Elana Schor, E&E reporter

Energy magnate David Koch quietly ceded his spot on a National Cancer Institute (NCI) advisory board last month, but green advocates are taking aim at the conservative mega-donor nonetheless by calling for a review of federal ethics policies that allowed him to sit on the panel despite a potential conflict of interest.

Koch Industries Inc., the privately held company run by Koch and his brother Charles, burst onto the political scene this year thanks to multimillion-dollar contributions the duo steered to right-leaning groups that help fuel the tea party movement. But David Koch’s membership on the National Cancer Advisory Board, which advises NCI, became a flashpoint of its own after The New Yorker magazine last month reported that a Koch-owned company lobbied against designating formaldehyde as a known human carcinogen while he sat on the panel.

In a request sent Monday to the Office of Government Ethics, which polices executive-branch conflicts of interest, Greenpeace and Physicians for Social Responsibility asked for a full accounting of any financial disclosures Koch was required to make ahead of his nomination to the advisory board by then-President George W. Bush.

“It is astounding that [advisory board] rules permit the selection of any board members with known bias and direct conflicts of interests to be on the [advisory] board where they can directly influence matters as important as public health policy,” representatives from the two groups wrote.

An NCI study published last year helped inform a recommendation by an expert panel of the National Toxicology Program (NTP) — like NCI, operating under the larger National Institutes of Health aegis — that formaldehyde be listed as a “known human carcinogen.” Georgia-Pacific, a wood products maker that Koch Industries purchased in 2005, later submitted public comments that “strongly disagree[d]” with the notion of a causal link between formaldehyde exposure and cancer.

“We want to know how much was known before the appointment was made and how the advisory board reconciles that it’s got a member who has a clear financial interest in promoting formaldehyde,” Greenpeace campaigner Gabe Wisniewski, whose group submitted a separate Freedom of Information Act request to NCI yesterday, said in an interview.

“If there is no plan for accounting for that conflict of interest, we expect not only Greenpeace but many groups within the health and environmental community would be reasonable in asking for Koch to be dismissed from the board.”

In fact, Koch has departed the board already. His name is no longer listed on its online roster, and an NCI spokeswoman confirmed that last month’s meeting of the panel was the swan song for the now-ubiquitous conservative donor. Koch’s appointment to the board was originally set to expire in March, but existing rules allowed for an extension of his membership, the spokeswoman said.

Meanwhile, political jockeying continues unabated over formaldehyde and the Koch brothers’ role in resisting stricter regulation of their chemical and oil interests. In an online response <http://www.kochind.com/kochFacts/>  to the New Yorker article, the company slammed its critics and touted the nine-figure donations that David Koch, a prostate cancer survivor, has sent to research centers working on the disease.

EPA’s draft assessment of formaldehyde, released in June, echoes the NTP expert panel’s conclusion that exposure to the chemical increases cancer risk in humans. But that finding is unlikely to spur new limits on the substance in the short term, given that industry successfully pushed for a delay in final action until after the National Academy of Sciences reviews the EPA decision (Greenwire , April 16).

click here  to read the two groups’ request for an OGE review.

BASRA, Iraq – Agence France-Presse

A young Iraqi cancer patient sits on a bed in the newly inaugurated Basra Children's Hospital. AFP photo

Iraq’s first specialist cancer hospital for children could not have opened in a needier location – since 1993, Basra province has seen a sharp rise in the incidence of childhood cancer.

“Leukemia among children under 15 has increased by about four times,” said Dr. Janan Hasan of the Basra Children’s Hospital.

“Most are high-risk cases, which means that they do not have a high survival rate,” she told Agence France-Presse on the sidelines of the opening ceremony, where hapless parents with sick children in tow, many with the tell-tale baldness of chemotherapy, clustered around the pediatrician.

The facility, which was built with multinational assistance and funds, officially opened on Thursday but has been partially operational for several months, Hasan said.

“This hospital is a very important achievement, and I thank everyone who helped build it,” she said.

“This is a very good effort, but we still do not have advanced equipment, labs and many medicines. We hope to acquire them over time.

“Three-year-old Muntadhar, his green eyes staring dolefully from his mother’s arms, is one of the patients the hospital cannot help because it does not have the equipment. Muntadhar, an intravenous insertion needle bandaged to his foot, was diagnosed with a cancerous tumor a year ago, his mother Inas Ahmed said.

“We took him to Iran a few months ago and they cut him open to try to help him,” she said, lifting his orange Mickey Mouse T-shirt to reveal a deep scar across his belly. “But they said they couldn’t help and now we are trying to take him abroad, maybe to Thailand,” she said with a look of resignation.

A hospital official said they were working through some charities to arrange the operation, which Muntadhar’s poor parents cannot afford.

Halima Mukhtar, draped in a loose black veil, carried her four-year-old son Musa on her right shoulder.

