NDCA teamed with the Natural Resources Defense Council (NRDC) to report on 42 disease clusters in 13 states. We intend to complete this pilot project and cover all 50 states and U.S. territories.

Read the report.

Health Alert: Disease Clusters Spotlight the Need to Protect People from Toxic Chemicals [pdf 1.5MB]

Victor Furman, op-ed
Press & Sun-Bulletin

The State of Delaware has confirmed a link between a coal-burning plant and an increase in cancer among exposed residents. The Delaware News Journal reports that years after citizen activists first asked the state to investigate the problem, the Delaware Division of Public Health has finally confirmed what the activists suspected: There’s a cluster of cancer cases near a coal-burning plant, the state’s worst polluter.

The coal-burning plant is NRG Energy Inc.’s Indian River complex and is located in Millsboro, Delaware. The study was conducted by examining the cancer cases in a six ZIP code area around the plant. The areas examined were Dagsboro, Frankford, Georgetown, Millsboro, Ocean View and Selbyville.

The Division of Public Health study showed an incidence of 553.9 cancer cases per 100,000 residents of this area between 2000 and 2004 compared with the Delaware state rate of 501.3 and the U.S. rate of 473.6 cancer cases per 100,000 residents. Thus, this study confirmed that the rate of cancer cases in this area is 17 percent higher than the national average.

According to the U.S. Environmental Protection Agency’s Toxic Release Inventory, coal-burning power plants in Delaware release large amounts of toxic hydrochloric acid, sulfuric acid, ammonia and hydrogen fluoride, along with lead, nickel and mercury compounds and other chemicals that may cause cancer or linger in human tissues or the environment.

No government study would be complete without a qualification blaming the exposed people. The Delaware study is no exception. In the study, the highest incidence of cancer among the exposed residents was lung cancer, which accounted for 19.5 percent of the cases. The Division of Public Health said that it is not sure whether the higher incidence of lung cancer could have been caused by tobacco or by people having moved into the area from a different environment.

The report also said that new state rules intended to reduce emissions “are a major step forward in providing a clean environment.” With this, we agree.

Does any of this sound familiar? As you may know, citizen activists first uncovered an unusual cluster of polycythemia vera cases along the Ben Titus Road in the Still Creek area of Rush Township. Polycythemia vera is a rare bone marrow cancer.

Two cancer studies by the Pennsylvania Department of Health (PA DOH) left the affected residents with little information of significance about the rates of cancer in the area or the cause of the polycythemia vera. The PA DOH attributed any increases in the incidences of cancer that did appear in its two studies to life style, specifically smoking and diet. The PA DOH was partially correct. The increases can be attributed to life style but in these studies the life style relates to living in an area contaminated with imported hazardous wastes and to being exposed to a toxic chemical soup.

A reporter, Sue Sturgis, from North Carolina has reviewed the PA DOH’s data of reported cases of polycythemia vera by county for the years 2001 through 2003 and suggests a possible association between polycythemia vera and power plants that burn waste coal www.hometownhazards.com. It is amazing to us that a reporter from North Carolina has done more investigating into the basis of our problems than the Pennsylvania Department of Health.

Finally, a recent article reported that the Agency for Toxic Substances and Disease Registry (ATSDR), part of the federal Department of Health and Human Resources, is completing a study on the incidence of polycythemia vera in Carbon, Luzerne and Schuylkill counties. The article reported that the ATSDR has found an almost quadrupling of the incidence of polycythemia vera in the area.

The primary purpose of all government is to protect the health, safety and welfare of its citizens. When will our government begin to protect our health, safety and welfare from the toxic emissions of coal-fired power plants? We are not asking that these plants be shut down but we are asking that our legislators stop giving these toxin-emitting plants licenses to pollute. We are demanding that they be operated in a manner that reduces the risks of toxic emissions for the people living near these plants.

*We thank Jill McElheney of the Ministry to Improve Child and Adolescent Health (MICAH’s Mission: Micahmission@aol.com), P.O. Box 275, Winterville, GA 30683, for calling our attention to the study by the Delaware Division of Public Health..

SO YOU thought smoking cigarettes was bad for your health? Try living next to a coal-fired power plant.

That’s the diagnosis that Physicians for Social Responsibility (PSR) relayed to the public in a comprehensive medical study released on November 18 called “Coal’s Assault of Human Health.” In it, the organization, comprised of physicians and public health experts, claims that coal pollutants damage every major organ in the human body and contribute to four of the top five leading causes of death in the United States.

Not since NASA’s James Hansen rang the global warming alarm about coal’s major contribution to climate change has there been a more dire call to shut down coal operations in the United States. It is not simply about cleaning up the coal process; it is about halting its production altogether in order to immediately save lives.

From an article in the Socialistic Worker.org:

At every stage in its life cycle, coal can negatively impact human health, from mining operations, cleaning, transportation to burning and disposing of the combustion waste. PSR reports that many Americans are being affected daily by coal and the exposure is contributing to horrible health problems; heart attacks, lung cancer, strokes and asthma, among others.

“The findings of this report are clear: while the U.S. relies heavily on coal for its energy needs, the consequences of that reliance for our health are grave,” said Dr. Alan H. Lockwood, a principal author of the report and a professor of neurology at the University at Buffalo.

