McCullom Lake, Illinois – (April 19, 2010) This upstate village of slightly more than 1,000 residents will soon have a decision to make: how best to use hundreds of thousands of dollars that could be remaining at the end of the month in a cancer cluster, medical-monitoring settlement fund.

Philadelphia attorney Aaron J. Freiwald, Esq., who negotiated the 2008 class-action settlement with nearby Modine Manufacturing, Inc. on behalf of the residents, has been actively involved in discussions to ensure that the local citizens derive the most benefit from the funds. “There is understandably a great deal of interest in how these funds are applied to the betterment of the McCullom Lake community and its residents,” explained Freiwald. “The Federal judge supervising the case has made it clear that she wants whatever funds remain after April 30 to go toward a deserving, non-profit organization.” After receiving additional feedback from residents, elected officials and community leaders regarding prospects, he will make a recommendation in a formal petition to the Court.

Freiwald, a partner in the firm of Layser & Freiwald, P.C., is encouraging anyone with suggestions to present them to the independent settlement fund administrator at www.mccullomlakesettlement.com. Ideas may also be submitted to Layser & Freiwald, P.C. via the firm’s website, www.layserfreiwald.com.

The original settlement fund has been used to provide numerous vouchers for pre-paid medical testing to past and present village residents to screen for brain cancer and brain tumors. In fact, two of the cases were detected through MRI scans performed for residents using the settlement medical vouchers.
The first of more than two dozen cancer cluster cases against the non-settling defendants, including Rohm & Haas, a subsidiary of Dow Chemical (DOW: NYSE) is scheduled to begin trial in Philadelphia in early June.

Freiwald emphasizes that there is still time for eligible village residents to be screened under the settlement agreement. “If you lived there between January 1, 1968 and December 31, 2002, you are likely still qualified to obtain a voucher to have medical screening. But you must act before the end of April.”
The settlement agreement with Modine provides that any funds left over after a Court-imposed deadline will be directed to a non-profit organization for the benefit of McCullom Lake Village.

The so-called cancer cluster at The Acreage in Palm Beach County may be claiming animals as victims in addition to people.

BY KRISTINA WEBB
Beacon Blog
Miami Herald

Acreage resident Gail Bass never expected what she saw from her window five months ago.

The creature perched on her bird feeder looked like a squirrel, but it was covered with tumors.

“It was strange because I noticed the one and it kept getting worse,” Bass said.

The tumors covering the squirrel varied in size and the number of tumors increased over the next three months. Then, Bass said, the cold snap came and she hasn’t seen the squirrel since.

The Acreage, a pastoral community in western Palm Beach County, is the focus of a state investigation into whether a pediatric cancer cluster exists in the area.

Bass wonders whether there is something making animals in The Acreage sick.

Dr. Vanessa Rolfe, a veterinarian with the Bird and Exotic Hospital in Greenacres, said the tumors on the squirrel were probably caused by myxomatosis — a disease usually seen in rabbits and very rare in the United States — or one of several bacterial or fungal infections.

“Chances are not great that is a noninfectious neoplastic condition, but certainly possible,” Rolfe said.

According to the American Veterinary Medical Association, neoplasia is “the uncontrolled, abnormal growth of cells or tissues in the body.” The resulting growths are not always malignant.

`ALWAYS IN THE POND’

Bass’ two Chesapeake Bay retrievers both had cancer by the time they were 2 years old, and both died after suffering from autoimmune disorders for several years — one from thyroid problems, the other from Cushing’s disease.

“They were always in the pond [on my property] swimming and drinking,” Bass said. The dogs did not come from the same litter, she said.

The veterinary medical association reports cancer is the cause of death in almost half of pets over 10 years old. The proportion is higher among dogs than among cats.

Susan Coffman saw the signs of a potential cancer cluster years ago.

Coffman, vice president of Doberman Rescue Concern in West Palm Beach, lives near the intersection of Seminole Pratt Whitney Road and Okeechobee Boulevard in The Acreage.

In her home, Coffman keeps urns of all the dogs who have died under her care.

“This is Eli,” she said. “Eli had head cancer.”

Coffman noticed a large number of dogs with cancer coming out of The Acreage when she began working with Doberman Rescue in 1985. She said “warning sirens” began to go off in her head when she tried to adopt several dogs from Palm Beach County Animal Care and Control.

“They were euthanizing any dog that came from The Acreage and had a tumor,” Coffman said.

Coffman said she understands the need for doing that.

“They did not want to house and spend money on animals that are not adoptable,” Coffman said.

Animal control officials could not be reached for comment on their euthanization policy.

Before long, Coffman began to notice other warning signs in The Acreage.

