By JOHN SEEWER, AP
Thu Dec 30, 2010

CLYDE, OH–Every time his kids cough, Dave Hisey’s mind starts to race. Is it cancer? Is it coming back? His oldest daughter, diagnosed with leukemia nearly five years ago when she was 13, is in remission. His 12-year-old son has another year of chemotherapy for a different type of leukemia. And his 9-year-old daughter is scared she’ll be next.

Hisey is not alone in fearing the worst. Just about every mom and dad in this rural northern Ohio town gets nervous whenever their children get a sinus infection or a stomachache lingers. It’s hard not to panic since mysterious cancers have sickened dozens of area children in recent years.

Since 1996, 35 children have been diagnosed — and three have died — of brain tumors, leukemia, lymphoma, and other forms of cancer — all within a 12-mile wide circle that includes two small towns and farmland just south of Lake Erie. With many of the diagnoses coming between 2002 and 2006, state health authorities declared it a cancer cluster, saying the number and type of diagnoses exceed what would be expected statistically for so small a population over that time.

“All you think about is what happened to these kids,” said Donna Hisey, 43, the mother whose family has been devastated by cancer. “Is it gone? Or is it still here? What is it?!”

After three years of exhaustive investigation, no cause is known. Investigators have tested wells and public drinking water, sampled groundwater and air near factories and checked homes, schools and industries for radiation.

They also set up a network of air monitors across eastern Sandusky County, finding cleaner air than in most places around Ohio, the health department said.

Nothing unusual was detected. Not even a hint.

“From the very beginning, we’ve said the vast majority of childhood cancer causes aren’t known,” said Robert Indian, the state health department’s chief of comprehensive cancer control. He’ll soon release yet another investigative report.

Without any answers as to what’s attacking their children, parents are left to question whether living within a known cancer cluster area is endangering their kids. Perhaps surprisingly, only a handful have moved away.

“It’s in the back of everybody’s mind,” said Scott Mahler, who has two healthy young sons. “Are you going to risk your children’s lives by living here?”

Eight children were diagnosed with cancer in and near Clyde between 2002-2006, nearly four times the number that state health experts figure is normal.

Ohio health investigators converged on the town of just 6,000 people halfway between Cleveland and Toledo and home to the Whirlpool Corp.’s largest washing machine factory.

What they found was worse than anyone suspected. The cancers affecting victims age 19 and younger included neighboring townships and much of the nearby town of Fremont.

One in five of the cancer cases were related to the brain or central nervous system, matching national rates, according to the American Cancer Society.

The diagnoses peaked in 2006, when nine children were told they, too, had cancer. Since then, there have been four new cases. The most recent came in the spring this year, when a 7-year-old girl was diagnosed with rhabdomyosarcoma, a rare cancer of the body’s connective tissues.

At first, investigators focused just on Clyde, where social calendars revolve around school, sports and church. Most families have been here for generations. It’s the kind of place where teens can’t wait to leave — only to find they can’t wait to come back to start a family.

Seeing their children afflicted by unexplained illnesses has strengthened the bond among parents and neighbors instead of scaring them away.

“Even if it would’ve happened to my family, I can’t imagine where else I would go to get the support I needed,” said Melanie Overmyer, an English and journalism teacher at Clyde High School.

“People in neighboring towns say ‘I can’t believe you still live there,’” said the mother of two. “You can’t pick up your life and move every time there’s something that scares you.”

Enrollment numbers at area schools haven’t dropped and real estate agents say they haven’t encountered anyone who doesn’t want to look for homes in the area or is desperate to get out.

“Clyde is small enough that we would really know if that was happening,” said City Manager Paul Fiser.

Ohio health and environmental regulators have speculated the cause was environmental and may have come and gone — maybe a chemical from a factory or a dump that polluted the air or water.

Air and water samples have not revealed any concerns around the Whirlpool plant or the Vickery Environmental waste site just outside town, where hazardous chemicals are injected into rock a half-mile below ground.

And in September, investigators said they found no radiation from homes, schools, or industries to link to the illnesses, ruling out the Davis-Besse nuclear plant, about 20 miles from Clyde, and NASA’s former nuclear reactor near Sandusky as a possible source.

Doctors also have been vigilant, making sure they’re not missing any signs or symptoms in young patients. And parents are more likely to bring their kids in for checkups instead of waiting for an illness to go away.

“You still have to treat common things first,” said Dr. Daniel Herring, who has a family practice in Clyde.

“But it’s definitely one of the things we worry about more.”

What’s stumped investigators is the lack of any common threads among the children — all of them don’t live in the same neighborhood, go to the same school or drink from the same water. They don’t all have the same type of cancer or even parents who work at the same factory.

State health officials have spent recent months asking the sick children and their families dozens of questions about their homes and health histories, hoping to find a link. A report due soon will reveal whether they found any connections among all or some of the children, Indian said.

Some parents think it’s likely that investigators will never identify a cause.

In a way, it’s not a surprise.

Pinpointing the cause of a cancer cluster rarely — if ever — happens.

During the 1960s and ’70s, the U.S. Centers for Disease Control and Prevention investigated 108 cancer clusters around the United States, most of them childhood leukemia. But they found no definite causes for any of them.

The CDC has since allowed states to take the lead investigating almost all suspected clusters while still offering some oversight, as the federal agency is doing in Ohio.

The outbreak around Clyde is only 50 miles north of another cluster that Ohio health officials spent four years investigating. Beginning in the late 1990s, nine former students from River Valley High School in Marion were diagnosed with leukemia.

Tests found toxic chemicals in schoolyard soil and students were relocated to new buildings miles away. Investigators never definitively linked the cancers to the old school site, a former World War II Army depot where wastes and solvents were dumped and burned.

The nation’s most intensive investigation ever of a cancer cluster began nine years ago in western Nevada and remains inconclusive. Hundreds of state and federal experts have spent millions investigating the leukemia that sickened 17 children and killed three between 1997 and 2004.

Some parents of Clyde area’s sick children question whether the state’s inquiry has been thorough enough. They point out that there’s been no soil testing or requests for experts from CDC to join the investigation.

“Why haven’t they brought all minds to the table?” said Warren Brown, whose 11-year-old daughter, Alexa, died of brain cancer in August 2009. “Why not throw everything at it?”

Investigators insist they’ve ignored nothing. Soil testing wouldn’t reveal any answers, they said, because the sick children come from a widespread area and all would have needed to come in contact with contaminated dirt.

Ohio Environmental Protection Agency Director Christopher Korleski said the state has consulted with federal health officials throughout the investigation and that they’ve signed off on the steps Ohio has taken.

The investigation is his top priority.

“It is disappointing and frustrating to not know,” said Korleski.

Brown wishes there were somebody to blame.

He’s been careful not to point fingers and doesn’t want the town to suffer. But he also said he wouldn’t hold back if something here was the cause.

“I’d be yelling at the top of my lungs to leave town,” he said. “I can’t do that.”

