By Barbara Anderson / The Fresno Bee

KETTLEMAN CITY — Five babies with cleft palates or other grave disabilities were born over a 15-month span in this small farming community off Interstate 5. Three died.

Many parents worry that poisons in the air, water and land are to blame. Their town of 1,500 is wedged in among agricultural fields, two highways and a hazardous-waste landfill.

Environmental-justice groups, who oppose a proposed expansion of the landfill, call it a “birth-defect cluster” — a surge in birth defects unlikely to occur by chance. They want an investigation.

But experts say parents may never know what hurt their babies. Apparent spikes in birth defects or cancer cases are notoriously difficult to verify, especially in small communities — and linking them to a specific cause is even harder.

Kings County health officials point out that different types of birth defects are involved, so it’s not yet clear whether the birth-defect rate was high enough to qualify as a cluster. But at least four of the babies had cleft palates.

Nationally, very few reports of elevated birth-defect rates are statistically out of line enough to be identified as clusters, experts say.

Even such instances do qualify as a cluster, an investigation likely would find no clear underlying cause: Birth-defect clusters sometimes happen randomly, they say. And many factors — genetics, nutrition, infections, the environment — can contribute to an increase. Untangling one factor from another to find a cause can be nearly impossible, they say.

The debate in Kettleman City has taken on fresh urgency as a hearing approaches on whether to allow an expansion of the Waste Management landfill three miles southwest of town.

On Dec. 7, the Kings County Board of Supervisors is scheduled to consider the company’s expansion request. The hearing is a result of an appeal by environmental groups after the county Planning Commission approved the expansion in October. Parents and environmental activists say the plans should be stopped until the birth defects have been investigated.

But investigations of possible clusters often take months, even years, said Lisa Croen, an epidemiologist who helped probe birth defects during 14 years at the California Birth Defects Monitoring Program.
“I know it’s very frustrating for families who have concerns, but that’s the challenge to scientists,” said Croen, who now is in charge of autism studies at Kaiser Permanente’s division of research in Oakland.

The landfill question
For about two decades, families in Kettleman City have voiced concerns about the nearby hazardous-waste landfill. It handles things like paints, batteries, solvents and pesticides, among other hazardous materials.
Now, they wonder whether there’s a connection between the landfill and the birth defects.

“I don’t say it’s the plant itself, but what else could it be?” Magdalena Romero said in Spanish through an interpreter. Romero’s daughter, America Romero, was born in September 2007 with a cleft palate and other problems from trisomy 13, a chromosome disorder. She died after 41/2 months.

Ivan Rodriguez, 28, said he and his wife, Daria Hernandez, both speaking through an interpreter, took walks in the hills near their home while she was pregnant with their son, Ivan Yhoel. “Once in a while, there would be some bad odors,” Rodriguez said.

Their baby was born with a cleft palate. Now he’s 1, but he can’t eat solid food and must drink formula through a special bottle. Hernandez, 23, said her doctor asked whether she used drugs or worked around pesticides that could have caused the birth defect. She had not, she said.

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