From Victor Furman:

As individuals responsible for our own carbon footprint we must look at the feet of the entire energy industry. Coal has the biggest set of feet of all other sources combined. I as many readers know, am an advocate for natural gas and natural gas drilling. I argue points and research every report of any source of problems that are connected to the hydro fracturing process. There are not any reports of water contamination or earth destroying mountain top removal scenario’s to where one can point a finger and say this was caused by fracking. There have been surface spills and production mishaps that were quickly contained and remedied but nothing, I mean nothing that compares with the intentional destruction of lands connected to the minning of coal. There is no comparison to the damage to our lands deforestation and no comparison to the many many many water tables, rivers lakes and streams that have intentionally been polluted by the by prodoct of coal, “coal ash” which has been said to contain more radioactive material then waste from a nuclear power plant as well as lead, cadmium, arsenic and mercury and other Total dissolved solids that are harm full to our environment and health.

We are afforded a great opportunity to begin to lift the feet of coal from the surface of our planet for a fossil fuel that is 47 percent cleaner, uses much less water to obtain, and need not have to tear down our mountain tops. and killing our waterways through mining and coal ash dumps. This is not just a bridge to Cleaner Energy, this the cleaner energy to bring us to the promise and development of greener technologies.

Yes I am an advocate for what some are calling a gift from God. And yes I do have land and stand to make money from signing a lease. I welcome those of you who might say my advocacy for natural gas is based on greed to check the deeds office and see that the vast amount of land I own that has promised, according to some, to bring me life changing wealth. What I own is 5 acres of highly taxed land. My real goal is not the monies, but the thought of reducing the carbon emissions that are destroying our earth through anyway necessary so that my grand children wont have to watch there mother or father die of diseases brought on by energy pollution. My family and I lived near a coal fired power plant, My wife died at 42 from cancer of the endocrine system, my daughter was cured from mouth cancer at the age of 15. My other daughter suffers from thyroid problems. was it coal and coal ash dust…. I believe so. Drilling for Natural Gas beats the heck out of drilling and mining for coal.

read online

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

What you haven’t been told about chemicals polluting the aquifer that serves Del., Md., N.J.

By JEFF MONTGOMERY
The News Journal

online videos, interactive graphics

Tainted groundwater is spreading across thousands of acres in northern Delaware and has reached the Potomac Aquifer, which supplies drinking water to people across much of Delaware, Maryland and New Jersey.

In some areas of the upper Potomac near Delaware City and New Castle, concentrations of benzene, vinyl chloride and chlorinated benzenes are so high that exposure poses an immediate health threat. Elevated levels of these industrial byproducts significantly increase the risks of cancer. Sustained exposure could kill.

Northern Delaware is home to some of the worst chemical dumping grounds in America, a legacy of broken promises and corporate misdeeds. Regulators working for Delaware and the U.S. Environmental Protection Agency have long claimed that the deep clay layers above the aquifer protected it from the foul waters discharged by chemical and petroleum manufacturers.

Those assurances have proved false.

The protective layer over the aquifer, scientists now say, is full of holes.

To prevent a public health disaster, the state has banned public use of groundwater under or near the Delaware City petrochemical complex.

Toxic pollutants, though, are now moving near the edge of that containment zone, outside the properties of Metachem, Occidental Chemical, Formosa Plastics and the Delaware City Refinery, and toward schools and houses.

One plume of chemicals has traveled a mile south of the refinery’s main production area and has seeped 190 feet into the earth.

While millions have been spent to test and track the spread of potentially lethal chemicals, little has been done to keep residents informed about the threats to their drinking water. Some of the worst polluters have walked away, leaving cleanups to taxpayers.

Public health officials have barely begun to gather the epidemiological data and household research that could connect environmental toxins to the higher frequencies of lung, prostate and colorectal cancers found from Wilmington to Dover and around Millsboro.

The News Journal spent a year investigating groundwater contamination and toxins moving through the soil. The investigation uncovered a damning history of corporate mistakes and lax government oversight, especially in the corridor bordered by the Delaware River, Du Pont Highway and the Chesapeake & Delaware Canal.

The newspaper obtained thousands of pages of corporate documents, consultant reports, hydrology and geology studies, well-water monitoring reports and ecological tests on fish and plants. The majority of the documents were gathered through state and federal Freedom of Information Act requests. Most have never been distributed to the public.

Among The News Journal’s findings:

Delaware City Refinery (cleanup led by former owner Motiva Enterprises). After nearly two decades of investigation, a Motiva consultant acknowledged to state regulators in 2008 that cleanup engineers don’t know the direction or extent of pollution moving under the refinery, according to a document never publicly released. Engineers sought approval to inject nitric acid deep into the ground to neutralize a plume of sodium hydroxide. The company retracted the request after a Delaware City resident, unaware of the project’s true purpose, requested a public hearing.

Delaware Sand & Gravel (private landfill near Army Creek owned by a trust). The EPA in April threatened to take over groundwater cleanup work after discovering that bis 2-chloroethyl ether (BCEE), an industrial solvent also used to make pesticides, continues to spread out of control near a major public utility well that supplies water to tens of thousands in northern Delaware. BCEE is a probable carcinogen. The EPA demanded a new plan to deal with the threat in a private letter to DS&G, obtained by The News Journal, that has never been publicized.

