By Christopher Dunagan

BREMERTON, Wash. — Puget Sound Naval Shipyard has agreed to pay a $56,000 fine for the improper handling and storage of hazardous chemicals, officials say.

The fine was issued by the U.S. Environmental Protection Agency following an unannounced inspection in January 2009. Inspectors from both the EPA and Washington Department of Ecology were involved.

State and federal officials had worked with the shipyard over the years to improve waste-handling techniques, said Jack Boller, an EPA inspector. During the surprise inspection in 2009, “we started finding things that we thought we had addressed years ago.”

Among the more serious violations was an open-grated floor in the shipyard’s plating shop, where hexavalent chromium was allowed to drip down and accumulate in the basement below.

Jeff Kenknight, manager of EPA’s hazardous waste compliance unit, said hexavalent chromium can cause respiratory illnesses and increase the risk of lung cancer.

“This is a toxic compound that can cause health problems and harm the environment,” he said. “Handling it improperly can have serious consequences.”

Officials with Puget Sound Naval Shipyard & Intermediate Maintenance Facility acknowledged that chemicals dripping into the subfloor should have been cleaned more frequently — but that system is specifically designed to contain and segregate waste, said public affairs officer Mary Anne Mascianica. The system protects the health of employees and prevents releases to the environment, she said.

“The facility’s design and operational controls have always ensured potential exposures to be far below OSHA permissible exposure limits,” she added.

Since the inspection, the shipyard has improved operating procedures in the plating shop to reduce the likelihood of drips going into the containment system, she said. Any drips that are contained get cleaned up promptly.

The inspectors also made note of an open drum of paint solvent near an open bay door in a storage shed at the pier. Because the pier was over the water, a spill had the potential of releasing the toxic chemical into Puget Sound.

When the inspectors noted the open drum, it was immediately closed up, Mascianica said, adding that there was no danger of it tipping over. Since the inspection, lids have been purchased to make it easier to seal the drums, and employees have been trained about the closure requirements.

“PSNS & IMF continues its commitment to be a good steward of the environment, striving for excellence in its work practices and processes to protect and improve the quality of our environment,” Mascianica said.

The two issues cited by inspectors were considered violations of the federal Resource Conservation and Recovery Act, which regulates hazardous waste.

Join an ongoing discussion about all things water-related at the blog Watching Our Water Ways.

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The National Disease Clusters Alliance (NDCA) announced its support for new legislation to strengthen protections for children and communities from disease clusters, introduced yesterday by Senator Barbara Boxer (D-CA), Chairman of the Environment and Public Works Committee. This long-awaited legislation helps communities determine whether there is a connection between “clusters” of cancer, birth defects and other diseases, and contaminants in the surrounding environment. Senators Amy Klobuchar (D-MN), Frank Lautenberg (D-NJ) and Bill Nelson (D-FL) joined Senator Boxer as original co-sponsors of the legislation.

The National Disease Clusters Alliance (NDCA) applauds this bill. “There is true vision in creating a solution in which government, science and community work as equal partners in responding to disease cluster inquiries,” NDCA Executive Director Terry Nordbrock stated. The National Disease Clusters Alliance (NDCA) was formed in 2005 out of the urgent need to identify and respond to emerging disease clusters. NDCA is made up of a unique cross-section of representatives across the country from non-profit organizations, community activists, scientists and academia.

“There is now an urgent need to identify and respond to emerging disease clusters in communities,” Nordbrock reports. “Fortunately, this bill will revolutionize the experience of communities facing disease clusters.” 

Senator Boxer said: “Whenever there is an unusual increase in disease within in a community, those families deserve to know that the federal government’s top scientists and experts are accessible and available to help, especially when the health and safety of children are at risk. I am pleased to be introducing this legislation today that will enable communities to get the answers they need as quickly as possible.”

Throughout the country, there are communities that experience unexpected increases in the incidence of birth defects, cancer and other diseases. The legislation being introduced today is designed to:

o Strengthen federal agency coordination and accountability when investigating these “clusters” of disease;

o Increase assistance to areas impacted by potential disease clusters; and

o Authorize federal agencies to form partnerships with states and academic institutions to investigate and help address disease clusters.

The legislation being introduced was initiated by Susan Rosser and Charlie Smith with her son, Trevor Schaefer, co-founders of Trevor’s Trek Foundation, in association with two scientists from the University of Arizona, Mark Witten and Paul Sheppard. Trevor survived a 7-year battle with brain cancer from the age of 13. Since that time he and his mother have worked tirelessly to raise awareness of disease clusters and their possible links to toxins in the environment. 

“Environmental toxin exposure is insidious in all instances, yet affects our children in greater proportion than adults,” says Trevor. “This bill will help eradicate predatory disease by bringing together agencies with the relevant expertise needed to investigate these clusters.”

Currently, chronic diseases like cancer, birth defects, and multiple sclerosis strike over 100 million men, women and children, accounting for more than a third of the U.S. population. These diseases are responsible for seven out of ten deaths in the United States.

Around the country-from the Acreage, Florida to Kettleman City, California to Fort LeJeune, North Carolina-communities are faced with unusually high rates of disease, or in other words, disease “clusters,” and health officials are unable to determine why. Questions abound about what is causing these elevated rates. Is there something in the drinking water? Does the nearby military installation impact our health? Is the air we breathe causing us to get sick? Too often questions posed to local health officials are not answered satisfactorily or not even responded to at all.

Although over 1000 concerned residents request investigations into suspected disease clusters every year, cluster investigations are rarely undertaken by government agencies. When it comes to tackling infectious disease, public health institutions perform well, but they do not have the same ability to identify and respond to environmentally-related illnesses. Health officials are currently working with their hands tied as they don’t have the resources or time to address the concerns. This results in tremendous frustration for concerned community members and a significant loss of trust in government. This bill will increase federal and state capacity to answer questions about disease clusters asked by concerned community members.

While no community is immune from a potential disease cluster, residents of low-income and racial minority communities are at disproportionate risk for exposure to environmental hazards, and potential disease clusters. This bill will create safer and healthier communities across the nation, by identifying communities at risk and halting emerging disease clusters.

This bill will provide more research into causation and prevention of disease. By investigating the environment in areas with health impacts, we have the opportunity to address significant weaknesses that presently exist in the investigation of possible disease clusters. Bringing environmental agencies to the table will support the ongoing work of health agencies and add important scientific expertise to these investigations.

A strength of this bill is that it includes access to laboratories to conduct biomonitoring and environmental analysis to measure contaminants in people’s bodies as well as in air, water, food, and soil. This lack of data is the weak link in current risk assessment and environmental exposure analysis. Communities currently lack access to technical assistance and this bill corrects that. 

Transparency and governmental accountability are overarching goals of this legislation and have the potential to make agencies more proactive rather than reactive.

The sponsors of the bill have also received letters of support from the Breast Cancer Fund; the Center for Health, Environment and Justice; the Children’s Environmental Health Network; National Disease Clusters Alliance; Natural Resources Defense Council; the Sierra Club; and Dr. Philip J. Landrigan, MD, MSc., Professor of Pediatrics, Dean for Global Health, Professor and Chairman of the Department of Preventive Medicine, Director of the Children’s Environmental Health Center, Mount Sinai Medical Center.

Disease Cluster and Hotspot Map

Washington, DC – Today, Senator Barbara Boxer (D-CA), Chairman of the Environment and Public Works Committee, introduced legislation to help communities determine whether there is a connection between “clusters” of cancer, birth defects and other diseases, and contaminants in the surrounding environment.

