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]

Families want answers on MS, cancer cases

By: Ellen McGregor
Cristin Severance from the Ohio News Network contributed to this report

CLEVELAND – No one wants their home in an area where a higher percentage of adults and children get cancer, leukemia, multiple sclerosis and more. These areas are called disease clusters. There are five in Ohio, including one in Lorain County. Now, a senator and an environmental activist are urging new action to help people who live in disease clusters.

en. Sherrod Brown (D-OH) is co-sponsoring a new bill, and Erin Brockovich testified at a senate committee hearing Tuesday. They both want more done about quickly identifying disease clusters, and helping people in those clusters find out what made them sick.

Sen. Brown’s proposed bill would get more federal resources to five Ohio areas identified as disease clusters. He said if it passed, the bill would “provide more federal support to communities that have been afflicted by high rates of diseases like cancer and multiple sclerosis.”

read full article

Letter to the Editor
Hartford Courant

Elizabeth Brown’s March 21 letter ["Nuclear Disaster Shouldn't Surprise"] makes an excellent point regarding our reactive response to Japan’s nuclear crisis. However, her statement that “we have known for a long time that our plants in the U.S. have the potential of leaking” deserves clarification. Nuclear power plants in the U.S. have been and are already “leaking.”

Routine operations at nuclear power plants require intentional releases of radioactive substances into the environment at levels that must meet Nuclear Regulatory Commission and Environmental Protection Agency requirements for public safety. But how can we be sure the NRC is doing its job?

According to a 2010 Union of Concerned Scientists document, authored by nuclear safety expert David Lochbaum ["Regulatory Roulette: The NRC's Inconsistant Oversight of Radioactive Releases from Nuclear Power Plants"], there have been more than 400 accidental leaks involving millions of gallons of contaminated water into the ground and waterways. Some of those listed include 27 accidental releases occuring in the years of 2006 to 2010, for which there were no NRC sanctions. Although the UCS paper also reports case studies in which the NRC did enforce its regulations, the risk of such regulatory failure carries serious implications for the public’s health.

“Clean, safe, nuclear power”? I think I have a bridge for sale!

Agnes Reynolds, Wethersfield

Specific language to be incorporated into your estate planning document(s) could be as follows:

“I give and bequeath ____% of my residuary estate to the National Disease Clusters Alliance, a California 501c(3) non-profit corporation, to be used by it for its general and campaign purposes.”

OR

“I give and bequeath ____% of my residuary estate to the National Disease Clusters Alliance, a California 501c(3) non-profit corporation, to be used by it for its general and campaign purposes. Specifically, the bequest shall be used to support the _________ Campaign.”

OR

“I give and bequeath $____ to the National Disease Clusters Alliance, a California 501c(3) non-profit corporation, to be used by it for its general and campaign purposes.”

OR

“I give and bequeath to National Disease Clusters Alliance, a California 501c(3) non-profit corporation all of my interest in the following described property ____________________. ”

If the National Disease Clusters Alliance is a designated charity in a will, trust or other estate planning document, please forward a copy of the document, or the relevant pages of the document, to the National Disease Clusters Alliance offices. This will allow the Foundation the opportunity to make sure that your wishes are carried out to the fullest extent.

National Disease Clusters Alliance

12555 High Bluff Drive, Suite 380

San Diego, CA 92130

Bill would give EPA authority to investigate possible causes

2/19/2011
Gannett Washington Bureau

WASHINGTON – Warning flags about carcinogens in the environment have been raised frequently over the past decade, from the 2000 movie “Erin Brockovich” to a 2010 statement by the President’s Cancer Panel saying that the problem has been “grossly underestimated.”

Now, lawmakers are pushing a bill that would strengthen the federal response to clusters of unusually high rates of cancer, birth defects and other diseases in communities across the country.

The legislation, sponsored by Sens. Barbara Boxer, D-Calif., and Mike Crapo, R-Idaho, would give the Environmental Protection Agency authority to investigate environmental causes of suspected clusters and require the agency to respond within 60 days to local concerns. The EPA would send teams of scientists and officials to affected communities and post findings in a public online database.

Scientists and health activists say the government’s current response to disease clusters ranges from piecemeal to non-existent.