Metachem Products (formerly Standard Chlorine). Despite repeated assurances that deep groundwater was safe from herbicide and pesticide ingredients spilled at the abandoned Metachem plant, EPA consultants this year confirmed finding extremely high levels of toxic contamination deep underground, some at nearly twice the depth seen five years ago. The result was drastically different than the picture painted in mid-2005, when government officials noted “no detections” in a mid-year sample from a shallower well.

Delaware City PVC Plant (includes cleanup work for Formosa Plastics, Stauffer Chemical and Akzo Chemical). Levels of ethylene dichloride used in the production of vinyl chloride have increased “significantly” in some wells near Du Pont Highway, according to a March letter obtained by The News Journal. State regulators did not publicize the developments, although they did send private letters just over a year ago to neighbors urging them to consider hooking up to a public utility to reduce the risk of exposure to the probable carcinogen.

Occidental Chemical. A consultant’s report filed with the EPA by Occidental Chemical speculated that mercury levels in sediments near the company’s shuttered chlorine factory could be high enough to pose a risk to insect-eating birds that feed in nearby marshland.

Nobody — not corporate consultants, not government regulators, not scientists — can say how badly the upper Potomac Aquifer is polluted or how long it will take these plumes of toxic chemicals to reach new drinking water sources. After decades of spills, explosions and dumping — and billions in corporate profits — most of the manufacturers along the Delaware River’s western border near Delaware City have closed or declared bankruptcy. The cleanup bill now belongs to a few corporate entities and to the public, which remains largely uninformed.

‘No fix’

Near Patti Bennett’s home, in a marshy hollow not far from Southern Elementary School, gasoline has pierced the Potomac and bled into Dragon Run creek, which meanders over several miles from Lums Pond to the Delaware River.

Monitoring tests conducted in 2006 found benzene and a since-banned gasoline additive at a level 160 times greater than the federal standard for safe drinking water.

The state Department of Natural Resources and Environmental Control never reported those findings, and the public still would not be aware of the danger if The News Journal hadn’t come across the report through a series of FOIA requests.

“I kind of know what’s out there,” said Bennett, whose relatives have owned land along Cox Neck Road, south of the refinery, since the early 1950s. “But nobody has ever come up and knocked at my door and said: ‘Look, we have a problem and you might want to check your water.’ ”

Many of the documents are held by DNREC or the EPA under the Resource Conservation and Recovery Act, a law that allows government oversight of cleanups by active and ongoing businesses. Those cleanups, while publicly supervised, provide few avenues for public participation or briefings.

The federal Superfund cleanup law, while more attentive to public interests, creates projects that take decades to complete, with years passing between public notifications.

Delaware’s top environmental officer acknowledged that the state hasn’t communicated the scope of the problems well enough for the public to understand.

“I think that the focus of the department going forward has to be on the resource, not just on the property boundary,” said Collin P. O’Mara, state secretary of Natural Resources and Environmental Control. “We’re trying to shift that mind-set. A lot of the focus in the past has been on legal issues. Maybe we haven’t done quite enough looking at the migration of some of these plumes, to try to move beyond the legal boundaries.”

His agency is trying to develop more aggressive and protective approaches to water pollution investigations, efforts partly driven by concerns about state cancer death rates and recently identified contamination risks from other types of pollutants.

State regulators have made big strides recently in curbing industrial and power plant air pollution, some linked to cancer, O’Mara said. But work is only starting on other potential contributors to unexplained clusters of high cancer rates in parts of Delaware.

“We’ve not studied nearly as much the link between water pollution and various health outcomes,” O’Mara said. “Water is probably the greatest environmental challenge facing the state right now.”

Longtime resident Alice Wilmoth said she knew little about the underground poison nearing her home until anglers began steering clear of fishing in Dragon Run and the large tidal marsh that borders it.

Wilmoth, 83, has run the family-owned Delaware Bait Center alongside Dragon Run at U.S. 13 since the late 1940s, before the refinery was constructed over a landscape of farms and swamps.

“It’s still really pretty. I used to fish a lot in there and I’d catch bluegill and pike — the fish with teeth,” Wilmoth said. “Now a lot of people are afraid to catch anything.”

More glaring problems have been found in Red Lion Creek, a waterway just north of Dragon Run and north of the refinery and Metachem Products Superfund site. In 2007, a consultant for the EPA concluded that both adults and children would elevate their lifetime health risks if they ate fish caught from the creek.

Researchers concluded that pollution from several dangerous chemical spills had reached the groundwater around Metachem and posed a cancer risk to workers at the site and potential trespassers.

Delaware Geological Survey scientist Tom McKenna said the only thing to do about pollution in the area now is to cut off the source, clean up as much as possible and wait to see how far it spreads.

“You’re not going to stop the tremendous volume of water from moving. You can’t possibly pump it all out. You just have to be able to predict where the water is going, so folks can be made aware,” McKenna said. “There is no fix.”

Scientific disagreement

Delaware City’s municipal drinking water is drawn from the Potomac hundreds of feet deeper than the private wells and a mile south of contamination from the refinery. Most homes and developments nearby today are served by public utilities that tap even more distant streams or wells.