Senators Amy Klobuchar (D-MN), Frank Lautenberg (D-NJ) and Bill Nelson (D-FL) joined Senator Boxer as original co-sponsors of the legislation.

Senator Boxer said: “Whenever there is an unusual increase in disease within in a community, those families deserve to know that the federal government’s top scientists and experts are accessible and available to help, especially when the health and safety of children are at risk. I am pleased to be introducing this legislation today that will enable communities to get the answers they need as quickly as possible.”

Throughout the country, there are communities that experience unexpected increases in the incidence of birth defects, cancer and other diseases. The legislation being introduced today is designed to:
o Strengthen federal agency coordination and accountability when investigating these “clusters” of disease;
o Increase assistance to areas impacted by potential disease clusters; and
o Authorize federal agencies to form partnerships with states and academic institutions to investigate and help address disease clusters.

The legislation being introduced today is supported by the Trevor’s Trek Foundation, co-founded by Charlie Smith and Susan Rosser with Trevor Schaefer, who survived after being diagnosed with brain cancer seven years ago at the age of 13. Trevor and his family have worked to raise awareness of disease clusters and their possible links to toxins in the environment, and to help build support for legislation to assist communities experiencing suspected disease clusters.

The sponsors of the bill have also received letters of support from the Breast Cancer Fund; the Center for Health, Environment and Justice; the Children’s Environmental Health Network; National Disease Clusters Alliance; Natural Resources Defense Council; the Sierra Club; and Dr. Philip J. Landrigan, MD, MSc., Professor of Pediatrics, Dean for Global Health, Professor and Chairman of the Department of Preventive Medicine, Director of the Children’s Environmental Health Center, Mount Sinai Medical Center.

Salon Magazine
Laura Miller

The shocking story of how industry and government poisoned and then abandoned the Navajo Nation

In the summer of 1979, an earthen dam over the town of Church Rock, New Mexico, broke, flooding the arroyo below and then the bed of the Rio Puerco (an intermittent stream) on the southern border of the Navajo Nation. It was a small flood, but a dangerous one. It burned the feet of a boy who stepped into it, and caused sheep and crops along the banks to drop dead. That’s because the pond it came from had been used by a nearby uranium mine to store the tailings (residue) of its excavations — the water kept the radioactive dust from blowing away. The 93 million gallons of contaminated water that poured into the Rio Puerco remains the largest accidental release of radioactive material in U.S. history, bigger than the notorious Three Mile Island reactor meltdown that occurred 14 weeks later.

The Church Rock flood is only one incident among many in the “slow-motion disaster” investigative journalist Judy Pasternak comprehensively recounts in her chilling new book, “Yellow Dirt: An American Story of a Poisoned Land and a People Betrayed.” Based on a prize-winning four-part series she wrote for the Los Angeles Times, “Yellow Dirt” begins during World War II, when secretive government surveyors first appeared on the remote reservation, supposedly looking for deposits of an ore called vanadium, used to strengthen steel needed for the war effort. Uranium was the real prize, and after the bombings of Hiroshima and Nagasaki and the ramping up of the Cold War, the American demand for the radioactive substance boomed.

The Navajo Nation and the area around it contained some of the richest deposits of uranium ore in the world, and certainly the most conveniently located. For about a decade, various corporations and government agencies reaped 1.4 million tons of uranium ore from the Monument Valley region alone; Pasternak makes a single mine there, known as Monument No. 2, her primary focus. The mining operations were relatively rudimentary, and by ordination of the tribal government, worked almost entirely by Navajo men. Even the cheapest and most elementary safety practices, such as wetting down blast areas to keep the miners from breathing toxic dust, were neglected in the rush to satisfy the Atomic Energy Commission’s insatiable appetite for uranium.

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NDCA Board President Scott Burdman and Founder and current Vice President Dee Lewis attended the Stand Up To Cancer broadcast event on Friday, September 10th, 2010. The National Disease Clusters Alliance is proud to be a SU2C Advocacy Resource Partner.

Dee Lewis is founding member and former Director of Concerned Residents Initiative (CRI). With CRI she investigated and catalogued cancers in her former neighborhood in order to push the state to research environmental factors in the community. She has been profiled in numerous newspapers, including the Sacramento Bee, Reno Gazette and the Trenton Times and in several video media news stories and special features. In her continuing efforts to bridge community and agency communication, NDCA has been a participant with the California State Health Tracking Program and the Centers for Disease Control National Health Tracking Program, since inception in 2003. Dee was a contributor to the expert working group of California Senate Bill 702(SB702) CA Tracking Bill. In 2005 she spearheaded efforts to form partnerships with state and federal departments of health, academics, researchers and community advocates from across the nation. In December 2006 this group formalized as the National Disease Clusters Alliance (NDCA) as the Red Cross responds to disasters, NDCA responds to disease clusters in communities and works as a liaison between community and agency.

Ms. Lewis serves as Co- Investigator with California Department of Public Health (CDPH) in the Environmental Health Investigations Branch (EHIB) the Tracking Implementation TIAG part of the CA Health Tracking Program and as a participant in the U.S. Centers for Disease Control and Preventions National Health Tracking Initiative 2004.

Scott Burdman, licensed to practice law in Arizona, Colorado, Nevada, California and Ohio, concentrates in the area of construction defect litigation. Mr. Burdman has recouped over $100 million in settlement and trial verdicts for his construction defect clients over the last six years. With more than 25 years experience, Mr. Burdman has represented over 100 homeowner associations to resolve claims of defective construction. Mr. Burdman has been successful in using mediation in lieu of litigation to resolve construction defect claims for a number of condominium projects and planned unit developments. Mr. Burdman is personally involved in attending site inspections, board meetings, mediations and trials of claims. He has presented over 100 legal seminars for property management companies and their boards of directors on construction defects, condominium law, and related issues. He is active in promoting legislation protecting consumers and is a member of Arizona Trial Lawyers Association, Community Associations Institute, Arizona Association of Community Managers, and Consumer Attorneys of California. Mr. Burdman earned a Bachelor of Business Administration from Ohio University and a Juris Doctor from California Western School of Law.

Visit the Stand Up To Cancer website for more information.

Study focuses on clusters to find cause of Del.’s high rates

By JEFF MONTGOMERY
The News Journal

A quarter century after Delaware found itself with the nation’s highest cancer death rate, health officials have narrowed their search for cancer clusters to the neighborhood level, where for the first time local rates of rare cancers could provide clues to environmental or other causes.

In one of the most unique studies of its kind, state epidemiologists identified 45 out of 196 zones with total cancer rates exceeding state and national rates by margins health officials regard as significant.

Some of those cancers are of a type known to have environmental links, an ominous discovery in a state with a national legacy of asthma-inducing air pollution, toxic waste dumps and groundwater contamination that has now breached an aquifer serving tens of thousands in Delaware, New Jersey and Maryland.

Across the state, cancers most often found to be significantly elevated were breast, colorectal, lung and prostate, already the most common types in Delaware and nationwide.

But in some spots, rarer cancers emerged at rates far higher than state averages, even after the Division of Public Health made large allowances for margins of error due to age and small sample sizes in U.S. census tracts with an average of 4,000 residents. Researchers examined reports of all cancers from the most recent years available, 2002-2006.

Among the worst neighborhood-level clusters, they found:

• Laryngeal cancer cases in Northeast Wilmington next to Brandywine Creek between Northeast Boulevard and Market Street.