“Thank God for this hospital, otherwise I wouldn’t know where else to turn,” she said, a bottle of medicine in one hand.

“In this world I have only God and the people at this hospital,” she added,” as Musa, wearing flip-flops on his feet and a surgeon’s mask that covered most of his face, stared down blankly from his perch.

Hasan said the increasing cases of cancer in Basra were best documented in a study published this year by the University of Washington in Seattle, conducted with input from her and the Ibn Ghazwan teaching hospital.

The report found leukemia in Basra among children under 15 had grown year to year from 1993-2007.

“We observed 698 cases of childhood leukemia between 1993 and 2007, ranging between 15 cases in the first year and 56 cases in the final year, reaching a peak of 97 cases in 2006,” said the study, authored by Amy Hagopian and Tim Takaro, and published in the American Journal of Public Health.

“Basra’s childhood leukemia rates compare unfavorably to those of neighboring Kuwait and nearby Oman, as well as the U.S and the European Union and other countries,” the study said. “The incidence of cancer is significantly higher in Basra province than in other parts of Iraq,” said Mohammed Kamil, the hospital’s deputy director.

Remnants of war

Speculation has focused on industrial pollution, the huge volumes of burning gas from oil wells in the energy-rich province, and Basra’s position in the frontline of wars in past three decades: the 1980-1988 conflict with Iran, the 1991 Gulf War and the U.S.-led invasion that overthrew dictator Saddam Hussein.” We hypothesize that hazardous exposures during these wars may have been leukemogenic,” said the Hagopian-Takaro study. What weapons were actually used in those wars, and by Saddam himself against his own people to put down a 1991 Shiite uprising in the south, is anyone’s guess. Some of the conjecture has centered on depleted uranium weapons used by U.S. and coalition forces in the 1991 war to liberate Kuwait and the 2003 U.S.-led invasion. But in Iraq the possible link between the radioactive metal and health problems has not been proven.

The hospital, decorated with portraits of Donald Duck and Mickey Mouse prancing about with his girlfriend Minnie, was built with help from the United States, Spain, Oman, the United Arab Emirates, the U.N. Development Program and Project Hope.

“This project will have a capability to serve the people of Iraq and its people and children of Iraq for many years to come,” said Brigadier-General Randal Dragon, Deputy Commander for Support of the U.S. army base in Basra.” From that perspective, all of us should be proud and hope this project will pay big dividends,” he told AFP.

By THE NEW YORK TIMES

Can environmental toxins be responsible for a cluster of thyroid cancer cases in one New York office? If your mother or father had thyroid cancer, are you at increased risk? These are among the questions posed last week by readers of the Consults blog. Dr. R. Michael Tuttle, an endocrinologist at Memorial Sloan-Kettering Cancer Center in New York City, responds.

Q. Can Environmental Toxins Cause Thyroid Cancer?

I was one of a group of nine people in my old office who had some type of thyroid issue. Another friend had Hurthle cell carcinoma, and several others did not have thyroid cancer but had either overactive or underactive thyroids. We obtained a review by the N.I.H., which concluded that our “cell” was too disparate in diagnoses to justify the conclusion that there was an environmental cause for the thyroid problems. What do you think?

Lisa, New York State

A. Dr. Tuttle responds:

Most of the time we don’t know what causes a specific patient’s thyroid cancer. The only well-accepted risk factor for the common types of thyroid cancer — papillary and follicular thyroid cancers — is exposure to ionizing radiation that occurs after exposure to fallout from nuclear reactors (like that following the Chernobyl accident), atomic bombs or therapeutic uses of radiation during young childhood.

However, since the incidence of thyroid cancer has dramatically increased over the last 20 years, both in the United States and abroad, many investigators are re-examining the possibility that some environmental factor may be linked to the rise in thyroid cancer. But as of now, no specific chemical or environmental factor has been demonstrated to commonly cause thyroid cancer in humans.

Q. Is Thyroid Cancer Inherited?

In 1977, our mother died of thyroid cancer that had metastasized to her spine. My brother and I were young at the time, and her records have since been destroyed. She was treated at what was then Columbia Presbyterian in New York. So we don’t have the pathology report to see what type of thyroid cancer it was. My question is — are there types that are hereditary? And, since hers had metastasized, it seems it was aggressive. Does that make it more likely hers was a hereditary form? In other words, how worried should my brother and I, and our own children, be about having inherited the disease?

Mary, Maine

Q. My father died of anaplastic thyroid cancer at the age of 53. Is there any known genetic component to this type of thyroid cancer, and do I need any screening for thyroid cancer beyond routine thyroid palpation at my annual gyn exam?

S., New York, N.Y.