“The federal government has a policy of not stepping in, and the states feel pretty overwhelmed when these problems come to them,” said Terry Nordbrock, executive director of the Disease Clusters Alliance.

Nordbrock’s son, Linus, was diagnosed with leukemia in 2001 at age 2. The family lives in Sierra Vista, where rates of childhood leukemia more than doubled from 1995 to 2005. Linus is now in remission.

Children are more vulnerable to chemical toxins than adults because they have faster metabolisms and less mature immune systems.

Government agencies lack funding to thoroughly research cancer clusters, said Mark Witten, a retired research professor at the University of Arizona’s Institute of the Environment who studied the Sierra Vista cluster.

read on the Arizona Central website

By Shan Juan (China Daily)
Updated: 2011-01-14

BEIJING – Health experts have warned the public that pollution and environmental deterioration are behind rising cancer rates among Chinese children aged under 14.

The Chinese mainland now has more than 32,000 children aged under 14 suffering cancer of various kinds, which translates into a prevalence of 104 in 1 million, Zhang Guangchao, general secretary of the Chinese Anti-Cancer Association and an expert in childhood cancer, said on Thursday.

“Notably, the fatal disease, long considered a problem in senior years, is striking more and more children. Major risk factors include pollution and unhealthy lifestyles,” Zhang told China Daily at an awareness-raising event held on Thursday by sohu.com, one of the biggest online news portals in China.

The most common kinds of cancer among children are leukemia, lymphoma and brain cancer, he said.

The incidence of bone cancer is higher among teenagers than younger children, he added.

“Personally, I’ve seen more cases of children developing leukemia after home decoration,” he said.

“Long-term exposure to harmful chemicals from decoration materials would substantially raise the cancer risks, particularly for children,” he said.

Similarly, parents’ occupations are also related, studies have found.

People such as drivers and painters are more likely to be exposed to lead and this means their children face higher risks of cancer, experts said.

Child cancer patients show common symptoms, including persistent low fever, weight loss for unknown reason and nose bleeds, said Zhi Xiuyi, a Beijing-based lung cancer expert.

Zhi also warned parents that unhealthy lifestyles greatly increase the risk of cancer, which is “a lifestyle chronic disease”.

It has been scientifically proven that factors such as obesity, physically inactive lifestyle and high-calorie diet are also factors in the development of childhood cancer, he said.

“Early intervention in children’s unhealthy lifestyles will greatly lower their risk of developing cancer both in childhood and adulthood,” Zhang said.

For instance, without intervention, overweight children, who are usually meat lovers, often become obese adults, who face much higher risks of breast and colon cancers, he said.

“Cancers of the breast, skin and colon are more related to unhealthy lifestyles than lung and liver cancers,” he said.

“The rates of these cancers are rising rapidly among Chinese people, who have become richer in recent decades and have then adopted a Western lifestyle,” said Zhi.

read online

Michio Kaku on January 11, 2011
Dr. Kaku’s Universe
BigThink.com

The Internet has been burning up this past week as massive groups of animals around the world have been suddenly dying en masse. We hear reports from Sweden, Louisiana, Arkansas, etc. and the list grows every day. We are starting to see similar incidents all over the world and it seems each week brings new reports. A recent story from AOL World News states “Other animal die-offs in the past two weeks include reports of 40,000 dead crabs washing ashore near Kent, England, hundreds of snapper fish dead in New Zealand, 150 tons of red tilapia dead in Vietnam, 500 jackdaws crashing to their death in Sweden, more than 450 birds falling onto a Louisiana highway and a mass of dead fish in a Florida creek.” Another incidence happened just recently when thousands of turtle doves fell from the sky.

Upon examinations of the dove’s, scientists have discovered that there was a small blue stain inside it’s beak. It was thought that the blue stain could have been caused be a lack of oxygen or some type of poison but the full results should take about a week.

Conspiracy theories are rampant, and it’s been suggested that the deaths could be a result of UFOs, government tests, or even secret weapons.