Brandy Kreider, a mother of five children, said she and her husband spent an agonizing week and sleepless nights wondering if they were making a mistake before buying a new home in town two years ago. In the end, leaving didn’t feel right.

“Those things don’t want to make us retreat,” she said. “They bring us together.”

The Hiseys faced the same question almost five years ago when daughter Tyler Smith, who’s now 17, was diagnosed with acute myeloid leukemia.

They put their house up for sale even though it had everything they wanted: ponds for fishing, a woods for hunting and plenty of space. They’re now glad it didn’t sell.

The outdoors surrounding their home has become a sanctuary for Tanner, 12, diagnosed with acute lymphoblastic leukemia two years after his sister was sickened.

Chemotherapy has kept him out of school most of this year so home is where he spends much of his time. It’s where he can catch catfish, watch deer romp across the fields and still be a kid.

“Everything else has been taken away,” his father said. “We can’t take their support, their comfort and their home away from them.”

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Cancer-causing chemical found in 89 percent of cities sampled

An Environmental Working Group report

Laboratory tests commissioned by Environmental Working Group (EWG) have detected hexavalent chromium, the carcinogenic “Erin Brockovich chemical,” in tap water from 31 of 35 American cities. The highest levels were in Norman, Okla.; Honolulu, Hawaii; and Riverside, Calif. In all, water samples from 25 cities contained the toxic metal at concentrations above the safe maximum recently proposed by California regulators.

The National Toxicology Program has concluded that hexavalent chromium (also called chromium-6) in drinking water shows “clear evidence of carcinogenic activity” in laboratory animals, increasing the risk of gastrointestinal tumors. In September 2010, a draft toxicological review by the U.S. Environmental Protection Agency (EPA) similarly found that hexavalent chromium in tap water is “likely to be carcinogenic to humans.”

In 2009, California officials proposed setting a “public health goal” for hexavalent chromium in drinking water of 0.06 parts per billion (ppb) to reduce cancer risk. This was the first step toward establishing a statewide enforceable limit. Despite mounting evidence of its toxic effects, the EPA has not set a legal limit for hexavalent chromium in tap water nationally and does not require water utilities to test for it. In 25 cities where EWG’s testing detected chromium-6 — in the first publicly available national survey for the contaminant — it was found in concentrations exceeding California’s proposed maximum, in one case at a level more than 200 times higher.

At least 74 million Americans in 42 states drink chromium-polluted tap water, much of it likely in the cancer-causing hexavalent form. Given the scope of exposure and the magnitude of the potential risk, EWG believes the EPA should move expeditiously to establish a legal limit for chromium-6 and require public water suppliers to test for it.

Next Section »

Chromium widely contaminates U.S. tap water

Red dots indicate EWG’s test sites and measured hexavalent chromium concentrations in parts per billion (ppb). Size of dot reflects the level found. Brown-shaded areas represent population-adjusted average concentrations of total chromium by county, calculated from EWG’s national tap water database (see Study Methodology).

Sources: EWG-commissioned testing for hexavalent chromium in tap water from 35 cities; EWG analysis of water utility testing data obtained from state water agencies (EWG 2009).

Tests find cancer-causing chemical in 89 percent of cities sampled

Chromium-6 in tap water of 35 cities averaged 3 times California’s proposed safety goal

*Geometric average based on level of chromium-6 measured in 35 U.S. cities and a statistical estimate for the four cities where no chromium-6 was detected. The lowest level detectable by these tests is 0.02 ppb. For the purpose of calculating the nationwide average, the concentration of chromium-6 in these four cities was assumed to be 0.01 ppb, or half of the lowest detectable level.

**”Proposed safe limit” is California EPA’s proposed public health goal (OEHHA 2009).

Source: EWG-commissioned testing for hexavalent chromium in tap water from 35 cities.

Executive Summary

Tap water from 31 of 35 U.S. cities tested contains hexavalent chromium (or chromium-6), the carcinogenic “Erin Brockovich chemical,” according to laboratory tests commissioned by Environmental Working Group (EWG). The highest levels were detected in Norman, Okla.; Honolulu, Hawaii; and Riverside, Calif.

Despite mounting evidence of the contaminant’s toxic effects, including a U.S. Environmental Protection Agency (EPA) draft toxicological review that classifies it as “likely to be carcinogenic to humans” when consumed in drinking water, the agency has not set a legal limit for chromium-6 in tap water and does not require water utilities to test for it. Hexavalent chromium is commonly discharged from steel and pulp mills as well as metal-plating and leather-tanning facilities. It can also pollute water through erosion of soil and rock.

The National Toxicology Program has found that hexavalent chromium in drinking water shows clear evidence of carcinogenic activity in laboratory animals, increasing the risk of otherwise rare gastrointestinal tumors (NTP 2007, 2008). In response to this study and others, California officials last year proposed setting a public health goal for chromium-6 in drinking water of 0.06 parts per billion (ppb). This is the first step toward establishing a statewide enforceable limit (OEHHA 2009).

Levels of the carcinogen in 25 cities tested by EWG were higher than California’s proposed public health goal. Tap water from Norman, Okla. (population 90,000) contained more than 200 times California’s proposed safe limit.

Millions of Americans drink chromium-contaminated water

EWG’s investigation is the broadest publicly available survey of hexavalent chromium to date. The 31 cities with chromium-polluted tap water draw from utilities that collectively serve more than 26 million people. In California, the only state that requires testing for hexavalent chromium, water utilities have detected the compound in tap water supplied to more than 31 million people, according to an EWG analysis of data from the state water agency (EWG 2009).

Top five chromium-contaminated cities tested by EWG

City City Population Hexavalent Chromium Contamination Level in Tap Water Norman, Oklahoma 89,952 12.9 ppb Honolulu, Hawaii 661,004 2.00 ppb Riverside, California 280,832 1.69 ppb Madison, Wisconsin 200,814 1.58 ppb San Jose, California 979,000 1.34 ppb

EWG’s tests provide a one-time snapshot of chromium-6 levels in 35 cities. But chromium pollution is a continuous, ongoing problem, as shown by the annual water quality reports that utilities must produce under federal law. Over the years, nearly all of the 35 cities tested by EWG regularly report finding chromium (in the form of total chromium) in their water despite using far less sensitive testing methods than those used by EWG.

The total number of Americans drinking tap water contaminated with this compound is likely far higher than is indicated by EWG’s tests. At least 74 million people in nearly 7,000 communities drink tap water polluted with “total chromium,” which includes hexavalent and other forms of the metal, according to EWG’s 2009 analysis of water utility tests from 48,000 communities in 42 states (EWG 2009).

The EPA has set a legal limit in tap water for total chromium of 100 ppb to protect against “allergic dermatitis” (skin irritation or reactions). Measures of total chromium include the essential mineral trivalent chromium, which regulates glucose metabolism, as well as the cancer-causing hexavalent form. Preliminary EWG-commissioned water tests found that in most cases, the majority of the total chromium in water was in the hexavalent form, yet the EPA’s legal limit for total chromium is 1,700 times higher than California’s proposed public health goal for hexavalent chromium. This disparity could indicate significant cancer risk for communities drinking chromium-tainted tap water.