A. Dr. Tuttle responds:

We don’t generally consider the common types of thyroid cancer — papillary, follicular, tall cell variants, anaplastic — to be hereditary. However, recent studies show that perhaps as many as 5 percent of patients with these types of thyroid cancer may have multiple family members with the same type of thyroid cancer. The specific gene that causes these rare family cases is unknown, and therefore no genetic testing can be done. I usually only worry about this type of thyroid cancer being hereditary if three or more family members have the same type of thyroid cancer. If only one other family member has the same thyroid cancer, it is still very unlikely to be “hereditary” and is more likely just to be random chance.

On the other hand, a rare form of thyroid cancer known as medullary thyroid cancer can be hereditary. As many as 25 percent of patients with medullary thyroid cancer do have a familial form of the disease that is inherited. The genetic cause of this form of cancer is known — it is caused by mutations in a structure called the RET proto-oncogene — and genetic testing is commercially available. We recommend genetic testing for all of our patients with medullary thyroid cancer.

For more information, see the Q&A with Dr. Tuttle in “Ask an Expert About Thyroid Cancer”> and The Times Health Guide: Thyroid Cancer. Additional responses from Dr. Tuttle will be posted in the coming week here on the Consults blog.

Medical News Today

Why was cancer detected in only one in a few hundred Egyptian mummies? Why is there such scarce reference to cancer in ancient Greek or Egyptian texts? A study carried out by researchers from the University of Manchester, England and published in Nature suggests that cancer, especially cancer among children and young adults is not simply due to our living longer these days – it must be a man-made disease. The scientists say theirs is “the first histological diagnosis of cancer in an Egyptian mummy”.

Investigators at Manchester University’s KNH Centre for Biomedical Egyptology say their study proves that during the Egyptian mummies’ time, cancer was extremely rare. After investigating hundreds of mummies, they came across just one case of cancer – worldwide only two cases have ever been detected. Incidence of cancer, especially childhood cancer exploded after the Industrial Revolution.

Professor Rosalie David, at Manchester University’s Faculty of Life Sciences, said:

In industrialized societies, cancer is second only to cardiovascular disease as a cause of death. But in ancient times, it was extremely rare. There is nothing in the natural environment that can cause cancer. So it has to be a man-made disease, down to pollution and changes to our diet and lifestyle.

The important thing about our study is that it gives a historical perspective to this disease. We can make very clear statements on the cancer rates in societies because we have a full overview. We have looked at millennia, not one hundred years, and have masses of data.

Professor Michael Zimmerman, a visiting professor at the KNH Centre, made the first ever histological diagnosis of cancer in an Egyptian mummy. The mummy was said to be an ordinary person, from the Ptolemaic period.

Zimmerman said:

In an ancient society lacking surgical intervention, evidence of cancer should remain in all cases. The virtual absence of malignancies in mummies must be interpreted as indicating their rarity in antiquity, indicating that cancer causing factors are limited to societies affected by modern industrialization.

The investigators examined literary evidence from ancient Greece and Egypt, as well as mummified remains from ancient Egypt. They also carried out medical examinations of animal and human remains further back in history, as far back as the period of the dinosaurs.

They found that:
* According to animal, non-human primates, and early human remains and fossil evidence, cancer was extremely uncommon. One Edmontosaurus fossil of unknown primary origin had evidence of metastatic cancer.

* Virtually all evidence of tumors, which were extremely uncommon anyway, were benign.

* The few malignancies were found were in non-human primates, but none of them are cancers found in modern adult humans.
Atherosclerosis, Paget’s disease of bone, and osteoporosis did exist in ancient Greece and Egypt – diseases that affect humans when they are older; old enough to develop common modern cancers. If humans at that time lived long enough to develop those diseases, the extreme rarity of cancer cannot be put down to very short life spans. People in those days lived long enough to develop the cancer adults develop today. Also, there is no evidence of any childhood cancers in ancient Greece or Egypt. Cancer among children is definitely much more common today than it was in ancient Greece/Egypt.

Some people have suggested that tumors do not preserve well, so evidence of them disappears over time. However, Zimmerman says mummification preservers malignancy features; in fact, it preserves tumors much better than normal tissue.

Of all the hundreds of mummies examined all over the world, just two have microscopic evidence of cancer. Radiologists have examined all the mummies at museums in Cairo and Europe and found no evidence of cancer at all.

Evidence of cancer and medical procedures, such as operations for cancers does not appear until the 17th century, the researchers reveal. Scientific literature depicting distinctive tumors have only been about for the last 200 years, when data started to be documented about chimney sweeps with scrotal cancer in 1775, nasal cancer in snuff users in 1761, and Hodgkin’s disease in 1832.

Professor David said:

Where there are cases of cancer in ancient Egyptian remains, we are not sure what caused them. They did heat their homes with fires, which gave off smoke, and temples burned incense, but sometimes illnesses are just thrown up.