The EPA contends pollution from the refinery, Metachem and the other nearby cleanup sites will take decades — or longer — to foul major public supplies.

Other experts say that scientists still don’t understand the geology of the area well enough to be confident in predicting how fast plumes of underground chemicals will move. They warn that the pollution may already have caused irreparable harm.

Llangollen Estates resident Barbara J. Bason firmly believes that tainted water harmed her family in 1977, a time when the nation was waking up to the dangers of toxic spills and tainted groundwater.

The problem hit home when Bason’s infant son, Chris, grew violently ill every time he took formula made with tap water from her house just south of New Castle, long served by public wells near some of the most-notorious toxic landfills.

“Whenever I used canned formula, there wasn’t a problem,” Bason recalled. “When I had to use tap water, he had projectile vomiting.”

Bason began hauling in water from public springs miles away, and eventually installed a heavy-duty home filter.

Not long afterward, news emerged about the thousands of leaking drums and chemical wastes seeping out of the nearby Delaware Sand & Gravel industrial waste dump and into water supplies.

“People were terribly upset,” Bason said. “They were finding serious stuff in the water that was apparently leaking out of what was dumped there.”

After years of cleanup work, the Environmental Protection Agency declared DS&G under control, in the mid-1990s, going so far as to include the project among its Superfund “Success Stories.”

By 2000, a toxic plume from the same landfill fouled Artesian wells serving Llangollen Estates and thousands of other homes near New Castle. State and federal officials ordered new remedies, only to admit earlier this year that groundwater threats remain out of control.

The spread of pollution can be impossible to predict in multilayered aquifers like the Potomac, said Rutgers University geologist Ken Miller.

“The Coastal Plain is notorious, because it has sands that are relatively unconsolidated that can transmit things a long distance,” Miller said. Believing pollution to be safely confined can be a serious mistake.

“That’s deadly,” Miller said.

On May 10, 2008, DNREC banned any new public or private wells for drinking water over roughly eight square miles around the refinery. Although state environmental officials admit that pollution at the petrochemical complex north of Delaware City is vast, they insist it isn’t hurting anyone.

“Right now, nobody is using groundwater from the area around the refinery or Metachem, and we believe the contamination is contained for the most part,” said Marjorie Crofts, DNREC’s acting Air and Waste Management Director. “All of the public wells in the area are much deeper, and it would take a very long time for any pollution from the refinery area to reach those supplies.”

Federal and state regulators, though, frequently have overstated their ability to contain and control plumes of toxic chemicals. The government’s response has been too slow and too weak, said Jane Nogaki, a member of the New Jersey Environmental Federation and Clean Water Action.

“A permit to operate isn’t a permit for an industry to pollute,” Nogaki said. “With our population continuing to grow, there’s no assurance that we won’t be needing all our sources of drinking water, and all groundwater should be treated as a potential source of drinking water.”

Complex network

Around northern Delaware, the most important water-bearing aquifers are underground seams of sand, clay, silt and pebbles that settled out of tidal and river waters millions of years ago. As coastlines changed and oceans receded, the most-recent layers became dry land.

Below ground, some older layers opened channels for water sinking from the surface. The makeup and type of material — sandy or rocky or clay-like — determined how fast and in what direction water flowed.

Michael Boynton, a scientist now researching the Potomac near Delaware City for the EPA, said that aquifers in northern Delaware sometimes are more like a chaotic marble cake than a neat layer cake, complicating water movement and mapping efforts.

“It’s very complex. The environment in the past that laid down the sediments in the first place were very high-energy. River materials can move around very rapidly and conditions can change as they’re laid down. Trying to figure out where channels may be isn’t easy.”

At Delaware City, Boynton said, “the interpretation has changed over the years, and we’ve all learned that it’s more complex. We’ve had to refine how we look at the water and the movement of the water and any contaminants that are associated with the water. It does take time.”

In mid-2005, state and federal officials wrote in a progress report on the cleanup at Metachem that testing to date had found “no signs of site related contaminants” in a well 70 feet below the surface.

At the time, officials said they foresaw little, if any, risk that highly toxic chlorinated benzenes would soak into the Potomac from the soils above, where pesticide and herbicide ingredients had fouled dozens of acres, including wetlands adjacent to Red Lion Creek. Some of those toxic chemicals were found in a very shallow Potomac well before and after the 2005 report, officials admitted. But nothing pointed to deep aquifer contamination.

Until last fall.

The News Journal learned earlier this year that in September tests of water from a well twice as deep as those sampled in 2005 found four pollutants at levels up to 800 times higher than any previously reported. Concentrations of one toxic compound, benzene, were 5,200 times higher than levels considered safe by the federal government.

Neither the EPA nor DNREC released the full report to the public at large, although the findings were posted six months ago by DNREC to a hard-to-find state Web page. No public hearing has been held to examine the new dangers.

At the Delaware City Refinery, contractors working for Motiva admitted to state regulators in 2008 that they still do not know enough about the geology of the area to estimate how badly the Potomac already has been polluted in southern areas of the plant. DNREC has never publicly released this report, but The News Journal obtained a copy during its investigation.

The problem is so great that refinery consultants said they have been unable to identify all sources of the benzene, toluene, naptha, perchlorethelene solvents, sodium hydroxide and other hydrocarbons percolating under the plant.