But there are three real possibilities behind this mystery:

a) Toxic Chemicals

b) Pathogens and Disease

c) Trauma

The first possibility (toxic chemicals) can be safely ruled out—at least in one case—since 95% of the 100,000 fish that died in Arkansas recently were of one species: bottom-feeding drum fish. The mature male drum fish have a series of muscles that are uncommon amongst other fish. When the fish is swimming, those muscles can vibrate against the swim bladder making a noise that doesn’t sound far off from a drum in the distance. We can assume that it wasn’t poisons that killed this one species because poisons would have affected many species as well. So disease is probably the reason behind the fish die-off, though it will take a month or so to culture the pathogens and determine for sure. We are also hearing stories of dead fish washing up on shores at an alarming rate. Over two million dead fish have reportedly washed up on shores of Maryland’s Chesapeake Bay recently. The Chesapeake Bay area is experiencing their coldest December in almost 25 years and the state’s Environmental Department reported that it rapid temperature drop in the water. Other reports are showing up in Europe, Brazil, and Asia; Not to mention that on Wednesday, thousands of fish washed ashore on Folly beach in South Carolina.

For the 5,000 red-winged blackbirds that suddenly died recently in Arkansas, the cause was probably blunt trauma. Autopsies show massive internal bleeding near the breast, consistent with a violent collision. But, what caused it? Red-winged blackbirds are a bit different from other birds. They are extremely common (200 million in the U.S.), have poor eyesight, and also fly in tight formation (to save energy). But if the lead bird is disoriented (due to thunderstorms, lightning, fireworks, or downdrafts or micro bursts), it can plow into the ground or into houses, taking the entire flock with it. So most likely, the culprit is mass suicide caused by the disorientation of the lead birds, causing the entire flock to plow into the ground, trees, buildings, each other, etc. Micro bursts or sudden downdrafts may have also disoriented the birds. These are violent downdrafts which are very unpredictable. In the past, fatal airline accidents have been linked to these micro bursts, which will actually push a plane into the ground as it lands, causing a crash.

Mass suicides are actually not uncommon in the animal kingdom. Look at lemmings: thousands will commit suicide by walking over a cliff, following their leader. In fact, over the past 30 years, about 16 mass die-offs of blackbirds have been recorded in the U.S.—about one every other year, involving over 1,000 blackbirds each time.

So these events really do happen all the time, except we are unaware of them, until something pushes these events into the national media, such as simultaneous die-offs. In fact; In the past eight months, the United States Geological Survey’s National Wildlife Health Center in Wisconsin reports that it “has logged 95 mass wildlife die-offs in North America and that’s probably a dramatic undercount… The list includes some 900 turkey vultures that seemed to drown and starve in the Florida Keys, 4,300 ducks killed by parasites in Minnesota, 1,500 salamanders done in by a virus in Idaho, 2,000 bats that died of rabies in Texas, and the still mysterious death of 2,750 sea birds in California. On average, 163 such events are reported to the federal government each year, according to USGS records. And there have been much larger die-offs than the 3,000 blackbirds in Arkansas. Twice in the summer of 1996, more than 100,000 ducks died of botulism in Canada.”

read online

Other articles:

Overeating and indigestion blamed for 1,000 turtle doves falling dead in Italy with strange blue stain on their beaks. UK Daily Mail. 1/11/2011.

Puzzling demise of Arkansas’ red-winged blackbird
All Things Considered, NPR. 13 January 2011.

Aflockalypse Now: The ongoing extinction crisis
By David Suzuki, with Faisal Moola. Canadian Press. Opinion, 12 January 2011.

Dugway Proving Ground: Dugway Sheep Kill Incident
In March 1968, 6,249 sheep died in Skull Valley, an area nearly thirty miles from Dugway’s testing sites. When examined, the sheep were found to have been poisoned by an organophosphate chemical. The sickening of the sheep, known as the Dugway sheep incident, coincided with several open-air tests of the nerve agent VX at Dugway.

DDT and Birds by Paul R. Ehrlich, David S. Dobkin, and Darryl Wheye

NECA note: It seems like a good time to re-read Rachel Carson’s Silent Spring, which in 1962 exposed the hazards of the pesticide DDT:

“It was a spring without voices. On the mornings that had once throbbed with the dawn chorus of robins, catbirds, doves, jays, wrens, and scores of other bird voices there was now no sound; only silence lay over the fields and woods and marsh.”