• Melanoma in a small tract around Brandywood, south of Naamans Road between Grubb and Foulk roads.

• Ovarian cancer rates in the Hockessin area that were more than four times the state average.

• Thyroid cancers in the Overview Gardens and Minquadale areas southwest of Memorial Drive.

• Leukemia in a suburban and rural tract west of Dover and northwest of Wyoming.

• Ovarian cancer east of Bridgeville and Greenwood.

• Melanoma, kidney and esophageal cancers west of Rehoboth Beach.

Census tracts with unusually high cancer rates turned up in all three counties, from the top of Brandywine Hundred to west Dover and the Love Creek area in coastal Sussex County.

Epidemiologists looked for four patterns: the rates of all types of cancers in a single tract, the rates for specific cancers in those tracts, differences between men and women, and average ages of diagnosis, especially early or late.

The top 10 average rates for cancers of all types and the highest rates for men and women were confined to New Castle County and Kent County, but scattered tracts in all three counties had unusual spikes of specific cancers.

The tract-level cancer study was ordered by the Delaware General Assembly after The News Journal waged a long struggle to persuade state health officials to release detailed cancer rate data. Delaware now is one of the few states in the nation to assess cancer rates for every census tract. To prevent identifying any one person with cancer, health officials released only average annual rates for all cancers and did not list the actual counts, which range from one or two new cases a year to a few dozen.

The Centers for Disease Control has investigated and confirmed dozens of clusters in dozens of states over the years. But federally led investigations seldom turn up a single, clear-cut cause. Cancers can have many, hard-to-verify triggers, the agency pointed out, including family background, lifestyle choices such as smoking and eating habits, occupational exposures and pollution encountered in communities far removed from the home of record where the cancer was diagnosed.

How far Delaware researchers will continue to explore the data depends on money and political will.

“There are a lot of red flags here,” said Dr. Paul Silverman, Public Health’s associate deputy director for health information and science. “I would agree with the concern. However, as is true with all of these census tracts, all you can do at this point is hypothesize. We would actually have to have additional information in order to answer any questions.”

Department of Natural Resources and Environmental Control Secretary Collin P. O’Mara said his agency is reviewing the results and will take the small-area cancer statistics into account while setting priorities in the future.

A lack of evidence of any direct tie to air or water toxins will not inhibit his agency from taking steps to reduce pollution, he said.

Environmental health concerns were behind DNREC’s recent push to curb releases from larger pollution sources, including NRG’s Indian River power plant, O’Mara said. The census tract findings could help focus its efforts on smaller sites or environmental programs that may have a large impact.

Initiatives have expanded

State lawmakers voted in 2008 to require an analysis of each year’s cancer reports by census tract. It was the latest in a series of cancer control initiatives that date as far back as 1986, when then-Gov. Mike Castle announced a push that included fielding mobile mammography vans and talk of statewide environmental reviews.

Castle’s move followed release of grim national health rankings that pegged Delaware as having the nation’s highest death rate from some cancers.

Cancer control services and initiatives have expanded in the years since, and cancer mortality rates have fallen. Yet rates for both deaths and new cancers in Delaware remain higher than the average for the nation as a whole.

In this latest study, overall rates in eight tracts appeared to reach “significant” levels, according to Public Health, because rates for several individual cancers in that area randomly edged higher than the state average.

For the remaining 37 tracts where Silverman said there could be concern, however, rates were significantly high for at least one of 23 types of cancer, including several diseases sometimes tied to environmental exposures, such as bladder, thyroid, liver and brain cancers, leukemia and non-Hodgkins lymphoma.

Bladder cancer can be caused by workplace exposure to chemicals. Liver cancer has been tied to arsenic in water, steroids and on-the-job pollution exposures. Radiation exposure can cause thyroid and brain cancer, as well as leukemia and non-Hodgkins lymphoma, although certain chemicals also can cause leukemia.

Retiree Irene Butcher rarely hears neighbors talk about the cancers that turn up far too often among residents in her Jefferson Farms community, just north of New Castle.

“I haven’t heard any talk, but I read the paper a lot and I do know that Delaware is kind of high up on the list,” for cancer rates, Butcher said. “It seemed like it used to be that if somebody in your family didn’t have it, you didn’t have to worry about it. Now cancer strikes anybody.”

Rates in Jefferson Farms were 70 percent higher than the Delaware average for all cancers — higher than anywhere else — according to Public Health’s study.

Just a few blocks from Butcher, Irene Jones has been battling breast cancer since 2004. Jones described cancer as a personal and family burden, recalling grandparents stricken with or lost to the disease. A retired Colonial School District teacher, Jones said her family originally was from New Jersey, but she also worried that cancer might fall more heavily on the neighborhood where she’s now settled.

“It’s something you’re always concerned about, maybe because of your family history, or where you work, or where you live,” said Jones, who said she has been cancer-free since treatment. “I worry here sometimes because of all the landfills around.”

“People need to be kept informed about cancer, and they needed to be reminded about taking care of their health care,” said Jones, whose cancer was detected by a routine mammogram. “You need to monitor your own health and you need to go for checkups.”

Both men and women had higher-than-average rates for cancer in Jones’ community, prostate cancer was detected at a rate 85 percent higher than the state as a whole, and breast cancer rates were just slightly over the state average.

Push for information

One tract that also stood out in the Public Health study is a swath of land between I-95 and Del. 273, northwest of the Delaware City petrochemical complex.

The zone from Salem Woods in the west to Raintree Village in the east had a cancer rate for men more than double the state average, with an average age at diagnosis eight years younger than was typical.

Prostate cancer rates were 1.7 times higher than the state average. Breast cancer rates were 84 percent higher, laryngeal cancer rates were four times the state’s average and leukemia rates 2.5 times higher.

Leukemia is a disease that state officials noted can have environmental ties, such as exposure to benzene, a common industrial chemical and motor fuel ingredient found in cigarette smoke and auto exhaust. In a yearlong investigation published this year by The News Journal, benzene was one of a number of chemicals found in groundwater across the state.

Salem Woods resident William K. Dadson said the state should press on and quickly share what it finds about the cancer clusters.

“I think it’s good for them to pinpoint it, and let people know what’s going on,” Dadson said. “Cancer is a concern for everyone. It’s very important, and health information should be available to the public.”

State’s rate 9.5% higher

Delaware has attempted several close-up looks at cancer in recent years, an effort partly rooted in nagging, decades-long concerns about the state’s chronically higher average rates of cancer detections and cancer deaths compared with national findings.

State officials struggled through the late 1980s to fend off connections between the state’s cancer rates and its industrial past, high pollution levels and proximity to a so-called “Cancer Alley” in neighboring New Jersey, where high cancer rates led to state and federal investigations.

The state’s most recent five-year report, released in May, found that cancer turned up 9.5 percent more often in Delaware residents than the nation as a whole, with cancer 4 percent more likely to kill.

Despite those sobering numbers, officials have pointed out, the state’s cancer mortality rate has fallen 18.9 percent from a decade ago, when it was among the nation’s highest. The annual rate of new cancer cases has dropped 3.8 percent over the same period.

“Looking at one point in time or one five-year period is not nearly as helpful as looking at trends,” said Dr. Karyl Rattay, Delaware’s public health director.

State officials were prodded again to dig deeper into cancer rates in 2006 and 2007, amid public demands for studies in southeastern Sussex County. Health concerns in that area had become entangled with politically charged debates over offshore wind power, clean energy and emissions from the oil- and coal-burning Indian River power plant near Millsboro.