They also cannot say how far the pollution has spread through an underground “paleochannel” that connects shallow and deeper Potomac water layers.

“Based on current data, the horizontal direction of groundwater flow and lateral connectivity of sand unit(s) within the Potomac Formation cannot be fully defined,” the consultants wrote in 2008. “The extent of the [dissolved pollution] … is currently unknown.”

Unsettling news

Some federal summaries of the cleanups near the refinery have asserted that the public has shown little interest in groundwater contamination there. Motiva provided DNREC and the EPA with a public participation plan in 2005, but since then has provided only a few limited updates to members of the plant’s Citizens Advisory Committee.

At the shuttered Occidental Chemical plant, where toxic mercury pollutants are a major concern, the public’s interest has been shrugged off.

“To date, there has been little interest expressed in this site by the local community,” a summary on the EPA’s website noted.

But more than a dozen residents who live nearby told The News Journal they had no idea plumes of chemicals were headed their way.

“It’s very hard for the public to grasp what’s going on down there,” said Seth Ross, a Delaware Nature Society member who has followed the issue for years. “If they don’t have enough information, it’s hard to have an interest.”

Delaware City resident Pamela Martin said she was unaware of problems in Dragon Run, which runs alongside the tiny, scenic home and horse stable that her family owns, about a mile southeast of the refinery.

Martin’s property includes a patch of wetland threatened by plumes of gasoline and benzene.

“I bought this property a few years ago, and nobody told me anything about that,” said Martin. “If there’s stuff like that in the water that’s going to be a detriment to the wetlands, it’s something that we need to know about now.”

Mark Summerfield, who has lived south of the refinery for nine years, also was unaware of the spreading pollution until a reporter questioned him. He said he found the news unsettling.

“We’d like to be made aware,” Summerfield said. “It might get more people out to public meetings when these issues come up.”

Kenneth T. Kristl, who directs the environmental law clinic at Widener University, said the public needs to know more about the problems around Delaware City.

“The fact of the matter is, if you have warning signs, the public may have a different view of the urgency of the situation,” Kristl said. “An industrial site is used for industry, but I don’t think that any fair reading of state or federal environmental laws says that, just because I have an industrial site, I get to pollute.”

Additional Facts
read online and see Interactive graphic

April 24, 2008

Cause of cancer clusters often never discovered

Toxins generally cause rare forms of disease

By HIRAN RATNAYAKE
The News Journal

Genuine cancer clusters account for only a small number of suspected clusters, said Tim Aldrich, an epidemiologist who has studied disease clusters across the nation for three decades.

And even in those cases, the actual cause of a cluster often is never discovered.

One of the best-known cases of a bona fide cancer cluster, Aldrich said, occurred in the mid-1990s at Toms River, N.J., where there appeared to be pediatric cancer clustering. Toms River is adjacent to two “Superfund” sites, designated as high priorities for cleanup by the Environmental Protection Agency because of the presence of hazardous waste.

A study over several years concluded that no single risk factor was responsible for the elevated level of childhood cancer in that region.

Environmental toxins generally cause a specific, rare cancer, experts say. Vinyl chloride monomer, for example, has been found to elevate the risk of hepatic angiosarcoma, a rare liver cancer.

“We tell students common things happen commonly and rare things happen rarely,” said Aldrich, an associate professor of epidemiology at East Tennessee State University in Johnson City, Tenn.

“The meaningful clusters are the result of something really bizarre and very strange becoming more common.”

The eight areas in Delaware identified by the state’s Division of Public Health as having cancer clusters do not show a cluster of any rare cancers. The clusters identified include prostate, lung, colorectal and all cancers.

The next step in Delaware, Aldrich said, is to monitor the region for the next three to five years.

“You want to just keep watching the community to see if something changes,” he said.

When clusters warrant increased surveillance, local universities typically apply for grants to do further study. Ideally, researchers want to compare the population with the cluster to a similar community to see if something sticks out.

“Sometimes you never figure out what it is,” Aldrich said.

Dr. Jaime Rivera, director of the Delaware’s public health division, said it would cost millions of dollars to do an in-depth study of the environmental factors.

People who live in poor socioeconomic areas where a cluster appears may actually have higher cancer rates because of other risk factors. People in poverty are more likely to live near power plants. But they’re also more likely than the general population to smoke and be obese and in worse physical shape.

All those are risk factors for cancer, said Dr. Michael J. Thun, vice president for epidemiology and surveillance research at the American Cancer Society.

“It’s always the case that cancer rates are distributed unevenly,” he said, “and almost always, they relate strongly to socioeconomic factors.”

Another difficulty in making the link is that cancer risks from environmental causes take several years to make their effect apparent. Cancer in the colon, Aldrich said, “isn’t going to go from a pinhead size to a golf ball size in less than five years.”

Eight cancer clusters discovered in Delaware

10 percent to 45 percent more cases in those areas than rest of state, study finds

By CRIS BARRISH • The News Journal • April 24, 2008

Residents of eight areas in Delaware get cancer at abnormally high rates, state public health officials concluded in a study to be made public today.

The cancer clusters comprise large swaths of Delaware’s landscape, upstate from Wilmington to New Castle and from Bear to Glasgow and Middletown, as well as Kenton and Millsboro downstate. Roughly four in 10 Delawareans live in areas with cancer clusters, according to the findings.