BBC

Newly released test results on a batch of contaminated German animal feed suggest it contained more than 77 times the approved amount of dioxin.

Some 4,700 German farms have been shut after tests in Schleswig-Holstein found excessive levels of the toxic chemical.

Initially the scare was confined to Germany, but then it emerged that a batch of eggs had been exported to Holland and from there to Britain.

South Korea has blocked imports of German pork and poultry products.

German officials are investigating possible “illegal activity” after a company allegedly supplied 25 animal feed makers with 3,000 tonnes of contaminated fatty acids.

Officials have traced the contamination to the Harles und Jentzsch plant in the northern state of Schleswig-Holstein, where oils intended for use in biofuels were distributed for use in animal feed.

“The first indications point to a high level of illegal activity,” said a spokesman for Agriculture Minister Ilse Aigner on Friday.

“There are indications that the company was not even officially registered, in order not to expose itself to official controls,” he added.

Egg ban
A sample test from the plant last March had found more than double the acceptable level of 0.75 nanograms of dioxin per 1kg of fatty acids used in animal feed.

The latest test results to be released by the state of Schleswig-Holstein’s agriculture ministry found the much higher levels.

Health officials only learned about the excessive level on 27 December, said a spokesman for the state agriculture ministry. The cause of the delay between the test results and the notification of the ministry remains unclear.

The extent of the problem was only revealed earlier this week when German officials said 3,000 tonnes of feed had been affected. They say the closures – mostly affecting pig farms in Germany’s Lower Saxony region – are only a precaution.

Authorities believe some 150,000 tons of feed for poultry and swine containing industrial fat have been fed to livestock across the country.

A doctor from the town of Havixbeck, near Munster, has lodged a criminal complaint of attempted murder and severe injury against Harles und Jentzsch, saying the company had acted out of greed.

Last week, more than 1,000 German farms were banned from selling eggs after dioxin was found in eggs and poultry.

Germany’s agriculture ministry said most of the closed farms were ones raising pigs.

The ministry said the farms would not be allowed to make any deliveries until they had been checked and found to be clear of contamination.

There were no immediate reports of health problems connected to the contaminated feed, it added.

By JOHN SEEWER, AP
Thu Dec 30, 2010

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

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

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

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

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

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

Nothing unusual was detected. Not even a hint.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

In a way, it’s not a surprise.

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

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

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

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

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

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

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

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

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

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

The investigation is his top priority.

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

Brown wishes there were somebody to blame.

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

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

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

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

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

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

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

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

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

read online

Cancer-causing chemical found in 89 percent of cities sampled

An Environmental Working Group report

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

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

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

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

Next Section »

Chromium widely contaminates U.S. tap water

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

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

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

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

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

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

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

Executive Summary

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

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

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

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

Millions of Americans drink chromium-contaminated water

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

Top five chromium-contaminated cities tested by EWG

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

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

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

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

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

Industry deception delayed protections

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

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

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

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

Recommendations

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

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

Health, Stem Cells, and Technology
Dr. Greg Maguire

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

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

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

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

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

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

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

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

University of Rochester Medical Center
December 16, 2010

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

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

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

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

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

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

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

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

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

By MATTHEW L. WALD
New York Times

Published: December 13, 2010

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

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

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

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

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

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

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

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

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

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

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

By Frederik Joelving, Reuters

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Animals in human care are fatter than they were 20 years ago.

Alla Katsnelson
Nature | doi:10.1038/news.2010.628

Pets and, puzzlingly, lab animals have grown steadily fatter in the last 20 years.Doyle/Corbis

It’s not just people that are getting fatter. A statistical analysis of more than 20,000 animals suggests that the obesity epidemic is spreading to family pets, wild animals living in close proximity to humans, and animals housed in research centres — perhaps indicating that environmental factors beyond diet and exercise are at least partly to blame for expanding waistlines.

