linking Logan Airport with high rates of respiratory disease in nearby residents. Airport officials had proposed adding a runway, and residents were worried that more jet fuel exhaust and other pollution would trigger an increase in breathing problems.

After a survey showed a higher rate of respiratory problems among residents close to the airport, they brought their concerns to state Representative Robert DeLeo of Winthrop, a Logan expansion foe. Within months, DeLeo had helped win a $150,000 earmark for a Logan Airport air study and has since helped earmark $540,000 more.

“It was all political,” said a former high-ranking Department of Public Health official, who still works in the field and didn’t want to be identified. “A lot of people didn’t want the new runway.”

DeLeo defends his Logan study earmark, saying he is deeply alarmed by stories of health problems surrounding the airport. He said it has nothing to do with the runway that is now under construction, and defended himself and other lawmakers who have earmarked health studies.

“No one knows these communities better than its representatives,” said DeLeo. “We hope they would only bring grave concerns forward.”

Walpole residents are still waiting for their promised study.

“Every time I call they tell us about budget cuts and staffing cuts,” says Chapell. “It’s been almost ten years and we’re still waiting.”

Resources stretched

Every morning by 7 a.m., Condon is at her desk on the seventh- floor environmental health office near Downtown Crossing. Phones ring constantly.

Many callers’ concerns are dealt with quickly, as health workers explain that chance can create disease clusters, just as a handful of pennies thrown on the floor can randomly come to rest in groups.

For other problems or clusters that appear too large to be explained by chance, callers are asked to get community officials to write a letter listing specific concerns. If the concerns seem legitimate to state health workers, the community is placed in a queue, although Condon moves children’s health studies to the top of the list. Some cursory studies can last a few weeks, others can take years.

Condon joined the department in 1980 and helped investigate the Woburn leukemia cluster . She was made director of environmental health programs in 1990 and promoted to assistant commissioner in 2000. After Sept. 11, 2001, she was asked to lead the state’s bioterrorism protection efforts.

Critics say that Condon has taken on too much responsibility, is pursuing too many studies, and needs to do a better job of prioritizing which cases to investigate with limited resources. They also say she should be vocally protesting legislative meddling in the mission of her office.

“She must fight for what she needs,” said Kyla Bennett of Public Employees for Environmental Responsibility.

Condon defends her office’s performance, pointing out that 44 reports have been completed since March 2002.

“We do prioritize, . . . and we do say no,” Condon said.

Condon said her office will soon have someone to help oversee bioterrorism. In addition, a new software tool is coming on line that will dramatically reduce the time it takes for many studies to be completed.

In 1998, it became harder for Condon’s office to say no. That year, Natick legislators set aside $50,000 of Condon’s environmental health funds to study cancer in Natick. Another $150,000 was set aside to study illness in Rockland.

The earmarks coincided with a spike in calls to the state for help after the 1998 movie “A Civil Action.” In 2000, there were a record 2,100 phone calls to Condon’s office by citizens, the same year earmarks completely ate up the state environmental health budget.

Legislators defend their earmarks, and say they try to increase the line item amount so state officials had the same discretionary funds to conduct investigations they deemed worthy. But a Globe analysis of legislative records and Department of Public Health data from fiscal 1998 through fiscal 2005 shows the earmarks clearly cut into the bureau’s ability to do its job.

From 1992 to 1997, the environmental health budget hovered around $850,000 a year, according to state health officials. Yet since earmarking began, it has hovered around, on average, $430,000 a year. Some years, Condon was only able to keep some investigations going because of federal funding she receives.

“In a case like public health, we would like to rely on our public health managers to determine what our highest priorities are,” said Glen Tepke of the Massachusetts Taxpayers Foundation. “These legislative earmarks clearly cut into their ability to make these kinds of decisions.”

Changes investigated

Citizens whose causes win earmarks say they had no choice but to turn to their legislators for help.

“If you wait in line, you will be very old before you get an answer,” said Audrey DiGiovanni of Belmont, who is worried about cancer cases around a nearby metal finishing company. Residents in her neighborhood have lobbied to secure two $50,000 earmarks for an ongoing study.

Some health officials around the country are looking at different ways of conducting cluster investigations that insulate them from politics and carry a better chance of finding meaningful results. Some states only conduct in-depth investigations if they first find a likely contaminant that could be causing illnesses.

In Massachusetts, the Boston University School of Public Health is developing a guide for New England communities to help them prioritize environmental health studies. Others suggest that Massachusetts should rely on an advisory board made up of academics, health officials, and citizens to decide what to study.

First, some Massachusetts residents say, the state needs to finish the studies it has promised them.

“Our study has taken longer than it’s taken to revamp the space shuttle,” Baeslack said.

Beth Daley can be reached by email at bdaley@globe.com.

PROBING HEALTH HAZARDS
Studies by the office charged with investigating disease clusters and other environmental health concerns are sometimes initiated by legislators who earmark funds in the budget.