Though Delaware residents have long gotten cancer and died from it at rates above the national average, the new study is the first statewide look for pockets of Delaware’s second-leading killer behind heart disease.

Cancer incidence — the rate at which victims get the disease — was 10 percent to 45 percent higher in those regions than the average for the entire state. Some clusters were identified only for specific types of cancer — prostate, lung or colorectal — but five of the areas exhibited clusters of “all cancer combined.” The cases studied were diagnosed between 2000 and 2004, the most recent period for which reliable state data is available.

The report, which has been given to all 62 members of the General Assembly, grew out of a study last summer that focused on several ZIP codes around the Indian River electricity plant near Millsboro, and discovered a lung cancer cluster. A public outcry followed the report, blaming pollution from the coal-powered plant, and some residents speculated that other areas also had clusters. So state officials decided to see if more clusters existed.

The report released today makes no attempt to identify the causes of the clusters. It said possible causes include environmental pollution along with smoking and other unhealthy lifestyle choices. Another factor could be that doctors have diagnosed more cases of cancer because of better patient access to screening. There is a small chance that the findings could be due to coincidence.

No surprise

Though Delaware has long had a reputation as a place to get and die from cancer, Dr. Jaime Rivera, secretary of the Division of Public Health, urged residents not to overreact to the findings.

“I’m neither alarmed nor surprised. The results were not unexpected,” Rivera told The News Journal after a reporter reviewed a copy of the report. “Any time you look at a large area for incidence, you are going to find areas that have a few more than others. But the findings always throw up a yellow flag to look further into what might be the cause.”

Gov. Ruth Ann Minner, who has made the cancer battle a focus of her two terms, echoed Rivera.

“There’s nothing in the report anybody needs to be alarmed about. There are some areas a little higher than others in Delaware, especially where people have moved from other states and retired here. It isn’t all of Delaware.”

The report noted that cancers take up to 40 years to develop, and those who recently moved to Delaware likely didn’t contract the disease here.

But just as the Millsboro-area findings led activists and residents to suspect pollution as the main culprit, so did the new report.

Sen. David McBride, a Democrat who represents the Hares Corner and Wilmington Manor areas — part of the New Castle region, with inflated rates of lung cancer, prostate cancer and all cancers combined — said he suspects the high rates stem from the area’s history as a “dumping ground” for chemical plants and other heavy industry.

“I’m highly concerned,” said McBride, who hadn’t yet read the report. “If in fact those clusters are showing up in these areas, I want to know what we’re going to do about it.”

Rivera said public health officials will soon be briefing state legislators and working with lawmakers to arrange meetings in communities where clusters were found.

Input will be sought from Minner’s Delaware Consortium of state officials, health professionals, civic leaders and activists. If appropriate, formal epidemiological studies will be conducted in affected areas; one is now being conducted in the Millsboro area, where cancer victims and their families are being interviewed to evaluate how they might have contracted the disease.

McBride, a consortium member,
said he definitely will hold community meetings about the cancer findings. “You can underline that. The residents will expect me to be their voice in this matter.”

27 areas studied

To look for clusters, researchers divided Delaware into 27 areas with populations from about 6,000 to 84,000. The state only studied incidence of the four most frequent cancer types — lung, colorectal, prostate and breast — as well as “all cancer combined.” The rates are age-adjusted to account for the fact that people get cancer more frequently as they age.

Studying smaller tracts, such as a section of Wilmington, was ruled out because scientific analysis is unreliable when there are too few cases of cancer. Instead the study focused on County Census Divisions, groups of adjoining census tracts.

In recent months, the state denied The News Journal’s requests for its cancer data — which officials had provided in 2001 and 2003 — denying the newspaper the ability to conduct its own study of cancer incidence. A 2004 newspaper series on Delaware’s high cancer death rate, especially among the poor, led state lawmakers to allocate several million dollars to Minner’s proposal for cancer screening and treatment programs for the uninsured.

Rivera’s office, meanwhile, spent several months conducting its own study.

Some of the findings:

•The Middletown-Odessa census division, which runs from the Chesapeake & Delaware Canal almost to the Kent County line, and has about 41,000 people, had a colorectal cancer rate 44.8 percent above the state average.

•The Kenton area near Dover, home to about 6,000 people, was 22.4 percent above average for all cancer cases.

•The city of Wilmington, with 72,000 people, was 10 percent above average for all cancers, 21.1 percent above average for prostate cancer and 17.5 percent above average for lung cancer.

•The Millsboro area had a lung cancer rate 29.8 percent above average.

Kim Furtado, a naturopathic practitioner who had led the fight to convince state officials to conduct the initial study around the Indian River plant, said she expected the state to find such clusters.

“If we refuse to look, we’ll never find,” Furtado said. “This is the cutting edge of what a public health department is supposed to do. So this is an excellent first step, to understand the depth and breadth of the problem. Now we need to roll up our sleeves.”

Jay Cooperson, chairman of the Sierra Club environmental group in Delaware, said members of his group would be itching to study the report but said his initial reaction was that the amount of cancer clusters is “a pretty shockingly high number.”