David Allison, a biostatistician at the University of Alabama at Birmingham and lead author on a study published online today in the Proceedings of the Royal Society B, stumbled across the trend while looking for a relationship between body weight and longevity in a population of marmosets housed at the Wisconsin National Primate Research Center in Madison. He decided to take a closer look. He and his colleagues examined changes in weight in a total of 24 populations (12 male and 12 female), drawn from 8 different species, including primates and rodents used for research, domestic cats and dogs, and urban feral rats. About half of the data in the analysis comes from rodents that had been used between 1982 and 2005 in the control arms of studies run by the National Toxicology Program, which assesses safe exposure levels for various chemicals.

The researchers tracked the animals’ percentage weight gain per decade, as well as animals’ odds of being obese. Because there were no clear guidelines for what animals should weigh, the authors defined obesity as the weight above the 85th percentile in each group at the earliest time point for which they had data. Both the percentage increase in body weight and the odds of an animal being overweight in a given population showed a strong trend upwards, and although the shift was statistically significant in fewer than half of the groups when they were analysed individually, it was highly significant when all of the groups’ figures were lumped together1.

“Now, we don’t know why these increases occurred, but it invites some very interesting speculation,” Allison says.

“We don’t know why these increases occurred, but it invites some very interesting speculation.”
The surge in human obesity is generally attributed to an increasing consumption of calories and a decrease in physical activity. “But maybe there are other things that are important — because those things can’t be acting on the marmosets, or the rats and mice in the National Toxicology Program,” he says.

In some cases, the explanation might be obvious: the more than 40% jump in body weight in feral rats scavenging on the streets of Baltimore may reflect the increasing richness of their diet as they feed on our more calorie-dense refuse. In other cases, hidden factors might be at play. For example, toxins that disrupt the endocrine system could be leaching into the water supply, or particular pathogens might be having a widespread effect on mammalian metabolism, Allison says.

Fat virus?

Nikhil Dhurandhar, an obesity researcher at the Pennington Biomedical Research Center in Baton Rouge, Louisiana, has shown that a human adenovirus called AD36 raises body-fat levels in animal models such as chickens and rodents. What’s more, he found that obese humans were three times more likely to be infected with the virus than non-obese people — and heavier individuals in both groups tended to be infected. Dhurandhar reported these findings in a 2005 paper on which Allison was a co-author2.

The current study is conceptually important, Dhurandhar says, because “it draws attention to having to look at the environment and how that is changing, instead of only focusing on lifestyle in a person”.

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By WALT BOGDANICH and JO CRAVEN McGINTY
The New York Times

Because children and adolescents are particularly vulnerable to radiation, doctors three years ago mounted a national campaign to protect them by reducing diagnostic radiation to only those levels seen as absolutely necessary.

It is a message that has resonated in many clinics and hospitals. Yet there is one busy place where it has not: the dental office.

Not only do most dentists continue to use outmoded X-ray film requiring higher amounts of radiation, but orthodontists and other specialists are embracing a new scanning device that emits significantly more radiation than conventional methods, an examination by The New York Times has found.

Designed for dental offices, the device, called a cone-beam CT scanner, provides brilliant 3-D images of teeth, roots, jaw and even skull. This technology, its promoters say, is a safe way for orthodontists and oral surgeons to work with more precision and to identify problems that otherwise might go unnoticed.

But there is little independent research to validate these claims. Instead, the cone beam’s popularity has been fueled in part by misinformation about its safety and efficacy, some of it coming from dentists paid or sponsored by manufacturers to give speeches, seminars and continuing education classes, as well as by industry-sponsored magazines and conferences, according to records and dozens of interviews with dentists and researchers.

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The Radiation Boom: Clarity at a Cost
Articles in this series examine issues arising from the increasing use of medical radiation and the new technologies that deliver it.

Terry Nordbrock, MPH, Executive Director of the National Disease Clusters Alliance, discusses childhood cancer causation, prevention strategies, and the role of cancer clusters in learning about carcinogens and disease etiology.Terry is the mother of a child diagnosed with leukemia and she was active in the Sierra Vista AZ childhood leukemia cluster investigation. Presented at the Candlelighters Childhood Cancer Foundation of Southern Arizona conference, 11/13/2010.

The video is 44 minutes long and can be watched here.