CAUSE OF DEATH

According to the Doberman Pinscher Club of America, cardiomyopathy — weakened heart muscle — is the No. 1 killer of Dobermans nationwide.

However, Coffman has kept records for almost 15 years that show cancer as the No. 1 cause of death among Dobermans in The Acreage.

“Cancer has always been a problem out here,” Coffman said.

Several of her dogs have died and one is undergoing treatment to remove a malignant tumor.

Coffman said she has also noticed an increase in autoimmune problems in Acreage dogs.

“I have tried to tell people about this for so long, but they seemed resistant,” Coffman said. “You can look at it as dead Dobermans or you can look at it as a warning.”

According to state investigators, there are many potential causes for the cancer cluster, including pesticide runoff from farms and orange groves.

The area is also surrounded by several industrial sites, including Pratt and Whitney to the north and the Palm Beach Aggregates to the west.

A lawsuit dismissed in federal court last month accused Pratt and Whitney of causing the cancer cluster. According to a Palm Beach Post article from 1999, the Pratt site on Beeline Highway just north of the J.W. Corbett Wildlife Management Area has been the focus of federal environmental clean-up efforts since the 1980s.

Corbett and the Pratt property are directly north of the affected area in The Acreage.

Lake Worth resident Brandon Zapf goes hunting and fishing at Corbett a few times a month. According to Zapf, he was hunting at Corbett about a year ago when he encountered a “strange” deer.

“I shot the deer, and between the skin and the meat there was green slime,” Zapf said. “I started to dress the deer and ended up just leaving it there.”

Zapf said he has also run across deer with growths.

A spokeswoman for the Florida Fish and Wildlife Conservation Commission could not comment on sightings of abnormal animals at Corbett because, she said, none had been reported to her.

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by GREG ALLEN, National Public Radio (NPR)

In Florida’s Palm Beach County, residents of a rural community find themselves caught in a medical mystery. Over the past 16 years, at least 13 cases of brain cancer have been diagnosed among children living in an area called The Acreage.

State and federal health officials have designated it a “cancer cluster” — meaning they’ve found a higher-than-expected number of one type of cancer in a single area.

As resident Michelle Damone noted at a recent residents’ meeting, that designation hasn’t brought any answers.

“Is there a contaminant out there? Do we need to do more testing? Have we not looked at something? Is there more to look at?” Damone said. “We need to review statistics together. We all need to ask, what do the statistics mean?”

For residents who have been packing into the meetings here in The Acreage, the issue is not statistics but the health of the community’s children.

A Chance Meeting

The Acreage is a sprawling area, with about 40,000 residents spread out over more than 100 square miles northwest of West Palm Beach. Homes are on acre-plus lots with septic systems and well water.

Jessica Newfield had a malignant brain tumor. Doctors successfully operated, and nearly five years later, Jessica is healthy and cancer-free.
Tracy Newfield says she moved here with her family in 2002 because of the area’s beauty and the large lots. The extra land gave her family room for Jet Skis, a boat and ATVs. But about two years after they arrived, her young daughter, Jessica began complaining of headaches. Newfield says doctors conducted tests and prescribed medicine but couldn’t identify the problem.

“Finally, as the tumor grew, in sixth grade, she came home from school one day and couldn’t stand the headache. And so I took her directly to the hospital. We did an MRI. We started to drive home and they told me to come back, come back to the hospital,” Newfield says.

Newfield’s daughter had a malignant brain tumor. Doctors successfully operated, and nearly five years later, Jessica Newfield is healthy with no recurrence.

For years, Newfield says, she thought her daughter’s cancer was an isolated — and rare — incident. That changed in 2008 with a chance meeting at Miami’s Children’s Hospital.

“Two families ran into each other in a hospital when they were getting the same exact surgery. They go to the same church and you’re told by the surgeon, you’ll never see one of these in your neighborhood. Little by little, when those two mothers found each other, and word got out in the neighborhood, we then found there were many of us,” Newfield says.

More Question Marks

After months of prodding, Florida’s health department began investigating. This year, the agency concluded that The Acreage was the site of a cancer cluster.

The finding was a vindication for some, but what followed infuriated many: A state health official said there was no plan to search for an environmental cause. Residents and elected officials protested, and that position was quickly reversed. But many residents in The Acreage remain suspicious about the state’s commitment to the investigation.

Stephanie Peskowitz is a nurse and a mother, with two kids younger than 5. Like many here, she’s frustrated that state investigators haven’t told residents exactly what they plan to do.

A cancer cluster is a statistical increase, but that does not mean there is one single cause for all the cancers in the cluster.
- Lauren Lewis, with the Centers for Disease Control and Prevention

“They’ve just started on the soil testing, and there are a lot of questions about that. So they really haven’t educated us enough about what their plan of action is. We haven’t seen actually even a plan of action, so, we don’t know where it’s going to go from here,” Peskowitz says.