The result was a widely reported cancer-cluster reflecting higher-than-average lung cancer rates in a large swath of land southeast of the power plant.

Those findings however, were based on ZIP code boundaries, geographic areas that sprawl across several census tracts, some far removed from the power plant.

But it also got the attention of lawmakers troubled by the state’s resistance to releasing cancer rate data by census tract to The News Journal.

State objections to data releases included claims that statistics could be used to identify patients. They also said that such small areas are more likely to be affected by random spikes or drops in cancer cases, distorting true rates.

The Legislature brushed those concerns aside, giving health officials 90 days to produce census tract studies after each year’s statewide cancer report.

Now that the first census tract report has been compiled and broken down further by individual cancers, Heather Woods resident Patsy A. Howaniec says the state needs to share what it knows.

Her neighborhood stands on the edge of a tract newly identified as having the state’s second-highest cancer rate.

“Scary stuff,” Howaniec said. “I’d like to know more.

Lung cancer rates in the tract, north of Du Pont Highway in Bear and including Brookmont Farms and Wellington Woods, were double the state’s average, and oral cancer rates 4.7 times higher.

Small areas produce quirks

Recent findings in Sussex show just how complicated cancer investigations can get in smaller areas, and some of the troubling quirks that they can turn up.

In the new census tract report, neither the greater Millsboro area nor any of the census tracts adjacent to it had unusually high average rates for any cancers, despite lung cancer statistics by ZIP code that inflamed earlier debates over the Indian River power plant emissions.

In fact, Sussex County had the lowest number of tracts with significantly elevated cancer statistics of any in Delaware. In two of the six tracts, no single cancer could be found with notably higher-than-average rates.

Silverman cautioned that Public Health would need more data, time and research to determine whether environmental cancers signal a problem.

“I regard all of these [findings] as clues, which may or may not bear fruit,” Silverman said.

In the case of the suspected lung cancer clusters in the Millsboro area, a series of individual surveys found that higher prevalence of the disease was mainly due to higher prevalence of tobacco use and past work in a range of “high-risk” jobs.

The high-risk job category takes in a huge share of the county work force, including those in jobs involving agriculture, chemicals, construction, manufacturing and pharmaceuticals.

In some areas, clusters represent real puzzles.

Among the tracts with the top 10 highest rates are three areas of Kent County where land use runs the gamut from suburban to small-town and rural — including parts of the county’s small Amish community.

Two tracts in Kent accounted for the state’s fourth- and fifth-highest average rates of all cancers. In some tracts in Kent, cancer was discovered at earlier ages, with high rates for scarce cancers including leukemia and non-Hodgkins lymphoma, which has been linked to radiation, weakened immune systems and some infections.

Some scientific studies also have found correlations between non-Hodgkins lymphoma and exposures to pesticides and emissions from older types of waste incinerators.

Inaccurate population data

Census tract studies are especially tricky, said Elizabeth Ward, the American Cancer Society’s vice president for surveillance and research.

High rates deserve a second look, she said, but a high prostate cancer rate may be evidence of better diagnosis rather than a higher incidence of the disease.

“If you see higher rates of prostate cancer, it may actually reflect higher utilization of screening, said Ward, who lives in Atlanta. “There are some cancers where it’s pretty clear that one of the things really driving the rates is utilization of testing.”

Another complication is the possible inaccuracy of population estimates. Delaware’s census tract populations estimates are based on the 2000 census. The new population count will not be available to the public until February.

Precision especially suffers, Ward said, if several years have passed since a full census tally.

“The smaller the area, the more the chances are that you can get statistical errors,” Ward said. “We saw that toward the end of the time before the last census. We started seeing some strange patterns in cancer rate by county, especially when we looked at cancer rates by county and race.”

In Delaware, Public Health has investigated cancer clusters in small areas of the state for years, based on cancer surveillance reports, requests from residents or other triggers. Studies have never confirmed a cause for any cluster, but some have raised eyebrows.

In fact, an individual resident’s concern about cancer in the Brandywood census tract last year led to a conclusion that melanoma rates among women were significantly higher than the state rate for 2001-2005. That same cluster also turned up in the latest study of the average for 2002-2006, with melanoma more than 330 percent higher than state rates.

A different citizen request this year led to a study of childhood cancer rates and deaths, and found that Kent County childhood cancer rates exceed national rates by a significant amount. In that case, Public Health said it would continue monitoring and “assume position of watchful waiting for childhood cancer incidence trends in Kent County.”

In Salem Woods — south of Old Baltimore Pike near Newark, part of a census tract with the third-highest rate for all cancers — longtime postal worker Earl C. Cunningham has plenty of questions about cancer. Some focus more on how he’s lived than where.

Cunningham was treated for prostate cancer in 1999 but has long wondered whether his sometimes-heavy exposure to the herbicide Agent Orange decades ago during two combat tours in Vietnam set the stage for discovery of the disease. Public Health does not include prostate cancer as having a confirmed environmental cause.

“If there’s a problem in this area, they need to own up to it. But it’s hard to say,” Cunningham said. “Most of the people in this community come and go; they move in and out. The longer-term ones, I’m not aware of them having any cancer-related illnesses.”

Gerard Rushton, a University of Iowa professor who developed Iowa’s cancer mapping program, praised Delaware’s effort but echoed Ward’s concern that random swings can get magnified when the focus gets too tight and the census records stale.

“Once you get down to saying that in this small area we have four or five cancers, the rates go up and down like a yo-yo. You can be looking at a map, but it’s really not a valid map. We call it the small number problem,” said Rushton, who said he is wary of any studies based on zones with fewer than 50 cases.

Rushton, who is awaiting a decision on a National Cancer Institute grant for research on cancer tracking, said that New York and California have developed census tract surveys in recent years. But the practice remains rare in statewide use.

“On the whole, it’s very useful and important to look at data for as fine a geographic area as possible,” said Ward, of the American Cancer Society. “Very often, the factors that determine whether or not there’s a high risk for a specific disease do vary at levels smaller than the county. You may see patterns that you wouldn’t see if you were just able to look at the county level.

“On the flip side,” Ward added, “for some diseases, there are just so few cancer cases that you would be concerned about looking at them at the census tract level, because of confidentiality reasons” and statistical swings.

Proceeding cautiously

Delaware is far from alone in its struggle to use state and national cancer data to improve prevention and detection, Ward said. While census tract records have been available to health agencies for years, public studies using those records are rare.

“I don’t think it’s common. I’m aware that New York did it, but there’s a fine balance with concerns about confidentiality when you bring the data down to that level,” Ward said. She added that high rates can be deceiving.

“It’s very tricky for numerous reasons, not just statistical variations,” Ward said

Rattay said that Public Health is moving cautiously.

Plans are now in the works to brief members of the state Cancer Consortium’s environmental committee, with a blueprint for follow-up action due later this month.

Steps are likely to include talks with community groups and the Department of Natural Resources and Environmental Control on possible reasons for the higher rates, including access to health care and possible sources of pollution exposure.

“We’re going to reach out to the communities in all 45 census tracts and let them know that this report is available, and that we would like to work with these communities to educate them on prevention efforts, screening services and to learn from them about their concerns,” Rattay said. “What this report does is help us to think about where the geographic areas are where we can prioritize our efforts.”

The results also could help the state prepare for more detailed studies of chemical “body burdens,” an idea that also arose out of the Millsboro cancer controversy and past debates over the state’s high rate. Delaware has made several attempts to launch such a study over the years and applied without success for federal help. A body burden study involves an analysis of selected chemical contaminants inside the bodies of residents in a selected part of the state. State officials have estimated in the past that a targeted study would cost as much as $5 million.