Rivera said that while the state cannot pin the high incidence on environmental causes, the impact of pollution on communities “goes beyond these cancers” to respiratory disorders, allergies and other ailments.

“By no means does this let industries off the hook, chemical companies off the hook,” Rivera said.

He also cautioned residents and activists to be aware that like pollution, behaviors can increase cancer risk.

“We’re seeing an increase in lung cancer, which is overwhelmingly the result of tobacco exposure. Delawareans need to avoid tobacco,” Rivera said.

Minner, who leaves office in January, said she will continue to battle the disease over the remaining months of her tenure.

“This report is just part of what we really need to know,” she said. “We’ll continue to work on this.”

Staff reporter Mike Chalmers contributed to this story. Contact senior reporter Cris Barrish at 324-2785 or cbarrish@delawareonline.com.

March 16, 2008

State keeps wraps on cancer information

By CRIS BARRISH
The News Journal

Last summer, after years of complaints by neighbors of the Indian River power plant that cancer was rampant, Delaware public health officials revealed the existence of a lung cancer cluster.

Could there be more cancer clusters in Delaware, once known as the “Chemical Capital of the World” and home to industrial plants that emit some of the nation’s dirtiest air? Delaware, after all, has long had one of the highest cancer death rates in the United States.

Although public health officials say they’re trying to find out whether other cancer clusters exist, they won’t let anybody else investigate cancer in Delaware. The Division of Public Health has adopted a policy that prevents even other medical researchers from examining cancer in Delaware.

The agency recently denied a request by the University of Texas’ Anderson Cancer Center, one of the nation’s most respected hospitals, for Delaware breast cancer records. The Texas center is one of dozens across the nation that use states’ cancer records to improve knowledge about cancer causes and treatments.

The News Journal, which twice received detailed records on cancer from Delaware in recent years, requested them again after the Sussex County cluster was revealed. Public health officials refused, even though the Attorney General’s Office said the records could be released.

Delores Whildin, a Claymont-area resident concerned about pollution from the steel plant on the outskirts of her home near Ridge Road, suspects a cancer cluster exists in her neighborhood. “Every time you turn around, you hear somebody is having cancer,” she said.

The fact that the state won’t make its cancer information available to the public for small geographic areas bothers Whildin.

“It sounds like a cover-up,” she said last week. “What else could they be trying to hide?”

11-worst death rate

For Delaware, understanding cancer and devising a strategy against the disease is critical.

From 2000 through 2004, the latest period for which government statistics are available, Delaware cancer incidence and mortality were 6 percent higher than the national average. Overall, Delaware’s death rate was 11th-worst in the nation.

State officials conducted a statistical study of the Indian River area in southeastern Sussex County last summer after years of complaints by local residents that too many neighbors were getting cancer. The state found that from 2000-2004, lung cancer incidence in six ZIP codes around the power plant — the state’s worst polluter — was 10.5 percent higher than Delaware’s average and 17 percent higher than the nation’s.

The Division of Public Health is following up with a survey of residents to determine whether the high cancer rate is explained by a high rate of smokers or some other environmental factor.

The state also is conducting a study to see whether there are any other such clusters in Delaware, said Paul R. Silverman, deputy associate director for health information. Results should be available later this month, Silverman said.

But the state will no longer let reporters, hospitals or other nongovernmental agencies conduct cancer research using more detailed cancer information, contending that a victim’s privacy could be compromised. The newspaper sought the number of cancers for areas smaller than Delaware’s three counties — the smallest areas for which the agency normally reports cases.

Individual records are contained in the state’s cancer registry, which includes details of nearly 45,000 cases diagnosed in Delaware since 1980. Like every other state, Delaware collects information on every cancer patient in the state, including the type of cancer, stage of diagnosis, treatments received and whether the patient is alive or dead.

The News Journal has never sought or received patients’ identities, addresses, birth dates or Social Security numbers.

Greater access to cancer-related health information, not less, has emerged as one theme of Lt. Gov. John Carney’s campaign for governor.

Carney, who will face State Treasurer Jack Markell in the September Democratic primary, wants better screening and prevention programs and an expansion of the public’s access to data about cancer in Delaware. New reporting requirements would provide more analysis potential as well as a response plan when the data reveal problem areas such as cancer clusters.

Central to Carney’s plan is continued support of the Delaware Cancer Consortium, created by Gov. Ruth Ann Minner after The News Journal published the results of its cancer data investigation. The Consortium has been the impetus behind much of the state’s progress in addressing cancer mortality rates, which led the nation a few years ago. Carney chairs the Consortium’s Disparities Committee, which has evaluated why cancer mortality rates are higher for some racial and ethnic groups.

Markell, whose wife was diagnosed with cancer, said he wants all families to have access to quality care. He is running on a plan that promises affordable health care for every Delawarean.

Despite the research that led to the creation of the Cancer Consortium, Silverman and Dr. Jaime Rivera, public health director, are now saying they will no longer release the data, arguing that it could lead to a patient’s identification. The state might have erred by releasing detailed information to the newspaper in 2001 and 2003, Silverman said.

“We recognize we have two missions and they are at conflict with each other,” Silverman said. “One is to give the public information they need to make health decisions and the other is to protect privacy. This is a difficult balance to reach and we’re doing the best we can.”