The EPA’s new analysis of hexavalent chromium toxicity, released in draft form in September 2010 (EPA 2010a), cites significant cancer concerns linked to exposure to the contaminant in drinking water. It highlights health effects documented in animal studies, including anemia and damage to the gastrointestinal tract, lymph nodes and liver.

Industry deception delayed protections

The plight of the cancer-stricken residents of Hinkley, Calif., who in 1996 won a $333 million settlement from Pacific Gas and Electric Co. for contaminating their tap water with hexavalent chromium, was the basis of the 2000 movie “Erin Brockovich,” starring Julia Roberts.

Subsequently, a 2005 Wall Street Journal investigation and a separate EWG report based on court documents and depositions from a similar lawsuit in Kettleman City, Calif. revealed that PG&E had hired consultants to publish a fraudulent analysis of cancer mortality in Chinese villagers exposed to hexavalent chromium, in an attempt to disprove the link between the chemical and cancer. The study was published in the respected Journal of Occupational and Environmental Medicine, and scientists and regulators — including the EPA — cited the fraudulent article in research and safety assessments. The journal retracted the paper in 2006 in response to EWG’s request for corrective action.

California officials then conducted a rigorous re-assessment of the study data, finding a statistically significant increase in stomach cancer among the exposed. Their analysis is consistent with laboratory evidence from the National Toxicology Program and others showing that hexavalent chromium in tap water causes gastrointestinal tumors in multiple species.

Industry has sought for more than six years to delay state-mandated regulation of hexavalent chromium in tap water in California. Aerospace giant Honeywell International Inc. and others have stalled the adoption of the advisory public health goal by pressing for additional external scientific peer review. California’s Department of Public Health can neither set nor enforce a mandatory tap water standard for hexavalent chromium until the goal is finalized.

Recommendations

At least 74 million Americans in 42 states drink chromium-polluted tap water, much of it likely in the form of cancer-causing hexavalent chromium. Given the scope of exposure and the magnitude of the potential risk, the EPA should move expeditiously to establish a legal limit for the chemical in tap water and require water utilities to test for it.

The state of California must establish a strong standard for hexavalent chromium in tap water immediately. A truly health-protective hexavalent chromium regulation will reduce the cancer risk for Californians and serve as a model for the nation. With an enforceable standard already six years past the statutory deadline and the health of millions of Californians at stake, the state cannot move too quickly.

Health, Stem Cells, and Technology
Dr. Greg Maguire

Across the US cancer statistics are alarming. According to the CDC and National Center for Disease Control, 46 children per day (two classrooms a day) are being diagnosed with cancers unrelated to genetics or family history. In contrast, recent studies by British scientist show that the ancient Egytians, whose society had few or none of the toxic chemicals associated with modern day socities, experienced few or no tumors.

Senator Barbara Boxer (D-CA) has filed a new bill “Strengthening Protection For Children and Communities From Disease Clusters Act,” or “Trevor’s Law,” that calls for an improved, streamlined process to investigate and address disease clusters across the U.S. by:

1. Strengthening federal agency coordination and accountability when investigating and helping to address potential disease clusters;

2. Increasing resources to communities who may be impacted by potential disease clusters, including by providing for community-based committees that play an integral role in actions to investigate and help address such clusters; and

3. Enhancing federal, state and academic capacity to investigate and help address such clusters, including through partnerships and grants and by developing new pollution and disease tracking tools to facilitate investigation and actions to address clusters.

Sen. Boxer’s legislation was named for Trevor Schaefer, a young cancer survivor and advocate who was diagnosed with brain cancer seven years ago at the age of thirteen. There were other children and young adults with brain cancer in his small town in Idaho at the time of his diagnosis. Trevor and his mother became aware that environmental contamination might have played a part in these illnesses. Yet authorities did not seem to care. Trevor’s mission is to be a champion for the protection of children and small communities from environmental contamination, and he wants to help them from slipping through the cracks of environmental regulation. Similar to laws in Europe, the bill hopes to hold companies accountable for proper disposal of toxins and to make sure that other children will not have to experience what Trevor did.

Nearly every state has reported cancer clusters, and some of the more notable include: Moreland, ID; Fallon, NV; The Acreage, FL; Sierra Vista, AZ; Carlsbad, CA; Santa Susana, CA; Kettleman City, CA; and Victor, NY. According to the National Disease Cluster Alliance (NDCA), state epidemiologists are charged with investigating an average of 1,000 suspected cancer clusters every year.

Senator Boxer’s bill would set up an objective, transparent process for conducting investigations and provide for the prominent involvement of concerned community members

MSNBC
The Dylan Ratigan Show
Posted: 12/20/2010

Cancer activist Trevor Schaefer, his mother Charlie Smith and Sen. Barbara Boxer, D-Calif., discusses whether American companies are making millions of people sick.

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University of Rochester Medical Center
December 16, 2010

When children are exposed to head and neck radiation, whether due to cancer treatment or multiple diagnostic CT scans, the result is an increased risk of thyroid cancer for the next 58 years or longer, according to University of Rochester Medical Center research.

The study is believed to be the longest of any group of children exposed to medical irradiation and followed for thyroid cancer incidence. It was published in the December 2010 edition of the journal, Radiation Research.

The data also might provide some insight about why the rates of thyroid cancer continue to rise, as the general public is increasingly exposed to higher doses of radiation through more frequently used imaging tests such as computed tomography (CT), said lead author Jacob Adams, M.D., M.P.H., an associate professor in the Department of Community and Preventive Medicine at URMC

„Ionizing radiation is a known carcinogen and, in fact, about 1 million CT scans are performed every year on children five years or younger,‰ Adams said. „Although CTs and other imaging tests are an important diagnostic tool and radiotherapy is an important treatment modality for cancer, with everything comes a risk. Our study attempted to measure the very long-term impact on thyroid cancer from medical irradiation. Our findings strongly suggest that those individuals exposed to irradiation from multiple CT scans to the head, neck and chest during early childhood and individuals treated with radiotherapy to the upper body as children have a lifelong increased risk of thyroid cancer.‰

Adams and colleagues indirectly evaluated the future risks of modern patients by assessing the rates of thyroid cancer in a group that was treated with lower-dose chest radiotherapy in Rochester, N.Y., between 1953 and 1987. The cohort had been treated during infancy for an enlarged thymus, a condition that physicians used to believe was a health problem. None of the radiation administered was for cancer, and thus the research is not confounded by a susceptibility to the disease.

Adams re-surveyed the population between 2004 and 2008, and compared the health status of the group to their siblings who had not received radiation. Thyroid cancer occurred in 50 of the 1,303 irradiated patients compared to only 13 of the 1,768 siblings. The association between radiation and thyroid cancer remained strong even after researchers accounted for other factors that could contribute to thyroid cancer risk.