By Chris Hamby | November 9, 2010, 5:14 pm
Public Integrity

Updated: 11/9/2010, 3:30 pm | Eighteen months after the Environmental Protection Agency announced reforms to its controversial process for evaluating health hazards posed by dangerous chemicals, significant problems continue to hamper the program and leave the public at risk, according to a new report by a nonprofit research group.

The agency has fallen years behind in meeting its statutory requirements to profile at least 255 chemicals and assess their potential links to cancer, birth defects, and other health problems. That delay has effectively halted numerous regulatory actions that would protect the public, according to the report by the Center for Progressive Reform, a public health and environmental protection group. “[The Obama administration has] been so busy reacting to the right wing and fighting off crisis after crisis that it’s been difficult for them to see this pattern of regulatory failure,” said Rena Steinzor, president of the center and a University of Maryland law professor.

The Government Accountability Office, Congressional committees, and other experts have criticized the EPA’s Integrated Risk Information System (IRIS) in recent years. Under President George W. Bush’s administration, critics say, the agency’s chemical assessment efforts ground to a near halt because of interference by other federal agencies, unwarranted delays, and a lack of transparency.

The GAO warned in a 2008 report that the IRIS database “is at serious risk of becoming obsolete.” In January 2009, the GAO added the EPA’s method for assessing and managing chemical risks to its list of “high-risk” areas requiring attention.

DATABASE INCOMPLETE, OUTDATED
Created in 1985, the database has become indispensable for regulators, public interest groups, and tort lawyers. But the EPA has fallen far behind in conducting chemical assessments, and, if the current pace continues, it will take 55 years to get through the backlog, the report says.

The net result of years of delay, observers have charged, is that the IRIS database, which lists the risks associated with certain chemicals, is incomplete and largely outdated — a serious problem given that the database underpins much of the regulatory action by not only the EPA, but also state and local governments.

The EPA said it was reviewing the new report. “Under the leadership of EPA Administrator Lisa Jackson, the IRIS program has been reinvigorated with a new streamlined assessment development process,” the EPA said in a statement. “Significant progress has been made toward addressing both new assessments and updating others.”

Democrat Brad Miller, chairman of the investigations panel of the House Science Committee, says IRIS was “badly broken in the Bush administration” and is still too slow and cumbersome. “We can’t wait for clusters of rare cancers or birth defects to tell us the consequences of a chemical exposure,” added Miller, a North Carolina lawmaker who held a hearing on IRIS in June 2009.

Responding to the GAO’s 2008 report, Bush-appointed EPA Assistant Administrator George Gray defended the agency’s handling of the program and said delays occurred in part because “today’s IRIS assessments are much more sophisticated, complex, and of higher scientific quality than at any other time in the program’s history.” The Bush administration sought to streamline the IRIS process, while striking a balance between transparency and “protecting the deliberative process,” Gray said in comments attached to the 2008 report.

Gray did not respond to an inquiry from the Center for Public Integrity.

INPUT FROM OTHER AGENCIES
The new report by the Center for Progressive Reform criticizes a 2004 policy giving other federal agencies advance input on the IRIS chemical assessments while keeping their comments — and any changes made because of them — secret as internal executive branch deliberations. Some federal agencies, such as the Department of Defense, could face steep costs if a chemical assessment led to new regulation or compelled a massive cleanup effort.

EPA Administrator Lisa Jackson instituted reforms in May 2009, giving the EPA — not the White House’s Office of Management and Budget (OMB) — more control over the assessment process, making written comments from other agencies public, and shortening the target timeframes for assessments.

But those changes have produced “only modest progress,” the Center for Progressive Reform says, while the database remains “woefully incomplete.” The report identified the interagency review process as a key concern, saying that the review system had greater transparency but did not eliminate the practice of giving other agencies an early review.

The continued involvement of the Office of Information and Regulatory Affairs (OIRA) – an office within the OMB that reviews federal regulations — provides an avenue for interference and delay, the center’s Steinzor said. “This is pure science, and OIRA doesn’t need to be involved,” she said.