The department hasn’t released a plan of action for its Acreage investigation, officials say, because it’s a process that unfolds step by step.

Carina Blackmore, the state’s environmental epidemiologist, says she can’t say how long the investigation will take or even what the next step will be.

“We will evaluate the data that the Department of Environmental Protection is collecting. And then we will get together with our partners in the state and the Centers for Disease Control and based on those results determine what the most prudent next step is,” Blackmore says.

All along, Florida’s health department has been upfront with a basic truth about cancer-cluster investigations — that they rarely pinpoint a cause, environmental or otherwise.

Peskowitz says she’s heard that a lot.

“I don’t want to hear that anymore, I really don’t, because that was the first thing that was said when they did the confirmation,” Peskowitz says. “And as far as I’m concerned, you can’t start being on the negative before you’ve done any investigating, before you know what’s going on. We want to hear that you are actively looking to see what the problem is, and you are going to do everything to the extent of your power to try and rule out what it is.”

While state health officials are investigating, the federal Centers for Disease Control and Prevention has also been involved, advising the state and monitoring the results. Lauren Lewis, an environmental epidemiologist for the CDC, says that in decades of cancer-cluster investigations, the CDC has never yet been part of one that pinpointed a clear environmental cause.

She says cancer-cluster investigations are difficult for a number of reasons: People move, cancers take years to develop and the numbers of cases are usually small.

“A cancer cluster is a statistical increase, but that does not mean there is one single cause for all the cancers in the cluster. And because there may be a cluster or there may be an increase in the number of cancers, it doesn’t mean those cancers are linked,” Lewis says.

Staying Or Leaving

In The Acreage, for every resident like Stephanie Peskowitz, a mother concerned about the health of her children, there are also residents like Sean Foster. Foster is a 35-year resident who helped build the neighborhood. He’s a homebuilder who put in many of the wells that are now being tested as part of the state investigation.

What worries Foster about the cancer-cluster designation is not just what it means for the health of residents but also what it means for the future of his community. He says that real estate agents tell him that some Acreage residents are talking about moving at the end of this school year.

I have to heal and make sure I can look at my daughter and say, ‘I don’t think it’s an environmental cause.’ I don’t feel that right now.
- Tracy Newfield

“And we need some leadership that puts out this positive news that defends our community and lets people know that with every good test, that there may be more and more reason to stay,” Foster says.

Realtors are unhappy that they’re now required to add a cancer-cluster disclaimer to homes sold in The Acreage. Some residents have already moved, including one of the families who prompted the cancer-cluster designation.

That decision — whether to move or to stay — is one Tracy Newfield says many families in The Acreage are wrestling with, including hers. She says she and her husband want the facts before they make any decision. If all the tests come back negative, she says, with time, she may eventually feel comfortable staying in the community.

“I have to heal and make sure I can look at my daughter and say, ‘I don’t think it’s an environmental cause.’ I don’t feel that right now,” Newfield says.

Officials with Florida’s Departments of Health and Environmental Protection seem to be getting the message. They’ve opened a special office in The Acreage to answer residents’ questions and to share information about the ongoing cancer-cluster investigation.

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By Louis Sahagun
LA Times

Reporting from Kettleman City, Calif.
On a rainy afternoon in a cramped trailer, the five homemakers listened as state officials with clipboards asked personal questions: Did they or their husbands smoke, drink or take illicit drugs? Had they been exposed to pesticides or other toxic substances in the United States or Mexico? Do their families have histories of birth defects?

Each had miscarried a fetus or given birth to a child with severe birth defects within the last three years. Each suspected it had something to do with a nearby toxic waste facility.

“You want to know if we ever smoked cigarettes or took drugs,” Maura Alatorre said bitterly. “But I’m telling you that if the dump is allowed to expand, we’ll suffer more damage and illness. Why? Because we are poor and Hispanic. The people who issue those permits don’t care about us getting sick from it because all they think about is money.”
full article and online video

By Sandra Jontz, Stars and Stripes
European edition, Saturday, March 27, 2010

A government decision to give disability benefits to a former Marine sickened by toxins at Camp Lejeune, N.C., could have far-reaching effects for thousands of other families who lived and worked at the military base over the years.

Paul Buckley, who was diagnosed with multiple myeloma four years ago, received a letter from the Department of Veterans Affairs earlier this month stating that “all reasonable doubt has been resolved in your favor.” Buckley’s incurable bone marrow cancer “was directly related to military service,” the letter continued.