Radiation doses in the mid-century group overlapped with current medical practices; however, in general, higher doses and less precision were used years ago. Doses at the lower end of the study cohort were comparable to a diagnostic pediatric chest CT given today, the study said. Not surprisingly, researchers found that thyroid cancer risk increased with higher doses of radiation.

The Rochester study confirmed the findings of a pooled review of five earlier population studies, and adds to the literature by showing that, at least in children, the risk of cancer due to radiation exposure continues for a median of 57.5 years.

The James P. Wilmot Cancer Center at URMC and the National Heart Lung and Blood Institute funded the study.

By MATTHEW L. WALD
New York Times

Published: December 13, 2010

Men who grew up in the St. Louis area in the early 1960s and died of cancer by middle age had more than twice as much radioactive strontium in their baby teeth as men born in the same area at the same time who are still living, according to a study based on teeth collected years ago by Washington University in St. Louis.

The study, published on Dec. 1 in The International Journal of Health Services, analyzed baby teeth collected during the era when the United States and the Soviet Union were conducting nuclear bomb tests in the atmosphere. The study seeks to help scientists determine the health effects of small radiation doses, and to say how many people died from bomb fallout. There is very little reliable data on the relationship of radiation to cancer at low doses, so scientists instead use extrapolations from higher doses, which introduces large uncertainties into their calculations.

The study implies that deaths from bomb fallout globally run into the “many thousands,” said the authors, Joseph J. Mangano and Dr. Janette D. Sherman, both of the Radiation and Public Health Project, nonprofit research group based in New York.

However, a scientist with long experience in the issue, Kevin D. Crowley, the senior board director of the Nuclear and Radiation Studies Board at the National Research Council, urged caution in interpreting the findings.

“It sounds like the best you could do is say this is an association,” he said. “An association is not necessarily causative.”

R. William Field, an epidemiologist at the University of Iowa, praised the authors for exploring the association between fallout in teeth and cancer, but he that said the sample size was too small and that the study had other limitations. He called for follow-ups.

The study’s authors had previously tried to link strontium in the teeth of children growing up near nuclear power plants to releases from those plants, but those findings have not met with much scientific acceptance. Strontium levels in a person’s body may have more to do with where the person’s food was farmed than with where the person lives. In addition, the Nuclear Regulatory Commission calculated that the doses from radioactive strontium in the environment add only about 0.3 percent to the average American’s background exposure.

But this study tries to link differences in tooth contamination more directly with health outcomes. The study measured the ratio of calcium, a basic building block of teeth and bones, to strontium 90, which is absorbed just as calcium is. The authors said they were using strontium as a proxy for all long-lived fallout components, and they picked boys born in a period when there was a lull in atmospheric testing, so that the boys’ exposure to short-lived radioactive materials, in utero or in the first few months of life, was minimized. They limited their research to boys because men seldom change their names and thus were easier to trace.

The authors found that among 3,000 tooth donors, born in 1959, 1960 or the first half of 1961, 84 had died, 12 of those from cancer. The authors selected two “control” cases, people still living, for each of those who had died. The controls were born in the same county, within 40 days of the person who later died. The study compared incisors with incisors, and molars with molars.

The people who would later die of cancer had an average of 7.0 picocuries of per gram of tooth; the control cases, who have never had cancer, had an average of 3.1 picocuries per gram.

But the picture is not completely clear. Measurements of the teeth of people who later had cancer but survived it did not show strontium levels markedly different from those who had never had cancer, according to the study. One reason may be that those nonfatal cancers were often polyps and melanomas not related to radiation.

By Frederik Joelving, Reuters

NEW YORK | Tue Dec 14, 2010 5:16pm EST

NEW YORK (Reuters Health) – Survivors of the World War II atomic bomb dropped on Nagasaki continue to fall ill today as a result of the radiation they received, a surprising Japanese study shows.

Researchers testing survivors between 1985 and 2004 found people who had received high levels of radiation from the bomb blast were eight times more likely to develop a rare blood disease than those exposed to low levels.

“It adds evidence to the fact that radiation even at moderately low doses is hazardous, and the diseases you can get aren’t only cancers,” said David J. Brenner, who heads the Center for Radiological Research at Columbia University in New York, and was not involved in the study.

The Japanese researchers focused on so-called myelodysplastic syndromes, or MDS, in which damage to cells in the bone marrow prevents blood cells from developing properly.

With a baseline rate of only a dozen MDS cases per 100,000 survivors per year, Brenner added, even an eight-fold increase in risk doesn’t amount to much.

“This is quite a small risk relative to getting the common cancers,” he said.

The findings nevertheless may add to ongoing debate over modern radiation sources, such as computed-tomography (CT) scanning, a high-resolution form of x-ray.

About one in three Americans develop some type of cancer during their lives, and researchers have worried the recent upswing in CT scans performed for a variety of reasons could drive the number even higher.

Although newer CT machines have significantly reduced the amount of x-ray radiation patients receive, a handful of average scans is still enough to land patients in the same exposure category as Nagasaki survivors living a couple miles from where the bomb landed. Whether that raises their risk of disease remains unclear.

According to a 2009 study from the National Cancer Institute, it takes 1,000 CT scans to cause a case of cancer in a 50-year-old. So experts agree that under appropriate circumstances, the benefits far outweigh the harms.

The new study looked at more than 86,000 Nagasaki survivors, 198 of whom developed MDS between 1985 and 2004. However, the Japanese researchers couldn’t pick up cases that happened before that.

They found the disease risk rose by between 70 and 88 percent for each kilometer (about 0.6 miles) closer the survivors had lived to the blast.

Among those survivors who had received the highest dose of radiation — more than one gray, the equivalent of a few hundred standard CT scans — 81 per 100,000 per year got MDS. Among those exposed to the equivalent of about one CT scan, the rate was about 11 MDS cases per 100,000. That’s within the range in the general population.

Dr. Rebecca Smith-Bindman of the University of California, San Francisco, noted that people with MDS are at very high risk of developing leukemia, adding that the new study was the first to show radiation could cause MDS decades later.

“The work highlights another harm of radiation and should increase our efforts to reduce radiation exposure to the degree possible,” she told Reuters Health in an e-mail.

By Don Hopey and David Templeton, Pittsburgh Post-Gazette
Pittsburgh Post-Gazette

Stacy Beisler's hand is covered with black soot she wiped from her backyard grill, which she had cleaned two days earlier. Robin Rombach/Post-Gazette

In many places around Western Pennsylvania residents see clusters of death and clusters of people sickened by cancer or heart and lung diseases.

And, like Lee Lasich, a Clairton resident, they’re frustrated that government health and environmental agencies don’t see them too, don’t do something about the problems and don’t take a tougher stance on enforcement of air pollution regulations.

Ms. Lasich, whose husband worked in U.S. Steel Corp.’s Clairton Coke Works and died after suffering from lung, prostate and throat cancers in 2004 when he was 53, is typical. She uses all the fingers of her right hand to tick off the names of friends who have died from brain cancer in her Constitution Circle neighborhood. She uses her left hand to count “a whole family that’s got pancreatic cancers.”