“It certainly would be helpful to get that funding,” Rattay said. “That would help us not so much to draw conclusions about whether people are getting cancer from certain exposures, but it would help us identify whether or not certain chemicals were higher in certain individuals’ bodies.”

Jay B. Hammond of Jefferson Farms, whose father died of prostate cancer, said he was unaware the disease was so common around the community.

“I don’t know of anyone here with it, but that’s one of the things that guys don’t talk about,” Hammond said. “With my family history, I keep an eye on it, but I also don’t know why this development would be any different.”

Environmental studies might leave plenty of questions unanswered, Hammond said.

“I don’t know why this development would be any different from one across the street or across the tracks. It’s not like it was built on a toxic waste dump,” Hammond said.

“We’re right up the street from the Delaware City Refinery, down the road from Marcus Hook [refinery] and across the river from a big chemical plant,” he said. “We’re east of everything that goes on in the western part of the country. So what the hell are you going to do?”

The News Journal

September 13, 2010

Jury selection begins Wednesday, September 15 and opening arguments on September 20 in the first of 31 related brain cancer-cluster trials, in which Dow Chemical’s Rohm & Haas subsidiary faces allegations that include wrongful death and negligence. Here is a summary of the case, believed to be the largest brain cancer cluster on trial in the U.S. courts.

Location: City Hall, Philadelphia – Courtroom 243 (The Hon. Allan Tereshko presiding). Philadelphia is the trial venue because Dow/Rohm and Haas, the primary defendant, is headquartered in Philadelphia. The trial is open to the public, but cameras and audio recording devices are prohibited by state Court rule.

Plaintiff: The lead case is that of Franklin Delano Branham (deceased, cause of death, brain cancer), formerly of McCullom Lake, Illinois, a village of about 1,000 in suburban Chicago. A former contractor, Branham is survived by his wife, Joanne Branham, who currently works as a waitress and lives in Apache Junction, Arizona. She represents his Estate and will be attending and testifying.

Defendant: Dow’s Rohm and Haas Chemical Company subsidiary owns and operates the chemical plant (the former Morton International plant) in Ringwood, Illinois, adjacent to McCullom Lake. Plant operations are at the center of the claims.

Allegations: Over decades, the plant secretly, recklessly and negligently dumped into a waste lagoon millions of pounds of hazardous chemical waste – including carcinogenic vinyl chloride – which seeped into the groundwater, eventually poisoning individuals, including Mr. Branham and at least 30 others who have filed claims. Ten of the brain-cancer victims to date have died as a result of their exposure. Mr. Branham and two of the other brain-cancer victims were next-door neighbors.

Related: An original defendant, Modine Manufacturing, which operates a condenser-manufacturing plant in Ringwood adjacent to the Rohm and Haas plant, settled with plaintiffs and agreed to pay $1.4 million toward a medical monitoring program to the benefit of the victims and their community. The monitoring program concluded this past spring, and the excess funds, approximately $850,000, will be distributed to several non-profit organizations to serve the community.

PHILADELPHIA, PA (September 12, 2010) – Jury selection is scheduled to begin September 15 in the first of 31 brain cancer-cluster trials, in which Rohm and Haas Chemical Company is the defendant. And opening arguments are set to begin September 20 in what is believed to be the largest brain cancer cluster series of cases being tried in the U.S. courts.

The trial focuses on allegations that the company dumped millions of pounds of chemical waste at the Ringwood, Illinois chemical manufacturing plant. The plant was operated for many years by Morton Chemical. In 1999, Philadelphia-based Rohm and Haas bought Morton for $5 billion. On April 1, 2009 the company became a wholly owned subsidiary of Dow Chemical, which acquired it for more than $18 billion.

Years of chemical waste dumping at the plant site have caused air and groundwater contamination. Among the chemical contaminants is vinyl chloride, which is associated with causing brain cancer. There have been more than two-dozen documented brain tumor cases and one case of severe liver toxicity in the nearby community of McCullom Lake, a village of about 1,000.

The victims, represented by attorney Aaron J. Freiwald, Esq., of Layser Freiwald, P.C., are seeking compensatory and punitive damages. Freiwald plans to begin his case by calling the company’s former CEO and the plant’s former manager following opening statements before presiding Pennsylvania Common Pleas Court Judge Allan Tereshko. According to court documents, both witnesses knew as early as 1973 that chemical waste from the plant’s eight-acre waste pit had leaked into the groundwater. However, they did not inform state or federal regulatory agencies of the situation for nearly a decade. Despite knowing that the waste pit was causing groundwater contamination, and suspecting that drinking water supplies were being impacted, records obtained through pre-trial discovery document that the company continued to dump waste into the pit for several years and then failed to implement a groundwater remediation plan until nearly another 20 years had passed.

The chemical plant, located in McHenry County, about 60 miles north of Chicago, came under scrutiny when on April 25, 2006, three McCullom Lake next-door neighbors, all diagnosed with rare malignant brain cancer within the same year, became the first of the victims to file complaints against Philadelphia-based Rohm and Haas, its then subsidiary Morton International and Modine Manufacturing.

Modine, which operates a condenser-manufacturing plant in Ringwood adjacent to the Rohm and Haas plant, settled with plaintiffs and agreed to pay $1.4 million toward a medical monitoring program to the benefit of the victims and their community. A Federal judge in Philadelphia is reviewing proposals to distribute funds remaining after the medical screening program was completed earlier this year. The funds will be distributed to several non-profit organizations to serve the community.

According to Freiwald, 17 of the 31 plaintiffs have been diagnosed with malignant brain cancer; 13 have benign brain tumors (most requiring brain surgery and other treatment); and one required a liver transplant due to severe organ toxicity. Ten victims – ranging in age from 42 to 74 – have since died, including Franklin Delano Branham, the subject of the first trial. Mr. Branham died in June 2004, just a few weeks after being diagnosed with glioblastoma, a malignant form of brain cancer. His wife, Joanne, a resident of Apache Junction, Arizona, near Phoenix, will represent his Estate at the trial in Philadelphia.

by John S. Hausman
Muskegon Chronicle

WHITE LAKE — After 35-year-old Montague native Doug Schlaff died from a rare form of cancer in December 2008, his mother and wife began wondering if he was part of a troubling trend.

“We were curious,” said his mother, Claire Schlaff of Montague. “There sure seemed to be a lot of cancer in the White Lake area.”

Photo courtesy of the Schlaff family
Doug Schlaff in 2007 with his wife, Polly, and their three young sons.

With the help of about a half-dozen volunteers, a White Lake residents’ council and Muskegon County’s health department, Claire Schlaff and Doug’s widow, Polly Schlaff, have channeled that thought into a cancer-mapping research project that might help answer a question many have long wondered: Are residents of the historically pollution-plagued White Lake area unusually prone to cancer?

Sad catalysts
Doug Schlaff grew up in Montague before moving as an adult to Manistee, where he worked at the high school as an English teacher, then as a counselor. At age 33, he was diagnosed with Ewing’s sarcoma, a rare bone cancer, and died two years later.

About that time, Claire Schlaff was involved in a breast cancer fundraising walk. She noticed what seemed like an unusually large number of women in their 30s with breast cancer.

She said other acquaintances, who had loved ones in the cancer unit of a Muskegon hospital in the 1990s, spoke of seeing a wall map with red flag pins marking each patient’s address — with a “sea of red” in the White Lake area.