“This is not the type of cancer you get from smoking or eating French fries,” said Buckley, 46, who now lives in Hanover, Mass. “I was too young to get this illness and I didn’t have any of the risk factors.”

But in the 1980s, Buckley was assigned to Camp Lejeune, where scientists found the presence of the degreaser trichloroethylene, or TCE, the dry-cleaning solvent tetrachloroethylene, or PCE, and the carcinogen benzene in the drinking water.

His doctors believe exposure to those chemicals was the likely cause of his cancer ? a claim the U.S. government repeatedly denied until he received his letter from the VA on March 8.

For Buckley, the sudden reversal means that he can start collecting VA benefits, which will extend to his wife when he dies.

The VA’s ruling could have much broader ramifications: By some estimates, up to 1 million people lived or worked at the base between 1957 and 1987.

“I think this has enormous national implications and is truly a breakthrough,” said U.S. Rep. Bill Delahunt, D-Mass. “The government has acknowledged, at long last, that there is clearly a causal relationship between the contaminated water and the cancer that afflicts Mr. Buckley.”

The letter, Delahunt said, will establish a precedent.

“It’s highly significant,” for the thousands of others, according to Joseph Anderson, a Winston-Salem, N.C., lawyer representing a woman who lived at Camp Lejeune in the 1980s and suffers from non-Hodgkin’s lymphoma. His client, Laura Jones, recently won a small battle in federal court when a judge ruled that her case against the Navy could go forward. The Navy had argued that the statute of limitations had expired.

“[The VA decision] can help us as we fight on behalf of families,” said Anderson, adding his office receives an average of 30 calls a day from military and civilians and families who once were stationed at Camp Lejeune.

Veterans Affairs spokeswoman Katie Roberts declined to address the department’s letter to Buckley or the reason for the reversal.

While not addressing the Camp Lejeune case specifically, Roberts stated that generally, the VA is working with the Defense Department on a number of exposure-related concerns, and the two departments have created a data-sharing agreement to let researchers cross-reference data and information.

She declined to speculate on whether the department’s decision would affect other veterans’ claims for benefits.

There are 2,044 pending legal claims by people who lived and worked at the Marine base, the Navy said Friday. In 2007, Stars and Stripes reported there were 853 claims pending.

For years, Marines have blamed their and their families’ ailments on the contaminated tap water.

The presence of TCE and PCE in the camp’s water sources was discovered in 1982. Yet some of the wells that supplied the water were not shut down until 1985. An environmental engineering company found benzene in a well near the base’s Hadnot Point Fuel Farm at levels of 380 parts per billion when water was sampled in July 1984; the EPA has established that levels more than 5 parts per billion in water is dangerous to human health.

As the health effects continue to be examined, the Marine Corps is trying to reach between 500,000 to 1 million people who lived and worked on the base during the three decades, according to Capt. Brian Block, a Corps spokesman. The Corps’ search for former base residents was spurred, in part, by health officials’ needs to conduct tests to determine whether exposure to the contaminated drinking water is causing ailments.

To date, 160,000 people have registered, which can be done online at https://clnr.hqi.usmc.mil/clwater or by calling (877) 261-9782.

Buckley hopes the letter he received will lead to help for more Marines and their families who lived at the base.

“I’m hoping the VA will loosen up, and maybe, just maybe, this means I can help a million people or so,” he said. “Giving hope to somebody is a wonderful thing.”

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BY FRANK X. MULLEN JR. • Reno Gazette Journal

The metal tungsten remains an important clue in research related to the Fallon leukemia cluster, which sickened 17 children and killed three of them between 1997 and 2004, scientists said Thursday.

Presenters at the University of Nevada, Reno symposium described their research into cancer genetics, water contamination, electro-magnetic fields, mouse studies, and contaminants found in tree rings and on tree leaves. They are looking for possible environmental underpinnings of the cancer outbreak, whose odds of being random have been estimated at 1 in 232 million.

Researchers from the UNR; the University of Arizona and the University of California San Francisco presented final reports on three years work relating to the cluster. The research was funded by about $700,000 in federal grants obtained by Sen. Harry Reid, D-Nev., on behalf of the Fallon families affected by the outbreak.

The theory is that something in Fallon’s environment makes the area unique. For eight years, the metal tungsten, which is found in greater concentrations in the area’s water, air and people than in other parts of Nevada, has been an element of interest.

“We have been looking at linking environmental exposures unique to leukemia clusters to the development of leukemia,” said Cynthia D. Fastje, who exposed laboratory mice to tungsten and a virus at the University of Arizona.

Scientists have a two-hit theory of cancer cluster causes. The first “hit” is something from the environment that damages a child’s genes, perhaps while it is in the womb. The second “hit” could be an infection, a chemical or a virus that strikes the community but causes further damage to children’s genes already affected by the first hit.