“They’re on our street and near where we live and they’re not that old,” said Ms. Lasich, a leader of the local grassroots group Residents for a Clean Healthy Mon Valley. “It’s too coincidental, and there’s too much there. This is a scary time to live here. People are starting to notice that something is going on; that something just isn’t right.”

The Pittsburgh Post-Gazette’s analysis of Pennsylvania Department of Health mortality data from 2000 through 2008 found that 14,636 more people died from heart and respiratory disease and lung cancer in 14 Western Pennsylvania counties than national rates would predict, or 12,833 after adjusting for excess smoking in the region. And the yearlong investigation found numerous people throughout the region who talked about what seemed like unnatural and unexplained clusters of illnesses and death in their communities.

This overlap of high mortality rates and pollution raises questions about whether there is a causal relationship. The question has not been definitively answered, but for the people who live among these clusters, the connection seems clear.

• In Lincoln, across the Monongahela River from Clairton, Stacy Beisler can quickly count the names of a dozen residents who either have some form of cancer or have died from it recently. There’s a half dozen more in her neighborhood who have lung disease or have died from it.

• In LaBelle, Fayette County, Gary Kuklish is one of several residents who point to nine cases of cancer in the 18 homes on Sauerkraut Hill.

• In Clearfield County, the United Methodist Church’s Greater Shawville Parish has numerous cases of cancer and respiratory disease, according to former pastor Jennifer Heikes. There’s hardly a family in the church that hasn’t been touched by cancer, said Leslie Shaw, a parishioner.

• Street maps hand-drawn by George Simo of his Jefferson Hills neighborhood, on top of a ridge along the Mon, are crowded with names and scribbled notations about fatal cancers, heart and respiratory disease at more than three dozen homes.

The U.S. Centers for Disease Control and Prevention defines a “cluster” as an unusual number of illnesses or deaths grouped together in the same time frame or location and reported to a public health agency. Cluster investigations seek to confirm cases of a single disease; establish whether the reported cases represent an unusually high occurrence of the disease; and explore potential causes when possible.

Epidemiologists say it is almost impossible to verify with scientific certainty reports of environmental disease and death clusters. But for the residents the clusters seem real and they raise real concern.

“In 36 houses on Silverdale and Silver roads I identified 17 cases of heart disease, three cases of lung disease, 17 cancers and five cases of dementia or Alzheimer’s,” Mr. Simo said.

Known around the neighborhood as “the cat man,” or “animal man,” Mr. Simo takes in stray animals. As he did with his neighbors, he’s kept records of death rates of those animals.

“People drop off live animals here all the time, but they’re dying young,” he said, pointing to the front of his 2 1/2-acre yard where homemade wooden markers adorn weedy graves of more than 60 cats, 280 birds and 13 dogs. “These dogs should have died of old age out on the farm but they’re dying here between young and middle age. What’s happening?”

It’s a question that hangs in the air in many communities. One is Greene Township, Beaver County, which has a mortality rate 44 percent above the national average for the three diseases reviewed by the Post-Gazette.

“There seems to be a lot of heart problems and a high rate of cancer around here, and it’s been around a while. Just about every road you go on I can name two or three people with cancer who lived there,” said Russell Morgan, board of commissioners chairman in Greene Township, home to FirstEnergy Corp.’s sprawling, 1,300-acre Little Blue Run coal-ash impoundment for the Bruce Mansfield power plant in nearby Shippingport.

“We should be looking at doing a study of the higher [mortality] rates,” said Mr. Morgan, whose father died of a heart attack there at age 56.

And upwind from highly industrialized Neville Island is Avalon, where each individual disease category — heart and respiratory disease and lung cancer — is above the adjusted national average and the total three-disease mortality risk rate is 18 percent higher. Janet Strahosky, a long-time Avalon activist, lamented the public apathy despite the community’s knowledge of the eight women with breast cancer and the dead-end street in neighboring Ben Avon where there are five people with cancers.

“I’ve canvassed all of these communities door-to-door and people know what’s happening, but they don’t speak out,” she said. The Allegheny County Health Department “needs to expand the chemical pollutants it tests for. There’s lots of stuff coming out of local industries that we don’t test for and don’t measure or monitor or connect them to health effects.”

A committee appointed by the Health Department board is working on new guidelines to regulate the emissions of air toxics by local industries. The board tabled a proposal in July 2009 that would have covered 300 hazardous chemicals, including all of the 187 hazardous air pollutants — many of them dangerous carcinogens — listed in the federal Clean Air Act. The county’s existing air toxic guidelines, which date to 1988, have never been updated.

Cause of clusters unproven
The Pennsylvania Department of Health gets 50 or more requests to investigate reported “clusters” every year — including calls from towns around Neville Island, from Shaler and Washington County — but hasn’t identified the environmental cause of any.

“They’re anecdotal, so we look at the mortality rates and try to get some sort of objective measure of what’s happening,” said Gene Weinberg, head of the department’s Bureau of Epidemiology. “As to clusters, well, we’ve seen some unusual rates. But discovering the factor causing them is rare.”

Even though it gets approximately 1,000 citizen referrals or reports a year, the Agency for Toxic Substances and Disease Registry in the CDC has never issued an environmental cause finding for a community “cluster” of death or disease in the United States.

The ATSDR, the principal non-regulatory federal public health agency responsible for addressing health effects associated with toxic exposures, works in cooperation with state health departments, which almost always act as the lead investigating agencies.

While such collaborations haven’t identified community clusters, the ATSDR has made determinations of a number of “occupational clusters,” including asbestos-related cancers and diseases related to W.R. Grace Co.’s mining of vermiculite in Libby, Mont. Even though that cluster is classified as occupational, the agency said, it caused health problems, disease and cancers for many women and children in Libby who never worked for W.R. Grace.

The CDC, working with the Council of State and Territorial Epidemiologists, is updating its 20-year-old cancer cluster investigation guidelines to incorporate new epidemiological survey and computer tools and best practices.

But those 1990 guidelines and any eventual updates of them are only advisory, which creates problems due to inconsistent investigations in different states, said Terri Nordbrock, executive director of the National Disease Clusters Alliance and an environmental health scientist.

“There’s also a lot of pressure not to declare a ‘cluster’ exists because it’s a controversial thing that takes a lot of work and attracts media attention,” Ms. Nordbrock said. “Many states don’t have the resources to do such investigations and any cluster findings can get them into a lot of trouble with not a lot of payback.”

In a written statement about the Post-Gazette’s ecological mortality study, Dr. Weinberg said the state Department of Health “recognizes that environmental pollution has health consequences.” Although associations may appear, he cautioned against attributing the mapped findings to any factor or combination of factors.

According to the ATSDR, the state health department has conducted 129 public health assessments and health consultations for the registry since 1994 and found no environmental cause for any cluster.