The EPA also continues to focus too heavily on a few complicated, high-profile chemical assessments while neglecting others that would take less time, the report says. Many of the chemicals covered under environmental laws governing air pollutants, drinking water contaminants, and hazardous waste sites are not listed in IRIS. For example, the agency has yet to profile 32 of the 188 hazardous air pollutants specifically named by Congress in the 1990 Clean Air Act amendments.

The nine assessments that the EPA completed in 2009 represent an improvement over the four completed in 2006-07, the report says. But to improve regulation of toxic chemicals, it says, the EPA must allocate more resources to IRIS, eliminate excessive outside reviews, and tackle both quick-hit and high-profile assessments.

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Americans living in high poverty bear the burden of more than 20 common diseases that the medical establishment largely does not monitor, diagnose or treat, studies show.

By Melinda Burns

Diseases that are common and chronic among the poor of Africa are showing up in high poverty areas in the U.S.

Millions of poor Americans living in distressed regions of the country are chronically sick, afflicted by a host of hidden diseases that are not being monitored, diagnosed or treated, researchers say.

From Appalachia to the Mississippi Delta to the segregated inner cities of the Great Lakes and Northeast, they say, and from Navajo reservations to Latino communities along the U.S.-Mexico border, more than 20 chronic diseases are promoting the cycle of poverty in conditions of inadequate sanitation, unsafe water supplies and rundown housing.

“These are forgotten diseases among forgotten people,” said Peter Hotez, a microbiologist at George Washington University, president of the Washington, D.C.-based Sabin Vaccine Institute and co-founder of the institute’s Global Network for Neglected Tropical Disease Control. “If these were diseases among middle-class whites in the suburbs, we would not tolerate them. They are among America’s greatest health disparities, and they are largely unknown to the U.S. medical and health communities.”

Now, based on a study published by Hotez for the Public Library of Science in 2008, the U.S. House of Representatives has passed the Neglected Infections of Impoverished Americans Act. The bill would, for the first time, require the Secretary of Health and Human Services to report to Congress within the next 12 months on the country’s neglected diseases of poverty and recommend funding to address them. After passing in the House in September, the bill has not advanced since it was introduced in the U.S. Senate.

“The first step is to raise awareness of these diseases,” Rep. Henry Johnson, the Georgia Democrat who introduced the bill, said after the Sept. 29 vote. “Today is an important step in recognizing the threat and moving toward a solution.”

Over the course of the 20th century, deaths from infectious diseases declined rapidly in the U.S., and polio, tuberculosis, typhoid fever and malaria no longer represent a serious health threat here. But diseases that are common and chronic among the poor of Africa, such as Chagas, a leading cause of heart failure and stroke among Latinos; cysticercosis, which causes convulsions; and ascariasis, which causes abdominal pain and fever, also likely afflict millions of people living in the American South, in Appalachia and along the U.S.-Mexico border, Hotez said. These illnesses are spread, respectively, by parasites in insects, tapeworms in raw pork and roundworms in soil.

Most of the diseases named in the legislation have not been surveyed in the U.S. for decades, if ever. None are tracked by the U.S. Centers for Disease Control and Prevention, though between 4 million and 10 million Americans could be infected, Hotez said. Drugs are available to treat a number of the neglected diseases, he said, but doctors are not trained to diagnose them.
“These are not even rare diseases,” Hotez said. “Yet there’s so little research on them, we don’t know the full extent of their impact, how they are transmitted, or how they contribute to disability. We do not have good diagnostic methods. We can’t even begin to think about controlling these diseases.”

The website of the Centers for Disease Control and Prevention lists six “major neglected infections of poverty” in the U.S., all of them parasitic or viral diseases, and notes that they can cause birth defects, epilepsy, hearing loss, infertility, blindness and heart failure. The site says that improved tracking, testing and treatment is needed to reduce illness and death.

The CDC conducts public health surveillance only at the request of states, and the states have not asked the agency to track of any of the diseases on Hotez’s list, said Susan Montgomery, an epidemiologist with the CDC’s Division of Parasitic Diseases and Malaria. Based in part on blood donor data, she said, the agency estimates that 300,000 Americans are afflicted with Chagas, and that between 60 and 300 babies are born with the disease in the U.S every year. But the agency does not formally collect reports from states about cases of Chagas here.