In the experiments conducted by Fastje, Dr. Mark Witten and others, pregnant mice were given tungsten water at levels similar to those found in Fallon. The mouse pups were born and exposed to respiratory syncytial virus (RSV), which causes a common childhood illness.
Tungsten weakens immune response

Fastje said the tungsten appeared to weaken the animals’ immune response to the virus. About half the mice had enlarged spleens and 25 percent developed tumors in their jaws and necks. Some mice had symptoms consistent with leukemia.

She said more research into the effects of tungsten exposure is needed and noted that it’s a big leap between mice and humans.

Dr. Paul Sheppard of the University of Arizona said his research since 2002 has looked at tungsten and other metals as airborne contaminants in Fallon. His studies indicated spikes over time in the tungsten levels in tree rings and that tungsten found on tree leaves in 2008 was more concentrated on the trees closer to the center of Fallon, a finding consistent with previous studies of airborne metals.

Since the 1960s, the Fallon area has been home to a tungsten refinery and a tungsten plant in the center of town. That firm has consistently denied its operations can have anything to do with the cancer outbreak. It’s undetermined whether the tungsten found in the latest tree or leaf studies is the industrial or naturally-occurring form of the metal.

Dr. Joseph L. Wiemels, associate professor of cancer epidemiology, University of California, San Francisco, has looked at the genetic roots of cancer and studied leukemia cases in California and the Fallon cluster. He said because of Nevada privacy laws he was only able to look at the genetics of four of the 17 Fallon patients, but found nothing unusual in their DNA makeup.

Based on the disease registry information that has been made available, he said, “it appears to be clusters of other types of cancer in Churchill County at the time of the leukemia cluster.”
Overall, he said, children who have early exposure to viruses and thus develop immunities seem to be more protected against leukemia than those who have limited viral exposure, such as children without older siblings or those who don’t interact with other children at an early age.

A change in the environment
One question that scientists have been asking throughout their investigations: what sharply changed in Fallon’s environment in the mid-1990s that may account for the cancer outbreak between 1997 and 2004?

Dr. Chris Chris A. Pritsos, UNR professor of nutrition, and Dr, Ralph Seiler, a geologist, have been investigating Fallon’s groundwater. They looked at the concentrations of arsenic, tungsten, uranium and polonium-210 in the water and exposed lab mice to the Fallon water and water from other sources.
The studies indicated that exposure to groundwater high in tungsten, arsenic and polonium-210 induced “oxidative stress” in mice. Oxidative stress affects the body’s ability to repair itself at the cellular level and may be involved in the development of several diseases.

Although tungsten remains an element of interest, Sheppard cautioned that “we can’t link environmental findings to leukemia itself based on environmental data alone.” He noted that Nevada health authorities and the federal government have no interest in further probes of the Fallon cluster.
Future investigations are up to scientists outside the government labs, he said.

“We’ll keep on trying,” Sheppard said. “It’s important to carry on environmental monitoring in Fallon and I intend to do that.”

The evolution from patient to environmental activist came naturally

BY ROCKY BARKER – rbarker@idahostatesman.com
Copyright: © 2010 Idaho Statesman

Shawn Raecke/Idaho Statesman

Trevor Schaefer, 20, from Boise had brain cancer earlier in his life. The cancer has been gone now for over five years but the illness set the wheels in motion for Trevor and his mother Charlie Smith to become strong advocates for looking for answers about the causes of childhood cancer. “We want to help cancer survivors and we want to help prevent new cancers,” Schaefer said.

Trevor Schaefer woke up at age 13 in November 2002 with a terrible headache that McCall doctors said was a sinus infection. His mother, Charlie Smith, wasn’t satisfied and urged them to give him a CAT scan.

When he woke up after the scan he could see the truth on his mother’s face.

“It’s not a sinus infection, is it, Mom?” he asked.

Schaefer had brain cancer and doctors urged immediate surgery. After surgery, radiation and chemotherapy, Schaefer healed. He then began a volunteer campaign to fight childhood cancer and to support cancer survivors like himself.

He was recognized by the Statesman in 2007 as the Treasure Valley’s most courageous person. Now at 20, he’s a Boise State University student and he’s moving his campaign to a national stage.

“We want to help cancer survivors and we want to help prevent new cancers,” Schaefer said.

He and his mother are working with California Sen. Barbara Boxer to upgrade cancer registries so scientists can use them more effectively to spot childhood cancer clusters. And they have used their own connections to help researchers learn more about the links between toxins and childhood cancer.

“Trevor and Charlie have helped us with our research and helped get us in with (Environmental Protection Agency Administrator) Lisa Jackson,” said Mark Witten, a researcher with the University of Arizona, who has linked leukemia cancer clusters to toxins in Nevada and Arizona.