When the newspaper’s series on high cancer mortality, late diagnosis and subpar treatment in Delaware was published in 2004, no patients or their families contacted state officials to complain that their identities were revealed. Patients identified in the newspaper stories were referred voluntarily to reporters by doctors, advocates and other victims.

The newspaper’s investigation spurred the General Assembly to spend millions of extra dollars on programs to detect and treat cancer.

Jay Cooperson, chairman of the Delaware Chapter of the Sierra Club environmental group, said he can’t understand why public health officials won’t follow the attorney general’s advice and release the information.

“It doesn’t seem to me to be any kind of invasion of privacy,” Cooperson said. “It doesn’t seem reasonable to refuse to release public health data. If there was an outbreak of cholera somewhere, the public has a right to know what are the areas of concentration for this disease.”

‘Could cold-call them’

Since the summer, the state has rejected two attempts by the newspaper for more detailed cancer information. The paper’s initial request sought data from 2000 through 2004, specifically, each patient’s census tract, cancer type, gender, race and five-year age group.

Rivera blamed that decision on a ruling by Attorney General Beau Biden’s office that the records must be considered protected health information because someone might be able to identify patients using other public records, such as voter registration files.

“We think it’s too restrictive, but we needed to follow the advice of counsel,” Rivera said.

So the newspaper revised its request, asking only for summaries of cases — known as aggregate data — for each of Delaware’s 197 cancer cases, broken down by cancer type and patient’s sex, race and age group. Biden’s office gave its consent but Rivera’s office rejected that advice, saying identities still could be discovered.

A memo Silverman wrote to Rivera outlines the state’s contention that identities of cancer victims could be discovered from the state registry.

Silverman cited the example of a 43-year-old black Hispanic woman with urinary cancer. If she is the only person of her sex, race and age group in her census tract with that form of cancer, “there is a reasonable probability that this individual could be identified using external, publicly available data,” Silverman wrote.

The likelihood of identification would increase, Silverman wrote, if her census tract had few black Hispanic women.

In a recent interview, Silverman said that someone who found out the names of the black Hispanic women in the tract using voter registration or other records might be able to identify her.

Asked how that could be done, Silverman said: “You could cold-call them.”

Biden, whose office by law must represent public health, and Minner, who appointed Rivera in 2004, would not agree to be interviewed.

Biden spokesman Jason Miller said the office “has already provided its advice on this matter to the client.”

Minner issued a statement that she has asked Rivera’s office to “continue working with the media to find a means of providing cancer information while protecting the legal rights of individuals who have cancer.”

Dr. Robert Frelick, one of Delaware’s foremost cancer experts for more than half a century, said he understand’s Rivera’s concern for patient privacy but questioned whether the public needs to worry about their medical condition being revealed without their approval.

“Somebody would have to go to a whole lot of work to figure it out,” Frelick said.

John J. Austin Jr., a former Environmental Protection Agency scientist who moved to the Rehoboth Beach area in 2004, said the public has a right to the information.

“So long as the names and addresses of the people are held private, it should be made available,” said Austin, a member of Citizens for Clean Power that has taken aim at the coal-powered electricity plant near Indian River, the area where the cancer cluster was found last year.

It’s not just the pollution from the Indian River plant that is causing worry across Delaware.

In Claymont, emissions for the steel plant include dioxins and mercury. In Delaware City, drinking-water wells have been contaminated with an industrial chemical suspected of causing cancer.

The most recent report on pollution within the state found that releases to the environment from the state’s 15 largest facilities rose to nearly 11.2 million pounds, up from 8.4 million pounds in 2005.

Austin said public access to the state’s information about cancer is critical to understanding possible health effects.

“Unless it’s in the public hands, the areas of the state with high disease incidence remains hidden and state officials have no reason to take action to solve the health problems throughout the state.”

FREEDOM OF INFORMATION ACT IN DELAWARE

What sort of records can I request?

Most records of government agencies, including e-mail communications, are part of the public record available for all to see. Personal notes, investigative files, executive committee minutes, personnel files and parts of criminal files are among the items that can be withheld.

What information must my FOIA request include?

Requests shall adequately describe the record(s) sought. Be as precise as possible. Include names, titles, dates, places, events — anything that pins down what you’re seeking.

What can I do if my request is denied?

Ask for reconsideration of the request or send a written appeal to the Delaware Attorney General’s Office.

Delaware’s Freedom of Information Act appears in Title 29, Section 10000, of the Delaware Code. The act calls for the conduct of public business “in an open and public manner,” so that citizens can monitor decisions and have “easy access to public records in order that the society remain free and democratic.” Terms of the state’s FOIA law take up eight printed pages, supplemented by a 35-page U.S. Department of Justice policy manual developed to keep state agencies current on the latest definitions of “public body,” “open meeting” and “public record.”

The law requires public notification of meetings and allows few reasons for closed-door sessions. It also requires reasonable access to public records and reasonable copying charges and gives citizens a process to seek enforcement of the law, including lawsuits.

Residents should allow 10 working days before expecting a response from the state; FOIA requests under federal law allow up to 20 days for a response, with additional time permitted to fill large or complicated requests.

http://www.nfoic.org/foi-center/sample-letters.html” target=new>View sample FOIA letters from the Freedom of Information Center.