Then Schlaff’s newly widowed daughter-in-law, Polly Schlaff, in early 2009 set up a Facebook group called “Cancer in White Lake.” Polly Schlaff was inspired by a research class in which she was studying a recent Centers for Disease Control report on chemical releases in Great Lakes “areas of concern” — the U.S. Environmental Protection Agency’s designation for toxic hot spots, including White Lake.
The response to the Facebook group was “overwhelming,” Claire Schlaff said.

“So many people said, ‘I’m glad someone is finally doing something about this’ that we said to ourselves, ‘We’re NOT doing anything, but maybe we should,’” she recalled.

None of the anecdotal evidence proved anything, but the women decided it might be worth investigating the possibility of “cancer clusters” in the White Lake area — contaminated in decades past by major industrial polluters including Hooker/Occidental Chemical, Dupont and the Whitehall Leather tannery.

They met with Tanya Cabala of the White Lake Public Advisory Council, a group of area residents who study the lake’s condition and lobby to protect it. That led to meetings of a small group of volunteers with officials of Public Health-Muskegon County. The county epidemiologist’s suggestion: Start making a list of people in the area who had cancer.

The Schlaffs and others weren’t sure at first if they wanted to tackle a major project. “For awhile in the spring of 2009, we were going back and forth,” Claire Schlaff said. “Would this be a waste of time? Would it be better to put time into advocating for the cleanup of White Lake?”

Then, around Memorial Day 2009, another relative was diagosed with brain cancer, Schlaff said. He had spent his years since age 11 living near White Lake.

“This just put us over the edge to looking at it,” she said.
The result was a mission.

Ambitious project
With the help of public-health epidemiologists, the volunteers devised their research project.

They began collecting names in June 2009. Schlaff’s hope is to complete the volunteers’ phase of the project by next summer, turning over their list to public-health officials for further research.
Here’s what they’re looking for: “Are there any cancer clusters of any particular types of cancers in the White Lake area, or any particular neighborhoods of the White Lake area? So we’re mainly looking at geography.”

The project is limited two ways.

Geographically, the researchers are looking at people who lived some portion of their lives in an area bounded by Skeels Road on the north, Hyde Park Road on the east and Duck Lake Road on the south. That means residents of the cities of Whitehall and Montague plus White River, Montague, Whitehall and northern Fruitland townships.

Chronologically, the project extends to residents, living and dead, who were born in 1910 or later. The one-century time limit is arbitrary, just a way to limit the scope of the project so it doesn’t keep expanding.

For expand it has.

“Any name anybody tells me about, usually when I call someone, they’ll give me four or five more names,” Schlaff said. At this stage, the group has a working list of roughly 800 names, she estimates.
The researchers get names any number of ways:
From people who’ve heard about the project by word of mouth or through media reports.

By soliciting information at booths at cancer fundraising events.
By searching old death certificates at the Muskegon County clerk’s office and noting those whose final address was in the White Lake area, no matter what cause of death is listed.

HOW TO HELP
Contact relatives or friends who have lived in the White Lake area and have had cancer or have a loved one with cancer. Ask them to contact Claire Schlaff if to participate in the cancer-mapping project, at 231-894-8908 or e-mail cschlaff@charter.net.

To see the survey questions, visit the Facebook page, Cancer in White Lake.

In the case of deceased residents, volunteers track down survivors through various methods, including checking obituaries and doing genealogical research at Hackley Public Library.

Once a willing resident, former resident or survivor of a resident who had cancer is located, the researchers ask a series of questions or have the respondent fill out a worksheet. Questions include address, type of cancer, age at diagnosis, workplace and job description, as well as the approximate dates each person lived and worked at each address and job site.

The workplace questions — added at the suggestion of Public Health-Muskegon epidemiologist Dr. Jean Chang — have been a revelation, Schlaff said. “I’m just finding out a lot of people had pretty risky jobs,” she said — for example, people who installed asbestos insulation and now have mesothelioma.
When Schlaff has compiled all the information needed about a person, she sends it on to her daughter-in-law, who has developed a spreadsheet based on guidance from the health department.

Not in vain
The final stage of the volunteer project will be presenting their information to the professionals at Public Health-Muskegon. Epidemiologists will be able to crunch the numbers, compare cancer incidences in various neighborhoods and workplaces to data from other areas and, possibly, come up with some conclusions.
Or possibly not.

“We, the health committee volunteers, are aware that the relationship between environment and human health is complex and that we can’t expect a simple cause-effect correlation,” Schlaff said. “We are also aware that we may not learn anything new from our efforts. However, we are certain that if we don’t do this research, we most certainly won’t learn anything new.”

The volunteers also have learned this: “People want to tell their stories. They want to participate in this project, perhaps because they want their suffering or the suffering of their loved ones to count for something,” she said.

“Our hope is that something useful will come out of it,” Schlaff said. “Maybe if we could learn something from it, maybe we could be helpful in the prevention of cancer.”

Her voice quavered as she added: “I guess way in the back of my mind, if I had to admit it, I don’t want my son to die in vain.”
E-mail John Hausman: jhausman@muskegonchronicle.com

read full Muskegon Chronicle article at their website

by William R. Levesque
St. Petersburg Times

The 13 breast cancer survivors gathered last month at a Boston hotel for a calendar photo shoot that will raise money to research the causes of the disease.

These 13 men all have connections to Camp Lejeune, a Marine base. All are breast cancer survivors. And all agreed to pose for a calendar to raise money and awareness. Photo by David Fox.

They shared stories of recovery. They talked about surgeries and hospital stays and their hopes for the future. In their camaraderie, some may have momentarily forgotten the improbable and puzzling novelty of their gathering.

They are all men. Most served in the Marine Corps. All have ties to Camp Lejeune, a sprawling Marine base on the North Carolina seaboard.

“It’s an attention grabber,” said Peter Devereaux, 48, of North Andover, Mass., who was diagnosed two years ago with breast cancer.

The men, including three from the Tampa Bay area, are working with the Art beCAUSE Breast Cancer Foundation in Boston, a nonprofit that raises money for breast cancer research, to release a calendar by Oct. 1. They want to increase awareness of what some believe may be the largest male breast cancer cluster ever identified.

At least 64 men diagnosed with breast cancer have ties to Camp Lejeune, according to research by Mike Partain, a Tallahassee insurance investigator who is a member of the group.

Lejeune was the site of one of the worst public drinking water contaminations in the nation’s history. Waters there were tainted with dangerous chemicals for 30 years, ending in 1987, say federal scientists.

Up to a million people may have been exposed to the pollution, including nearly 14,000 Floridians who have signed a Marine Corps health registry — the most of any state except North Carolina.

Partain, 42, who was born at Camp Lejeune in 1968 and diagnosed with breast cancer in 2007, said he is convinced Lejeune’s polluted water is the source of this cancer cluster.

Partain posed for the calendar shirtless to emphasize the improbable notion that a man can be struck by the disease. As he was photographed, Partain held a chilling photo taken shortly after his birth. It shows his mother holding her baby at a Camp Lejeune hospital — a glass of water on the table beside them.

“I want people to pick up the calendar and wonder why Marines are getting breast cancer,” Partain said. ” I want them to wonder what in the hell happened at Camp Lejeune.”

Jim Fontella of Michigan will be featured in a calendar of male breast cancer survivors with ties to Camp Lejeune, a Marine Corps base that is suspected in a cancer cluster. Photo by David Fox.