“It is important to understand that clusters, or elevated rates in time and space, can be identified,” said Beth Abrams, a spokeswoman for the ATSDR, “but that does not mean that those diseases necessarily share the same cause or an environmental cause.”

Another cluster view
Daniel Wartenberg, an epidemiologist, professor and director of the Division of Environmental Epidemiology at UMDNJ-Robert Wood Johnson Medical School in New Brunswick, N.J., said he’s concerned that state health departments and the CDC are missing legitimate clusters.

“Some of the pollutants cause multiple types of cancer and even multiple diseases,” he said. “To say that a state health department will look at only one type of cancer or one disease when considering a cluster is crazy. It’s like calling a doctor when you don’t feel good and he treats your cold symptoms but not your broken leg.”

Dr. Wartenberg, who is on the board of the National Disease Clusters Alliance and also a member of the CDC committee working to update cluster investigation guidelines, said there’s better science, computer techniques and years of experience that states should be applying to cluster investigations that will make them work better for communities and the states.

There’s also a better way to approach such investigations, including analyzing death and disease data and pinpointing problem areas, he said.

“Now the health departments wait until they are called up or approached by individuals or communities about a perceived problem. The state doesn’t go out and look for these clusters. It’s passive.” he said.

In Clairton, Rex Cole Jr., a lifelong resident, has seen family members — uncles, aunts, father, grandparents — die of some form of cancer or heart disease in their 60s along with many neighbors. It’s the way of life and death in the mill town dominated by the world’s biggest coke plant.

“What you did was, you went to high school, then got a job at U.S. Steel,” said Mr. Cole, 28, who is leading a faith-based effort to attract alternative energy industries and jobs to Clairton. “The neighbors said everybody on the street basically died of cancer … Sometimes the smell is so thick you can taste it. But most people are more worried about putting food on the table than the long-term effects of lung or heart diseases.”

U.S. Steel declined to comment on the Post-Gazette’s study and its findings, or comment on whether its emissions have affected the health of residents in the Mon Valley. It did outline its ongoing $1.2 billion replacement and upgrade of its operations in Clairton, including new coke batteries and three new coke quenching towers.

Pollution in the Liberty-Clairton region has exceeded federal health standards for airborne particles since 1995. The coke works is the largest local contributor of airborne particles. It is operating under a county consent order and agreement designed to reduce those emissions.

Don Hopey: dhopey@post-gazette.com or 412-263-1983. David Templeton: dtempleton@post-gazette.com or 412-263-1578.

First published on December 13, 2010 at 12:00 am

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By Gary White
The Lakeland (Fla.) Ledger

Published: Saturday, December 11, 2010 at 3:30 a.m.
LAKELAND, Fla. | They have been called “Poisoned Patriots,” and no one is sure exactly how many of them are out there.

Their numbers include former Marines, their wives, children and civilian employees at Camp Lejeune, the sprawling United States Marine Corps base in Jacksonville, N.C. They drank, showered and bathed in water contaminated by chemical compounds with unpronounceable names, chemicals that have been linked to cancers.

The Marine Corps has acknowledged that water supplies at Camp Lejeune were tainted with dangerous compounds between 1957 and 1987. Following orders from Congress, the Marine Corps has taken steps to inform the hundreds of thousands potentially affected.

But many ex-Marines and former Camp Lejeune residents are far from satisfied. Activists, including former Winter Haven resident Mike Partain, have sifted through reams of documents, challenging minute details of the Marine Corps’ version of events at Camp Lejeune.

They say the contamination was far more widespread than the Marine Corps has admitted. They accuse the leadership at Camp Lejeune of ignoring repeated warnings about hazardous drinking water for years before it took action. They charge the Marine Corps with deliberately withholding crucial information and misleading investigators.

“Trying to get the truth out of the USMC is akin to nailing Jell-o to the wall,” Partain said. “As we unravel lie after lie, the USMC simply changes their story.”

Camp Lejeune represents the worst contamination of a public water system in United States history, according to Congressional testimony by scientists. The maximum level of toxins was more than five times the highest measured at Woburn, Mass., in the case detailed in the book and movie “A Civil Action.” In that case, a leukemia cluster was traced to contamination of water supplies resulting from improper disposal of industrial solvents.

One contaminant at Camp Lejeune was measured at 1,400 parts per billion in water from a faucet at the base hospital where Partain was born. That is 280 times the current allowable limit, though the government had not established limits for the chemical compound at the time.

An estimated 700,000 to 1 million people lived or worked at Camp Lejeune during the period of water contamination.

Marine Corps officials say the base leadership followed all pollution regulations of the era. They say investigations by federal agencies absolve the base leadership and the Corps of any intentional wrongdoing.

Advocates push for wider investigations, support legal actions against the Marine Corps and lobby for Congressional action to assure medical care for those with health claims.

Many Floridians exposed

More than 161,000 people have joined an official online registry for former Camp Lejeune residents and employees created in 2008. Floridians compose more than 14,000 of that total, second only to North Carolina.

Those Floridians include Kim Ann Callan of Lakeland. Callan, the daughter of an ex-Marine, was conceived at Camp Lejeune and lived there for the first nine months of her life.

Callan, 52, was treated for malignant melanoma a few years ago and was diagnosed in July with leukemia.

“It’s not just me,” Callan said. “Everyone in my immediate family that was associated with even a short period of time on the base has significant medical issues.”

Carla Morris of Auburndale is convinced that impure water at Camp Lejeune is to blame for her mother’s death from a rare gastric cancer in 2006 at age 69. Cora Hoffman worked as a labor and delivery nurse at Camp Lejeune’s Naval Hospital from 1966 through 1976 and again in the 1990s.

Morris, 45, said she has investigated her mother’s ancestry and found no other examples of cancer.

“I sat there … and watched my mother beg the doctor to cut her stomach out,” Morris said. “I’m mad as hell. I don’t know any other way to put it. That was my mama. Like I told my husband, she was only 69. That’s not old. My mom’s mom lived to be 92 years old.”

Partain, 42, was diagnosed with male breast cancer, an extremely rare condition, in 2007. He underwent a modified mastectomy, with the removal of one lymph node, and endured chemotherapy.

Partain said he has found 66 other men connected to Camp Lejeune who have been diagnosed with breast cancer.

Partain, the son and grandson of Marine Corps officers, was born in the base hospital at Camp Lejeune, where his father, Warren Partain of Winter Haven, was stationed, and the family resided in base housing during the first 13 months of Mike’s life. Partain said Camp Lejeune had been little more to him than a name on a birth certificate until he first learned about the water contamination through a CNN report in 2007.

It is almost impossible to determine clear causation for cancer and other diseases, said Dr. John Kiluk, a breast cancer specialist at H. Lee Moffitt Cancer Center in Tampa. But Kiluk said some of the male breast cancer cases in men with ties to Camp Lejeune are unusual.