Cancer clusters are occurrences of cancer found in a small area or a short period of time at rates higher than statistically normal. But linking a cluster of cancers to a particular toxin or event is very hard scientifically.

One in two men and one in three women in the United States will be diagnosed with cancer sometime in their life, according to the Cancer Data Registry of Idaho. Cancer is the second leading cause of death in both the United States and Idaho, accounting for about 22 percent of deaths in the state in 2005.

Smith asked the registry to study a cluster of brain cancers in McCall at the same time as Trevor’s case. In 1998-2002, there were 457 cases of brain cancer diagnosed among Idaho residents, including six in Valley County, ranking it third-highest in the state. But the cluster was not considered statistically significant.

Registry officials said other cancers that metastasized into the brain made it appear there was more brain cancer than there was, said Chris Johnson, epidemiologist with the Cancer Data Registry of Idaho.

Smith said measuring at the county level isn’t enough. She wants records kept uniformly nationwide down to the zip code level.

Witten and his associate Paul Sheppard, also of the University of Arizona, have been tracking down cancer clusters and possible causes by measuring toxic substances in tree rings. This gives them definitive time frames for when a population was exposed to toxins.

In Fallon, Nev., they found high levels of tungsten associated with a cluster of childhood leukemia cases. Animal studies suggest that respiratory virus outbreaks may trigger the cancer in children sensitized by high tungsten exposure, Witten said.

They have done tests in Idaho but have not found anything conclusive, he said. But working with Schaefer and Smith has helped him create better animal testing.

“Coming to Idaho has helped us develop models to show what’s happening,” he said.

Schaefer caught Boxer’s attention when he gave a speech in California. Smith and Schaefer have gone to Washington to push for the establishment of a federal disease network.

“She said, ‘I really respect your passion because I’m a mother, too,’” Smith said.

Justin Hayes, program director of the Idaho Conservation League, said Schaefer already is making a difference in Idaho efforts to fight toxins like mercury and heavy metals. His testimony before environmental officials put a face to the threats that numbers can’t.

“He really crystallizes the issues from the abstract to the concrete,” Hayes said.

Rocky Barker: 377-6484

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Palm Beach Post Staff Writer

A study that identifies the bottom third of Florida as a massive brain cancer cluster has set off a firestorm among Acreage residents worried about their community’s reputation.

They insist the report, which surfaced on the Internet last month, is proof that cancer isn’t a problem solely for their central Palm Beach County community, where health officials last month declared a cluster of cases among children and teenagers.

They have besieged state legislators, health officials and anyone else who could change the local designation or spread word of the report.

But in interviews, the study’s authors say their findings don’t discredit the state’s cluster designation in The Acreage.

What’s more, The Acreage’s cluster is part of what’s pushing up rates throughout southern Florida in the new study, said Richard Clapp, an epidemiologist and professor of environmental health at Boston University.

The state Department of Health declined to discuss the study, due to be published next month in the scholarly journal Pediatric Blood & Cancer. The authors include researchers from the University of West Florida in Pensacola and the Nemours Center for Childhood Cancer Research in Delaware.

The study has swiftly grabbed attention in The Acreage.

“Our community has been labeled as the poster child for ‘Pediatric Cancer Clusters’ in the State of Florida,” Acreage residents Carl and Debra Garcia wrote to state Rep. Joseph Abruzzo last week in an e-mail seeking answers about the new report. “We want the truth both for those directly stricken by health issues and the community at large.”

The study, which compares childhood cancer rates throughout Florida ZIP codes from 2000 through 2007, wasn’t meant to challenge or conflict with state findings, its authors said.

The report doesn’t address causes of the elevated cancer rates but says the findings “are suggestive of environmental factors or common risk factors in the areas.”

The study found that in 2006 and 2007, southern Florida had more than twice as many childhood brain tumors and cancers as would be expected in that size population: 52 cases instead of 24.

“This may be an area of concern for the health authorities to look deeper into — that’s pretty much where the results in the article end,” said study author Raid Amin, a statistics professor at the University of West Florida.

Based on maps accompanying the study, the region with elevated cancer rates appears to include the Glades and other parts of western Palm Beach County, as well as barrier islands along the Atlantic, but not the bulk of the county’s cities and suburbs. It also includes parts of Broward and Miami-Dade counties, the Gulf Coast and sites north of Lake Okeechobee.

Researchers declined to provide more detailed geographic data.

The study has its acknowledged shortcomings, chief among them its population counts.

The authors used 2000 U.S. Census data to estimate the region’s overall population, which they then compared with numbers of cancer cases taken from a state registry.