The Marine Corps maintains that no science has proved a link between polluted water and disease. Federal scientists are studying Lejeune, where everything from fuel to industrial solvents once fouled waters.

The calendar idea came about after Devereaux, the Massachusetts man, posed last year for a 2010 calendar that otherwise featured only female breast cancer survivors. He said he told Art beCAUSE officials that he wouldn’t mind doing so again — in an all-male calendar.

“This may help other guys who don’t feel comfortable,” said Devereaux, who served at Lejeune from 1980 to 1982. “We all have male breast cancer, and it’s a female disease. Guys can’t get past that.”

Male breast cancer is exceedingly rare. From 1975 to 2006, just 1.09 men out of every 100,000 are diagnosed with breast cancer, according to federal statistics.

Photographer David Fox, who shot the calendar and who lost his own wife to breast cancer, said he was startled when he learned about the cancer cluster tied to Camp Lejeune.

“The stories of these men are just incredible,” Fox said. “The way we approached this project is that the photos are about the beauty of the person and the ugliness of the disease. Even though the disease has mutilated the body in some way, it hasn’t broken the spirit of that person.”

Ellie Anbinger, executive director of the foundation, said her nonprofit hopes to raise $50,000 through calendar sales — each will cost $20 and will be sold on the foundation’s Web site and individually by the men photographed — to fund research about the Lejeune cancer cluster.

“We want to know what would trigger so many guys to get breast cancer,” Anbinger said.

Fourteen men will appear in the calendar — two for the months of November and December 2010, the rest in 2011. Of the 14 men, one is not a breast cancer survivor but had a daughter who died of leukemia after exposure to base water.

The calendar will be titled “Men, Breast Cancer, the Environment: A Photographic Journey.”

Joe Moser, 71, of Riverview, who was stationed as a Marine at Camp Lejeune from 1957 to 1960, also posed for the calendar. He said most people he meets can’t get over the surprise that so many men from Lejeune are breast cancer survivors.

“I hope it alerts people to what is happening,” said Moser, diagnosed with breast cancer in 2008. “Something has to be done about this. We Marines are united forever by this.”

Partain, the Florida man who first identified the cancer cluster, said he already has plans for the first calendar he gets his hands on.

“I intend to send the commandant of the Marine Corps his very own copy.”

William R. Levesque can be reached at levesque@sptimes.com or (813) 226-3432.

read online at St. Petersburg Times

Palm Beach Post, The (FL) – Tuesday, September 7, 2010
By MITRA MALEK Palm Beach Post Staff Writer

When children were coming down with leukemia roughly once a month in a small farming community in western Nevada, health experts were confident they would pinpoint the cause.

Potential culprits weren’t hard to find in Fallon, 30 miles from an old underground nuclear test site and not far from the naval air station that’s home to the “Top Gun” training program. Amid one of the largest cancer-cluster investigations in U.S. history, scientists and residents alike said they suspected some type of pollution.

“It’s not random,” Floyd Sands, whose daughter had leukemia, told the Reno Gazette-Journal in 2001, a year into the seven-year study. “The cause is out there, somewhere in Fallon.”

But in the end, the study found no answers. And since 2004, only one new case of childhood leukemia has been reported in Fallon or the surrounding county.

A similar ending without closure may be in store for The Acreage, where more than a year of state investigations has failed to explain a spike of tumors in children’s brains and central nervous systems.

In some ways, The Acreage’s case is unique among Florida cancer studies: The northwestern Palm Beach County community is the only place where the state Department of Health has declared that a suspected cancer cluster exists.

Yet here, too, tests of soil and water have turned up no signs of pollution that could explain the cluster, the state’s health and environmental agencies say. In a summary released last month, the state Department of Environmental Protection declared that “residential property in The Acreage is safe.”

It may be baffling, but it should be no surprise. Rarely, if ever, have scientists found a firm environmental cause for a cancer cluster afflicting a geographic region.

Real cases not as simple as Hollywood scripts

Hollywood movies about these types of cases usually suggest a far different conclusion: With enough digging, investigators discover that pollution is the root problem — then collect big money from the polluters. Examples include A Civil Action, starring John Travolta as a crusading lawyer, and Erin Brockovich, with Julia Roberts in an Oscar-winning role.

“There’s this intuitive sense that seems so straightforward: If there’s too much of something occurring, there must be some reason to it,” said David Savitz, director of Mount Sinai School of Medicine’s Disease Prevention and Public Health Institute in New York. “The problem is, in practice, it just doesn’t work that way.”

One reason is that cancer is complicated: It has many origins, including random genetic mutations, and not everyone exposed to even high doses of carcinogens will get the disease.

Moreover, scientists say that even if disease rates are normal, some areas are bound to have more cases than others — creating clusters with no environmental cause.

Some scientists even argue that chance is the most plausible explanation for a cluster when artificial boundaries are drawn around an area where cases exist. That’s how the state determined the cluster boundaries for The Acreage, where health officials say the community experienced four cases of pediatric brain tumors from 2005 to 2007 — when one or two would be normal.

“You never know when you’re simply drawing a target around the bulls-eye,” said Michael Thun, vice president emeritus of epidemiology and surveillance research for the American Cancer Society.

And not all who live in a community are exposed to the same hazards. “It’s not like working in the same factory with the same chemical,” Savitz said.

Historically, cancer investigations based on geography — “community-based” clusters — have been harder to solve than those based on exposures in a workplace.

In one classic example, a surgeon discovered in 1775 that chimney sweeps developed scrotal cancer from exposure to soot from coal. In 1965, researchers identified the link between World War II-era exposure to asbestos and ship workers’ cases of mesothelioma, a rare cancer of the lining of the chest and abdomen.

The full list of “solved” clusters isn’t much longer.

Among them: In 1974, an angiosarcoma cluster was found among chemical workers working with vinyl chloride. And mothers who took diethylstilbestrol, or DES, to prevent premature labor during the 1940s and 1950s caused their unborn daughters to develop vaginal clear-cell carcinoma, a cluster discovered in 1971.

The key to all these: The cancer was rare, and contaminant exposure was clear and intense.

Community-based cluster investigations don’t usually fit that mold.

CDC sometimes assists state investigations

Take the cluster of childhood leukemia that struck Woburn, Mass., made famous in A Civil Action. That cluster led to an $8 million settlement from the chemical company W.R. Grace –but it, too, closed with a caveat.

In that case, 21 children who lived near contamination from tannery and chemical operations were diagnosed with leukemia from 1969 to 1986. Two municipal wells were closed in 1979 when tests found solvents.

Still, a subsequent study only “suggested” that the risk of leukemia was higher for a child whose mother drank from the contaminated wells while pregnant. The study warned that “results must be interpreted with caution as small numbers of study subjects lead to imprecise estimates of leukemia risk.”

And the case from Hinkley, Calif., that hit the screen as Erin Brockovich was never declared a cancer cluster, although Pacific Gas & Electric paid $333 million in damages to more than 600 victims in 1996. The suit blamed the company for leaching chromium 6 into the town’s water supply, causing problems varying from cancer to miscarriages.

Despite the difficulties, health departments are ethically obliged to pursue community-based cluster investigations.

People report about 1,000 potential clusters to state health departments each year, the American Cancer Society says. Only 50 to 150 turn out to be clusters — defined as a statistically elevated number of cases of a particular kind of cancer in a certain population over a certain period.

States are primarily responsible for cancer cluster studies, sometimes seeking help from federal agencies.