“There’s an information gap,” Montgomery said. “These are diseases that are disproportionately affecting parts of our population who are living in poverty, but it’s in the context of many other health challenges our country is facing, including obesity, diabetes, HIV and tuberculosis. The states have not determined that those are diseases that they want the CDC to conduct surveillance for. They are not being monitored in the public health system. They may be diseases that physicians are not aware of and don’t think to test for.”

If the Senate passes the new bill, the CDC will conduct a review of existing data on the neglected diseases and try to identify the information gaps, Montgomery said.

According to a report by Families USA, the National Institutes of Health in 2007 accounted for 76 percent of $376 million in U.S. government spending for research on eight globally neglected diseases, including three that afflict hundreds of thousands of Americans — Chagas disease, dengue fever, which can be fatal, and leishmaniasis, a centuries-old disease that produces skin ulcers. Tuberculosis and malaria received nearly three-quarters of the funds. (And the private market sees more opportunity in battling the scourge of baldness.) Overall, the Families USA report said, NIH funding for the eight diseases represented less than 1 percent of the agency’s total research budget of $29 billion.

In 2009, the National Institute of Allergy and Infectious Diseases, which is part of the NIH, spent $367 million of its $4.7 billion budget researching most, but not all, of the 24 neglected U.S. diseases listed by Hotez, not counting stimulus funds, the institute staff said. At the same time, $1.6 billion went to biodefense and emerging infectious diseases.

Still, $367 million is “not a trivial amount of money, by any means,” said Lee Hall, chief of parasitology and international programs for the institute. There is ongoing and substantial government research on most of the diseases on Hotez’s list, and the research helps both the developing world and the U.S., he said. The work itself is difficult because parasites must often be grown in live animals, so the institute helps researchers by providing them with biological material for the lab, Hall said. To date, there are no licensed vaccines for any of the parasitic diseases that afflict humans.

“The NIH has had a long-standing commitment to these diseases, and we have supported research on them for a very long time,” Hall said. “I’ve spent most of my career on parasitic diseases, many of which fall into this category. I don’t think we’ve neglected these diseases at all.”

Yet even as research goes forward, the public health problem persists.
According to a study published by Hotez in 2009, trichomoniasis, or “trich,” one of the most common sexually transmitted diseases in the world, afflicts up to 29 percent of African-American women in the South and impoverished inner cities of North, approaching rates in Nigeria, where 38 percent of women are infected. People with trichomoniasis are more susceptible to HIV. About 880,000 African-American women in the U.S. are infected with the parasite that causes trichomoniasis, Hotez said.

Hotez’s list includes bacterial diseases spread by rats and lice in the poor neighborhoods of Baltimore and Detroit; parasitic diseases from Africa, prevalent among the “Lost Boys and Girls of Sudan” who resettled in the U.S.; parasitic diseases among the Inuit of Alaska who eat infected seal and caribou meat; and CMV, or cytomegalovirus, a congenital virus that infects an estimated 10,000 infants in America yearly. Babies with CMV develop hearing and vision loss, sometimes years later.

Along the U.S.-Mexico borderlands and in the Gulf Coast region, Hotez said, up to 200,000 people living in poverty may be infected with dengue fever, a viral disease that is transmitted by mosquitoes. Dengue can lead to failure of the circulatory system.

In the 1970s and 1980s, Hotez said, 30 percent of rural black children in the South tested positive for toxocariasis, or roundworm, a parasitic disease that is transmitted through the feces of dogs and cats. Toxocariasis causes abdominal pain, swollen glands and vision loss and may be linked to the rise in asthma among inner-city children. Extrapolating from old data, Hotez estimates that between 1.3 million and 2.8 million poor Americans are infected with toxocariasis today.

“These are truly neglected problems,” he said. “People have these diseases for years, and during this time, they promote poverty. They interfere with child growth and development and, in some cases, impair intelligence and cognition. They affect pregnancy outcomes and are co-factors in the AIDS epidemic.”

As reported in Miller-McCune, Hotez has previously challenged both drug makers and policymakers to divert more funding to the neglected diseases of poverty in the developing world.

“They have no advocacy,” he said. “It’s been very frustrating.”