“You have to wonder as you get further away from 2000 whether that rate is influencing the results,” said Kimberly J. Johnson, a postdoctoral research fellow with the University of Minnesota’s Division of Epidemiology and Clinical Research. Johnson peer-reviewed the study, titled “Epidemiologic Mapping of Florida Childhood Cancer Clusters,” for its publication in the journal.

To ensure that nearly decade-old population figures hadn’t skewed the results, the researchers examined census estimates and state demographic data for later years. Those estimates made them reasonably confident that southern Florida’s population did not rise significantly faster than other parts of the state, Amin said.

Still, “you could have small-area migration that could really influence the rates,” Johnson said. “They did the best they could.”

Population, as well as age breakdowns within the population, could skew the results, agreed Babette Brumback, an associate professor of biostatistics at the University of Florida.

“The validity of the results would depend on the validity of those projections,” Brumback said.

In verifying The Acreage’s cluster, state health officials used multiple methods to estimate population and age, including school district data and customer counts from Florida Power & Light.

The study’s five authors used statistical analysis software known as SaTScan, which Harvard biostatistician Martin Kulldorff developed more than a decade ago. The program, which the National Cancer Institute also uses, compares cancer rates in adjacent ZIP codes. The study’s authors used the patients’ addresses at their times of diagnosis. They obtained cancer data from the state’s cancer registry and considered children up to 19 years of age.

The Nemours Center for Childhood Cancer Research initiated the study almost two years ago. The center is part of the Nemours Foundation, which was formed through industrialist Alfred duPont’s estate in 1936 and owns several children’s clinics and hospitals in Florida. It is building a new facility in Orlando and hoping to attract patients and philanthropy from the entire state.

The online version of the study was circulated around the same time that state health officials last month declared the cluster in The Acreage.

Health officials said in early February that five pediatric cases of brain tumors or cancer had occurred from 2002 through 2007 among The Acreage’s estimated 39,000 residents, when only two to three cases should have occurred.

At the same time, county health director Dr. Alina Alonso told reporters that a broader area of South Florida likely had an elevated rate of pediatric brain cancer as well. She didn’t cite a study and did not respond later to requests for comment on the West Florida findings.

At the health department’s main offices in Tallahassee, a spokeswoman responded with only a few comments this week.

“The data analysis methods by the University of West Florida Report are relatively new and untested,” spokeswoman Susan Smith wrote. She added: “The authors indicate that their findings cannot be used to determine health impacts in small geographic areas. Independent researchers will use this report to identify areas that require additional study using more traditional methods to verify the University’s hypothesis.”

State health officials hadn’t contacted the study’s authors since they released their findings, Amin said Wednesday.

On Thursday, Brian J. Calkins, director of the Florida Association of Pediatric Tumor Programs, which collects state cancer registry data, said he had just gotten word that state health officials were trying to coordinate a meeting with the study’s authors.

Staff writer Stacey Singer contributed to this report.

Number of childhood brain and central nervous system tumor and brain cancer cases from 2006-2007 in southern Florida, according to new study:

Expected: 24

Observed: 52

Number of cases the Florida Department of Health’s investigation of The Acreage showed for 2002-2007:

Expected: 2-3

Observed: 5

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by Al Pefley
CBS12.com

Tonight, an I-Team Investigation reveals there was possible ground contamination discovered years ago in the Acreage.

It happened long before the pediatric cancer cluster was ever confirmed.

A new report shows state health officials likely knew about environmental contamination in the Acreage decades ago.

We just got our hands on a report that shows authorities knew there was a problem.

They were asking about contamination then, and they are asking about it today.

The report is dated October 1988.

And it basically says investigators determined that Pratt and Whitney, located just miles from the Acreage, had contaminants that posed a human health threat. This week, health officials are taking soil samples, looking for the cause of the Acreage cancer cluster.

But this report points the finger at Pratt and Whitney as one possible source.

The report, prepared in October 1988 by the Florida Department of Health and Rehabilitative Services, says Pratt produced a number of hazardous wastes that it stored and buried on its property.

Even back then, 22 years ago, authorities found Pratt was a potential threat to public health.

As this aerial map shows, Pratt and Whitney, a major defense contractor, is only about 7 miles from the Acreage in northern Palm Beach County.

The report says: “…this site is considered to be of potential public health concern because of the risk to human health caused by the possibility of exposure to hazardous chemicals in the ground water and air…”

Among the stuff that Pratt disposed of in landfill and incineration trenches on its site were solvents, sludges, pesticide and herbicide residue, fuel, mercury, asbestos and unnamed commercial and laboratory chemicals.

The report says: “Human exposure to contaminated ground water is of concern.”