Kiluk said the lifetime risk for a man to develop breast cancer is one in 1,000. Kiluk said he has treated about 20 men for breast cancer, and some — he wouldn’t give an exact number — have connections to Camp Lejeune.

The average age of diagnosis is 70. Partain was just 39 when he was diagnosed.

Kiluk said most men who develop breast cancer have a family history of female breast cancer. Partain said he knows of no breast cancer in his family.

“I think the thing that’s surprising in meeting a few of these gentlemen is some of them fall outside of that normal description,” Kiluk said. “Some are very young. When you’re very young with a very rare disease combined with no family history, it just makes you wonder what’s going on.”

Partain has testified twice about Camp Lejeune before Congressional committees. He has been interviewed for a film documentary about Camp Lejeune scheduled for release next year.

“I would like very much to have never been born at Camp Lejeune and never set foot in that place,” Partain said. “Who in their right mind would go overseas and fight for this country knowing that their family was being poisoned at home? These people left their families on this base and other bases across the country thinking they’re safe, and in reality they were in just as much danger as the guys overseas being shot at. That’s the betrayal part.”

Focus on fuel leaks

The saga of toxic water at Camp Lejeune is a complicated one covering decades and involving questions about military orders, federal pollution regulations and emerging knowledge about the dangers of certain chemical compounds.

Investigations have focused on four contaminants: trichloroethylene (TCE), tetrachloroethylene (PCE), benzene and vinyl chloride (VC). The Environmental Protection Agency lists all four as known or suspected carcinogens, meaning they can cause cancer in humans.

TCE and PCE are both solvents. TCE is commonly used as an engine degreaser and PCE is used in dry cleaning. Investigations have traced some of the contamination at Camp Lejeune to two private dry cleaners adjacent to the base.

Benzene, an ingredient in motor fuels, has been linked to leukemia and other diseases. Vinyl chloride, which arises from the breakdown of TCE and PCE, can affect the heart, liver and immune system.

Partain and other activists have uncovered a history of fuel leaking from underground tanks at Hadnot Point Fuel Farm, constructed in the early 1940s. Recently discovered documents estimate the amount of fuel lost at between 400,000 gallons and 1.1 million gallons.

“Imagine taking a freighter and dumping (the contents) in the ground,” Partain said. “That’s what they did at Hadnot Point Fuel Farm. The Marine Corps has known this since 1996.”

First Lt. Gregory A. Wolf, a spokesman for the Marine Corps based at the Pentagon, said the Marines aren’t sure how much fuel leaked at Hadnot Point. He said 1.1 million gallons is the upper end of an estimate from a 1996 draft document.

The Marine Corps says the first clear evidence of contamination in drinking-water wells at Camp Lejeune came in 1984, after which it promptly closed down those wells.

Partain and others argue that Camp Lejeune’s leaders should have acted much earlier, noting volatile organic compounds were detected in water systems in 1980.

Documents posted on the “Forgotten” website show repeated warnings from 1980 onward, first from Army chemists and later from employees with a private company hired to analyze the water. One, written by U.S. Army Lab Services Chief William Neal in 1981, reads, “Water highly contaminated with other chlorinated hydrocarbons (solvents)!”

Camp Lejeune officials ordered testing of water systems located near a landfill in the lightly populated Rifle Range area in 1980. Water-supply wells at Hadnot Point and Tarawa Terrace, where thousands lived and worked, were not tested until 1984. Wolf, the Marine Corps spokesman, said wells were not tested there earlier because “sources of contamination … had not yet been identified.”

Partain makes the analogy to the average person learning that the water coming out of his kitchen faucet contains harmful chemicals.

“A reasonable person would go and find the source,” he said. “The Marine Corps claims it didn’t know the source for 4½ years. In the court system that’s called negligence.”

As the Marine Corps has repeatedly pointed out, the federal government did not set safe standards for the contaminants detected at Camp Lejeune until 1989, meaning the Marines were not required to take action before then.

Activists deride that stance as legally correct but irresponsible. Partain points to historical documents setting standards for drinking water at Department of Navy facilities, including Camp Lejeune. A 1963 order defines pollution as “the presence of any foreign substance (organic, inorganic, radiological or biological) in water which tends to degrade its quality so as to constitute a hazard …”

Another order from 1974 described organic solvents in drinking water as hazardous.

“Where is the due diligence?” Partain asked. “Do you have to have a (federal) regulation to say it’s hazardous? If they were following their own orders, they could have prevented all this contamination going back to 1963.”

Investigations, skepticism

Several federal agencies have investigated the issue. The Environmental Protection Agency in 1989 added Camp Lejeune to Superfund, a program that designated federal money for the cleanup of major hazardous waste sites. That remediation project is expected to last for decades.

As part of the Superfund process, the Agency for Toxic Substances and Disease Registry in 1997 issued a public health assessment that said Camp Lejeune residents faced little or no risk from drinking and using water at Camp Lejeune. Last year, though, the agency withdrew the assessment, saying it was flawed by inaccuracies and the failure to consider the presence of benzene in the water.

The EPA and the Government Accountability Office, an investigative arm of Congress, found no evidence of improper actions by Camp Lejeune’s leadership or the Marine Corps.

Partain and other activists, though, are highly critical of those reports. They say the investigations missed key documents and didn’t review historical regulations on water quality from the Department of the Navy, which oversees the Marine Corps.

An EPA investigator told a Congressional committee in 2007 that he recommended that charges be filed but was overruled by the Department of Justice, which is defending the Marine Corps for any tort claims filed in relation to Camp Lejeune. Partain also dismissed the results of an investigation by a Marine Corps Commandant Blue Ribbon Panel released in 2004 as tainted by a conflict of interest.

The National Research Council, a federal scientific agency, released a report in 2009 finding no conclusive link between water contamination at Camp Lejeune and diseases. In October, the director of the ATSDR released a letter criticizing the NRC report as flawed and incomplete.

The ATSDR is compiling a new assessment of water quality at Camp Lejeune that is scheduled for release late in 2011.

Advocates say the Marine Corps has withheld crucial information from investigators. As one example, Partain said a sub-contractor to the ATSDR last year accidentally found an undisclosed web portal operated by the Department of the Navy that yielded new details about Camp Lejeune.

Another activist, Jerry Ensminger of North Carolina, said the Marine Corps is unable to produce crucial documents that were the basis for the original ATSDR public health assessment from 1997.

“They mysteriously got lost,” Ensminger said of the documents. “I said, ‘For God’s sake, how can you stand behind an official public document for which you can’t even produce the supporting documents you created it from?’ ”

The Marine Corps insists it has cooperated with all investigations.

“The Marine Corps’ primary goal is to get answers for our Marines and their families,” said Wolf, the Marine Corps spokesman. “We have proactively preserved and forthrightly provided relevant documents and information to the scientific community and the public.”

Marine feels betrayed

Ensminger, a retired Marine Corps drill sergeant, ranks as probably the most prominent Camp Lejeune activist. Ensminger’s daughter, Janey, died of leukemia in 1985 at age 9.

