clustera on Nov 4th 2008
Cape Cod Times
Cancer study triggers debate
A longtime skeptic of the Air Force’s PAVE PAWS early warning station in Sagamore has set his sights on the state health department.
Dr. Richard Albanese, a physician who works for the Air Force, claims a recent state Department of Public Health (DPH) study that ruled out the radar station as a primary cause of a rare cancer cluster among children on Cape Cod was flawed.
State health department officials and others say the study was scientifically legitimate.
The 11-month, $40,000 study compared the strength of the radar’s beam that is hitting the homes of the sick children with sites that were not associated with someone who had been diagnosed with Ewing’s sarcoma.
Albanese claims the study had a pre-determined outcome because of the way the research was designed.
Albanese, who worked on the original military panel that cleared PAVE PAWS for operation in 1979 but has since grown wary of the radar station, takes issue with several aspects of the study. His biggest concern is that the comparison sites state investigators used in the study were at similar elevation and distance from the radar station as the homes of the sick children.
Because like was compared to like, the measurements were predictably similar, Albanese said.
For the study to have been done properly, random comparison sites — at different elevations and distances from the radar station — should have been conducted, Albanese said during a phone interview from his Texas home. Albanese emphasized he was commenting on the DPH study as a private citizen.
“It’s a profound error,” he said. “The study has limited to no utility.”
The DPH study, released in December, concluded it was unlikely that PAVE PAWS was the main cause of 14 local cases of Ewing’s sarcoma, a rare bone cancer, since 1982.
The study focused on eight individuals — seven children and one adult — diagnosed between 1995 and 2004. The expected number of cases on Cape Cod during that time is two.
According to the American Cancer Society, the expected incidence rate of the disease is 2.9 cases in 1 million people. There are slightly fewer than 50,000 children under 21 in Barnstable County, according to the 2004 Census.
Broadcast Signal Lab of Cambridge was hired last year to take the radar-beam power measurements for the DPH study. Broadcast Signal Lab technicians took measurements at the homes of the 14 people diagnosed with Ewing’s sarcoma since 1982. They also took measurements at 17 comparison sites at similar elevation and distance from PAVE PAWS as the homes.
Albanese likened the DPH study to comparing a small group of people who smoke and have cancer with a slightly larger group who smoke and do not have cancer, and concluding that smoking does not cause cancer.
The DPH study also was far too small and shallow to reach the conclusions it did, he said.
State study defended
Suzanne Condon, DPH assistant commissioner, said Albanese confused the type of study her department conducted.
Condon said the comparison measurements Albanese is looking for were done by Broadcast Signal Lab in 2005 for an Air Force-sponsored study looking at whether PAVE PAWS was contributing to health problems on the Upper Cape.
The 2005 study, which did not look at Ewing’s sarcoma cases, and was reviewed by the National Academies of Science, concluded the radar station did not pose a threat to public health on Cape Cod.
The more recent DPH study was an “exposure study,” Condon said.
“We did a very focused study looking at PAVE PAWS emission levels in close proximity to homes of children diagnosed with (Ewing’s sarcoma). When you’re looking at an exposure, you try to match as closely as you can on all the variables,” she said.
The study was intended to help state health officials determine whether to launch a more intensive phase of investigation, Condon said.
In addition to the radar power measurements, DPH asked two pediatric oncologists to examine the results, and they agreed that more investigation of PAVE PAWS was not necessary, she said.
The way DPH approached the study makes sense to Dr. Thomas Burke, an epidemiologist at Johns Hopkins University in Baltimore, Md.
What DPH did with the study “has to be interpreted in light of the monitoring that was done before. That said, there does not appear to be high levels of exposure throughout the Cape,” he said.
It made sense to look at data collected at the homes of the children diagnosed with Ewing’s sarcoma, and other areas of similar elevation and distance to see whether there was something unique about those exposures, in comparison to what was found across Cape Cod in 2005, said Burke, who is former deputy director of New Jersey’s health department.
“They had specific questions about peak exposure, and they did a good job of following up on that,” he said.
Scientific certainty elusive
Ann Aschengrau, professor of epidemiology at Boston University, agreed with Albanese that the DPH study was not rigorous enough to rule out PAVE PAWS as a factor in the Ewing’s cluster on Cape Cod.
“Matching on elevation and distance was essentially matching on exposure level, and so was a fatal flaw,” she wrote in an e-mail. “We often do match in epidemiological studies, but it’s usually done for variables like sex, race, etc.,” not possible disease exposures, she said.
For the study to be done properly, Albanese said peak power measurements of at least 1,000 random comparison sites would need to be done — preferably in off-Cape locations. The measurements would need to be repeated over time to see whether there was any seasonal variations in the measurements, he said.
Burke expressed confidence that the Massachusetts health department can get to the bottom of the Ewing’s sarcoma mystery. The department is viewed nationally as “having a pretty solid, good approach to investigating these kinds of things.”
Victor Vyssotsky of Orleans, a retired Bell Laboratory development director, said launching a full investigation into the cause of the Ewing’s sarcoma cluster would “use up resources and time” the state health department does not have.
Vyssotsky helped design an Alaskan radar station similar to PAVE PAWS and served on the first National Research Council panel that reviewed and cleared PAVE PAWS for public use in the early 1980s. He claimed the federal Centers for Disease Control and Prevention or the Mayo Clinic in Baltimore, Md., are the two best places to research the cause of the elevated Ewing’s sarcoma cases on Cape Cod.
While Vyssotsky said he is not an epidemiological expert, he has worked extensively in the field of military radar. He called Albanese, whom he knows personally, “a very dedicated, very sincere physician whose concerns about the effects of high-powered radiation in general are well-warranted.” He also asserted that “some of the inferences (Albanese) draws are a bit far-fetched.”
Albanese praised DPH investigators, but he said adequately researching whether PAVE PAWS is affecting residents’ health was beyond the realm of their expertise.
“I think they try to do a good job, but they have no experience with radiation and disease,” he said.
The Air Force doctor claimed the DPH study — as well as many of the past studies that have been conducted by the Air Force — did little to ease his concerns about PAVE PAWS. There has never been a human, laboratory animal or plant experiment to assess the biological impact of phased array radiation, he said.
To continue to expose the public to a type of radiation that has never been tested in the laboratory is like giving citizens a drug that was never tested for its safety, he said.
“I have no data to say that absolutely it is PAVE PAWS (that caused the Cape Ewing’s sarcoma cases)” he said. “But I am certain it cannot be ruled out.”
Robin Lord can be reached at email@example.com.
Filed in Massachusetts