And it also says: “Surface water runoff and flooding may introduce contaminants to the wetlands and canals that drain the site.” It also says contaminated, wind-blown dust is a concern at the Pratt site. Again, that was in October 1988.

Richard Cotromano and his wife live have lived in the Acreage for almost 8 years and they have a 6 year old girl, Elizabeth, with an inoperable brain tumor.

“They should’ve cleaned it up. I mean, that to me is unacceptable.”

It angers him he says, to know that Pratt was identified as a concern 22 years ago.

“Being the area was not very heavily populated at that time…who knows what could’ve been dumped out there.”

We just received a statement from Pratt and Whitney.

It says in part “We maintain a comprehensive network of groundwater monitoring wells at this facility, overseen by state agencies, that shows our past and current operations pose no threat to human health. We continue to cooperate fully with all regulatory agencies in their investigation of health concerns in The Acreage.”

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Jill U. Adams
The Los Angeles Times

Gov. Arnold Schwarzenegger has ordered state health and environmental agencies to continue to investigate a rash of birth defects that occurred in the small San Joaquin Valley town of Kettleman City.

Five of 20 babies born in Kettleman City over a 14-month period had cleft lips or cleft palates, an unusually high rate compared with what’s considered normal. Worldwide, cleft deformities occur in about 1 in every 700 live births, according to a November study in the journal the Lancet.

Residents suspect a nearby toxic waste dump is to blame, although it’s only one of many potential causes.

Smoking, nutrient-poor diets and use of certain medicines by pregnant women have been linked to cleft deformities, as have environmental exposures such as pesticides, organic solvents used in industry and infectious diseases.

A high rate of disease within a specific locale, as is the case in Kettleman City, is called a cluster. Here’s a look at what’s known about disease clusters and how scientists go about determining cause and effect.

The U.S. Centers for Disease Control and Prevention defines a cluster as “an unusual aggregation, real or perceived, of health events that are grouped together in time and space and that is reported to a public health department.”

Sometimes clusters happen just by chance. Disease rates, after all, are averages, but the cases aren’t distributed perfectly evenly: Within a large population there will be subgroups with higher and lower rates. “It’s like flipping a coin,” says Daniel Wartenberg, an epidemiologist at the Robert Wood Johnson Medical School in Piscataway, N.J. Getting five heads in a row doesn’t mean the coin isn’t fair — and in the same way, a local cluster of some disease does not automatically mean there is an environmental cause.

Certain kinds of clusters are more easily pinned to a cause than others. Examples are clusters that involve infectious disease — such as outbreaks of illness from food contamination or the 1976 outbreak of pneumonia at an American Legion convention in a Philadelphia hotel, an infection now known as Legionnaires’ disease.

In addition, diseases resulting from workplace exposures or from adverse drug effects are often solved because it’s easier to figure out what everyone in the cluster had in common.

There are also some rare instances in which scientists can link an environmental factor in a community to a very specific disease.

For example, a 2002 study published in Toxicology Letters linked a cluster of lung cancer cases in Turkey to asbestos-containing rocks in the area, with which people built their homes.

A 1997 study, published in the journal Environmental Research, found a similar cause for a lung cancer cluster in Manville, N.J., home to the largest asbestos manufacturing plant in the U.S. People who lived in town (but had never worked at the plant) had 10 times the rate of lung cancer as residents living outside the town. Key to unraveling the mystery was the fact that the type of lung cancer involved was mesothelioma, which is a very specific and known outcome of asbestos exposure, says Dr. Beate Ritz, professor of epidemiology and environmental health at the UCLA School of Public Health.

Cluster investigations work well when you have a cause and an effect within a very short period of time, Ritz says. But more often, they are fraught with uncertainty. They’re extremely difficult with diseases that take years to develop or when many different factors can contribute to a disease. For cancers other than mesothelioma, “it’s almost hopeless,” Ritz says.

Birth defects are similarly difficult because there are so many things that might cause them.

No one disputes that the rate of birth defects in Kettleman City is higher than usual. Many doubt that they will find the cause, though.

“By the time [babies] are born, the toxin may have left the mom and never be shown,” Ritz says. “And in areas where clusters happen, there’s usually more than one thing happening: a toxic waste site, constant pesticide spraying.”

And, says Wartenberg, “we know some of the things that cause clefts, but we don’t know that much.”

Moreover, he adds, “even when the numbers are improbable, that doesn’t mean they’re impossible by chance.”

A preliminary investigation by the California Department of Public Health compared rates of birth defects in Kettleman City with those in neighboring towns for the years 1987 to 2008 and found no evidence of a common cause. The investigation will continue, says Dr. Rick Kreutzer, chief of environmental and occupational disease control at the state agency.

health@latimes.com
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