The U.S. Centers for Disease Control and Prevention gets as many as six requests a year for aid. It doesn’t have a record of how many investigations it has participated in, but it has never been involved with one that proved an environmental contaminant to be the cause.

The Fallon case was one investigation the CDC assisted. The study held the promise of finding a culprit, in part because of new technology that could trace toxins in blood and urine.

“The CDC was very hopeful that they might be able to pinpoint something,” said Martha Framsted, a spokeswoman for the Nevada State Health Division.

Yet tests for dozens of contaminants in blood, urine, soil, dust and the air showed the cancer-stricken families had virtually the same exposure to pollutants as did healthy neighbors.

Only two readings came back abnormally high: tungsten and arsenic. But tungsten isn’t considered a carcinogen, and arsenic isn’t associated with leukemia.

“They’ve acknowledged that this occurred, but they’ve pretty much moved forward,” Framsted said.

Florida officials hope Acreage residents will do the same. The state is wrapping up the second phase of its investigation.

In its Aug. 10 summary, the DEP said that despite finding some contaminants beyond acceptable limits in soil samples, it “found no evidence of significant spills, dumping or area-wide contamination.” And water quality in the community of 40,000, which relies mainly on wells, is “generally good.”

Staff researchers Niels Heimeriks and Michelle Quigley contributed to this story.

~mitra_malek@pbpost.com

Kettleman City mothers—including Magdalena Romero, left, and Maura Alatorre, center—show photos of their babies to EPA officials.

Maybe it’s the toxic waste dump. Maybe the pesticides, or the diesel fumes, or the arsenic. How a small-town mystery could change the way we look at pollution.

Mother Jones
— By Jacques Leslie
July/August 2010 Issue

THE FIRST BABY’S NAME was America. She was born in September 2007, with Down syndrome, two heart murmurs, and part of her upper lip missing. She couldn’t suck from a nipple, so her mother, Magdalena Romero, would stay up through the night to feed her with a special tube. America showed pleasure in music and delighted in being held by her four siblings. Magdalena thinks they felt a special tenderness for her because of her vulnerability.

Hospital officials told Magdalena that the baby wouldn’t live a year, but she didn’t want to believe it. Then, one morning when America was nearly five months old, her lips turned purple. Concluding that paramedics would consider a rescue futile, Magdalena drove the baby to the hospital herself and insisted that all efforts be made to save her. For a few days, America survived, tethered to machines. Then she died in her mother’s arms.

A few flowers struggle to grow in the tiny patch of soil in front of the Romeros’ house in Kettleman City, California, a farmworker community halfway between Los Angeles and San Francisco. Outside, the powder blue trim is peeling; inside, the house looks sparse, unfinished, except for an alcove off the living room that has become a memorial to America. On the wall hangs a carefully embroidered cloth with her name and birth date in red script and her tiny hand- and footprints rendered in pink; rosary beads are draped over the frame. Nearby, three photos of America sit atop a VCR—they’re typical baby pictures, filled with pink and lace, that startle because of America’s missing lip. Magdalena stands in front of the shrine; her lips form a slight smile, but her eyes look uncertain. “You feel all the time, every hour, that something is missing,” she says. Magdalena, now 33, dared to have another child, whom she also named America. The toddler is healthy, but Alondra, her six-year-old sister, keeps asking, “Is this baby going to die too?”

There are between 30 and 64 births each year in Kettleman City. In 15 of the 22 years since California’s public health department began tracking birth defects, all babies in the town were healthy, and in five other years, only one birth defect occurred. But in the last two years and 10 months, residents say, at least 11 babies have been born with serious birth defects. Three eventually died; another was stillborn. Most have cleft lips or palates, and some have other, graver maladies. “When my child was born,” Magdalena says, “I thought she was the only one with a deformity. But when it began happening to other babies, I realized there was something abnormal in my community.”

Maricela Mares-Alatorre, who is related to Maura by marriage, has been battling Kettleman City’s hazardous-waste dump for years; her son Miguel, 15, is part of a youth group called Kids Protecting our Planet.

KETTLEMAN CITY—a dot on the map so insignificant that it is technically not even a town but a “census-designated place”—rose out of the scrublands of the western San Joaquin Valley in the late 1920s, following the discovery of oil in the nearby Kettleman Hills. The second-longest street in town, all half a mile of it, is named General Petroleum Avenue, and the third-longest is Standard Oil Avenue. Those names are as close to wealth as the town gets. Nearly half its 1,500 residents live below the poverty line, according to the 2000 census. A couple of miles south on Highway 41, at the junction with Interstate 5, sits an agglomeration of motels, gas stations, an In-N-Out Burger, and a Starbucks, but the town itself has no pharmacy, high school, or movie theater. It also lacks sidewalks, a supermarket, and a clean drinking-water supply (though the 444-mile California Aqueduct, which conveys water from the Sierras to dozens of Southern California cities, runs just past its border). Most Kettleman families travel 32 miles to Hanford, the county seat, to shop for food and bottled water.

Kettleman City does have a few convenience and liquor stores, three well-attended churches (Catholic, evangelical, and Pentecostal), and one tiny restaurant, La Perla, where the most popular menu item is a $3 burrito. Then again, popularity at La Perla is a relative concept; on most days it attracts only five or six patrons. Many families hail from the same Mexican town—La Piedad, in the state of Michoacán. Many have lived in Kettleman City for three generations; others arrived in the last few years. Maricela Mares-Alatorre, a 38-year-old teacher in a GED program for farmworkers, is one of a tiny number of residents with a college degree. She describes Kettleman City as having “a Mayberry feeling with a Latino twist—that’s why I stay. Even if I left, that doesn’t mean the problems get solved. There are still vulnerable people here who can’t speak for themselves, and we’re supposed to abandon them?”

The “problems” are not just the recent wave of birth defects, but the many possible explanations for it, and, most worrisome of all, the prospect that the reason will never be identified. That uncertainty—which no one quite wants to admit—hovers over the town like smog.

Alatorre with her son, Emmanuel, who was born with a cleft lip.

Despite Kettleman City’s remote setting amid almond groves and tomato fields, its residents are exposed to a startling array of toxic chemicals (PDF). Nearly 100 trucks spewing diesel fumes roll through town daily on Highway 41, and many more come by on Interstate 5. More than half of Kettleman City’s labor force consists of farmworkers who are routinely exposed to toxic pesticides, and residents can smell the chemicals sprayed on the fields that border the town on three sides. Kettleman City’s two municipal wells are contaminated with naturally occurring arsenic and benzene. And there are projects in the works to build a massive natural gas power plant nearby, as well as to deposit 500,000 tons per year of Los Angeles sewage sludge on farmland a few miles from the town.

But the biggest environmental villain, in the view of local residents, is Waste Management Inc., which operates a vast hazardous-waste dump three miles from town. Waste Management is the nation’s largest waste-disposal company, and the Kettleman Hills landfill is the biggest toxic-waste dump west of Alabama, where another Waste Management facility is located in another poor, minority community. California’s two other toxic-waste dumps are also located near Latino farmworker towns.

A wooden cross made by a friend hangs in one of the Romero household’s two shrines to baby America, who died at five months.

Last year the Kettleman site accepted 356,000 tons of hazardous waste, consisting of tens of thousands of chemical compounds including asbestos, pesticides, caustics, petroleum products, and about 11,000 tons of materials contaminated with PCBs—now-banned chemicals linked to cancer and birth defects. Waste Management has been seeking permission since 2006 to increase the dump’s size by nearly 50 percent.

read full article at Mother Jones website