“Anybody who has a child who’s been diagnosed with a catastrophic, long-term illness, once you get over the initial shock the first natural thing for a parent to do is start wondering why,” Ensminger said. “I was no different from anybody else. … I never thought I’d get an answer. I never dreamed I would.”

After seeing a TV news report in 1997, Ensminger said he began calling the environmental management department at Camp Lejeune and was assured the water contamination had been small and posed no health threat. As more details emerged, partly through Freedom of Information Act requests by other activists, Ensminger became convinced the military had deliberately understated the problem.

Ensminger, a co-creator of the “Forgotten” website, now devotes most of his waking hours to research about Camp Lejeune. He said he and other former Marines feel betrayed by what they see as deceit on behalf of the Marine Corps’ leaders.

“I trained over 2,000 new Marines at Parris Island,” Ensminger said. “I instilled in those young people our core values, our saying, ‘Semper Fidelis,’ which means ‘always faithful,’ and our slogan, ‘We take care of our own,’ and I can tell you without any doubt that no one is more disillusioned by the misconduct of the leadership both past and present of the United States Marine Corps and the Department of the Navy than I am.”

Partain was never a Marine, but his father — Warren Partain of Winter Haven — was.

“My dad had a bunch of sayings,” Mike Partain said. “One of them was, ‘Character is defined by what you do when nobody’s looking.’ The Marine Corps has known about this. They’ve known the extent of the contamination, and instead of doing the right thing and taking care of their people they turned their backs on us and left us out there to die. That goes against everything about the Marine Corps.”

Morris, the Auburndale woman whose mother died of gastric cancer, applauds the efforts of Partain and other advocates but doubts the military leadership will admit to what she sees as its culpability in the water contamination at Camp Lejeune.

“The first thing I told Mike (Partain) was, ‘They can come here and offer me every penny in the world; it ain’t going to change the fact that my mama’s gone,’ ” Morris said. “Money’s not going to bring my mama back to me, but if getting the story out reaches someone who doesn’t know about it and makes them find out something conclusive, then I’m all for it.”

Callan, the Lakeland woman with leukemia, also expressed anger at the government’s handling of the issue.

“It makes me absolutely sick that our government asks men and women who serve to fight for our country and then they don’t have our backs,” Callan said. “People are not necessarily looking for, ‘Here’s a check to make good all the trauma you’ve gone through.’ I don’t want that. I want accountability for the past and future. … I in no way think money cures that, but an admission or an apology for putting people through something that didn’t have to happen — that’s justice to me.”

Gary White can be reached at gary.white@theledger.com

ScienceDaily (Dec. 9, 2010) ˜ Older people who live in racially segregated neighborhoods with high crime rates have a much higher chance of developing cancer than do older people with similar health histories and income levels who live in safer, less segregated neighborhoods.

That is one of the key findings of a new study forthcoming in the January 2011 issue of the American Journal of Public Health. The study was conducted by Vicki Freedman, an epidemiologist at the University of Michigan Institute for Social Research and colleagues at the University of Medicine and Dentistry of New Jersey.

One of a growing number of studies documenting the connection between neighborhood characteristics and chronic health conditions, it is the first to show that living in more highly segregated areas with higher crime rates is linked with an increased risk of developing cancers of all kinds — for whites as well as Blacks.

The chance of developing cancer is 31 percent higher for older men living in these kinds of neighborhoods, and 25 percent higher for older women.

The study also found that living in low-income neighborhoods increased the chances that older women would develop heart problems by 20 percent. They found no impact on older men.

The researchers based their analysis partly on data from the ISR Health & Retirement Study, a nationally representative, longitudinal survey of more than 20,000 Americans age 50 and over, funded primarily by the National Institute on Aging, part of the National Institutes of Health.

For their analysis, the researchers analyzed detailed measures of self-reported individual health histories, matched with multiple indicators of the social, economic, and physical conditions of the neighborhoods in which individuals lived.

According to the authors, the study’s findings point to potentially new pathways through which the neighborhood environment may influence the development of chronic disease. For example, much of the previous research on cancer and the environment has emphasized lifestyle factors such as tobacco use, diet and exercise, and exposure to cancer-causing agents, rather than the social and economic aspects of the environment.

Although the link between racial segregation and health is often cited as a fundamental cause of health and mortality disparities between Blacks and whites, the most common explanation for the link is that segregation influences socioeconomic deprivation and individual socioeconomic attainment. “But we found that segregation and crime increased the chances of developing cancer even after we controlled for socioeconomic resources at both the individual and the neighborhood level,” Freedman said.

The researchers also examined levels of exposure to air pollution and other environmental toxins, but found that crime rates and racial segregation levels independently predicted cancer onset.

“The remarkable similarity in the size and strength of this relationship for both men and women is quite surprising given differences in the types of cancer each gender develops,” she said. “This suggests that a nonspecific biological mechanism may be involved, possibly a stress response that interrupts the body’s ability to fight the development of cancer cells.”

Freedman and co-authors call for further research into the social and biological mechanisms that underlie this link, noting that the addition of biological measures to the ISR Health & Retirement Study, the ISR Panel Study of Income Dynamics, and other longitudinal national surveys will makes this type of analysis possible in the near future.

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Cancer epidemics in Turkey could hold the secret to staving off a public health disaster in North Dakota.

Nature 468, 884-885 (2010)
Brendan Maher

Cappadocia, a region in central Turkey is known for stunning rock formations. But several small villages in the region have a less welcome reputation. For generations they have been plagued by mesothelioma. Photo credit: M. Carbone/H. Yang

They became known as the cancer villages — tiny hamlets in Cappadocia, Turkey, that for generations have been haunted by an extremely rare lung condition. Mesothelioma, responsible for up to half of the deaths in these towns, is almost always associated with exposure to asbestos. But here, researchers found a different cause: a mineral called erionite, which is built into the very fabric of the villages. It is on the roads, in the fields and in the stone used to construct the houses.

Now, decades of research in Turkey may help to save lives 9,500 kilometres away, in a rural corner of North Dakota. The Killdeer mountains in the western part of the state are rich in erionite, and they serve as the only nearby source of stone for surrounding Dunn County. When Ed Murphy, the state geologist, heard about the Turkish cancer villages five years ago, he grew concerned and launched an investigation that found erionite in gravel covering hundreds of kilometres of roads. It also turned up in driveways, car parks and even a playing field used by children. The North Dakota study eventually grew into a global collaboration including cancer biologists, geologists, epidemiologists, environmental scientists and physicians. And this week, the team is reporting some worrying results: that levels of exposure to erionite in North Dakota are the same as in some of the Turkish villages ravaged by mesothelioma.

The cancer hasn’t yet shown itself in North Dakota, but mounting evidence suggests that large-scale clean-up efforts should commence immediately, says Michele Carbone, a mesothelioma expert at the University of Hawaii in Honolulu who has worked in both North Dakota and the Turkish villages. “The reason that I find it exciting is that here we have a chance to do something,” he says.

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