The ancient Egyptian data offers both physical and literary evidence, giving a unique opportunity to look at the diseases they had and the treatments they tried. They were the fathers of pharmacology so some treatments did work.

They were very inventive and some treatments thought of as magical were genuine therapeutic remedies. For example, celery was used to treat rheumatism back then and is being investigated today. Their surgery and the binding of fractures were excellent because they knew their anatomy: there was no taboo on working with human bodies because of mummification. They were very hands on and it gave them a different mindset to working with bodies than the Greeks, who had to come to Alexandria to study medicine.

(Conclusion) Yet again extensive ancient Egyptian data, along with other data from across the millennia, has given modern society a clear message – cancer is man-made and something that we can and should address.

“Cancer: an old disease, a new disease or something in between?”
A. Rosalie David & Michael R. Zimmerman
Nature Reviews Cancer 10, 728-733 (October 2010) | doi:10.1038/nrc2914

read online

By Bryant Furlow on Oct 05, 2010

A neighborhood cluster of newly-diagnosed measles or tuberculosis – or any of a dozen other infectious diseases — unleashes an onslaught of federal expertise and resources.

But not so for clusters of birth defects or chronic diseases like cancer, asthma or autoimmune disorders.

More than 1,000 citizens ask public health agencies to investigate suspected chronic disease clusters across the U.S. each year, but state agencies are usually unable to offer a substantive response to such requests because of funding and staffing limitations – problems first highlighted by epiNewswire in 2006.

Now, proposed legislation introduced by U.S. Senator Barbara Boxer (D-CA) would create a nationwide database of suspected clusters and deploy federal agency resources to investigations into environmental correlates of local disease clusters.

“Health officials are currently working with their hands tied as they don’t have the resources or time to address the concerns,” explains National disease Cluster Alliance (NDCA) Executive Director Terry Nordbrock, MPH. “I keep being contacted by people whose state cancer registry officials have confirmed an unexpectedly high rate of disease, but their only suggestion for intervention is to invite the concerned residents to speak at smoking cessation workshops. This boil will be a real game-changer as we will now be able to directly address the environmental concerns that community members are asking.”

The proposed law would strengthen federal inter-agency coordination of cluster investigations and authorize federal partnerships with states and universities to investigate disease clusters. Federal labs would support biomonitoring and analysis of environmental contaminents, for example.

The legislation was initiated by Susan Rosser, Charlie Smith, and Smith’s son Trevor Schaefer, a childhood brain cancer survivor, and University of Arizona toxicologist Mark Witten. Schaefer and his mother founded the Trevor’s Trek Foundation to push for more research into environmental causes of chronic disease clusters.

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

Local business and real estate interests often oppose public discussion of suspected disease clusters, which may implicate corporate pollutors or otherwise harm local economies.

The U.S. Centers for Disease Control investigated two childhood leukemia clusters in the early 2000s: the Fallon, Nevada leukemia cluster and the Sierra Vista, Arizona cluster, without successfully identifying the cause of those clusters. Part of the problem, leukemia epidemiologists like UC San Francisco’s Joseph Wiemels say, is that even pronounced clusters like Fallon – which involved 16 children diagnosed in a town of 8,500 in fewer than five years – involve case numbers so low that meaningful statistical analyses can be a challenge.

But by encouraging nationwide tracking and analyses of such clusters, proponents say, the proposed law could provide larger numbers – and new insights into the elusive causes of greusome chronic diseases.

“The online database that this bill will create will go a long way toward creating transparency that is currently lacking for communities experiencing disease clusters,” Nordbrock says.

epiNewswire

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Disease Cluster and Hotspot Map

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

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

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

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

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

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

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

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

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

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

Visit the Stand Up To Cancer website for more information.

by John S. Hausman
Muskegon Chronicle

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The project is limited two ways.

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

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

For expand it has.

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

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

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

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

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

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

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

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

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

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

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

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

read full Muskegon Chronicle article at their website

by William R. Levesque
St. Petersburg Times

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

read online at St. Petersburg Times

Sponsorship_Flyer

Invite&ticket_order

By Bryant Furlow on Jul 30, 2010
epiNewswire

Epidemiologist Peter Infante, who originally identified occupational benzene exposure as a leukemia risk in the 1970s, Thursday questioned a decision by the Centers for Disease Control (CDC) and editors to remove mention of benzene exposure as a childhood leukemia risk factor from a 2007 CDC review published in the U.S. government’s flagship public health journal, Environmental Health Perspectives.

The review originally listed both benzene and ionizing radiation as significant risk factors for childhood leukemia in its summary, a section of the paper entitled “risk factors,” and the conclusion section. But the authors of the review asked editors to remove benzene within two to three months of the paper’s publication in 2007, spokeswoman Christine Bruske Flowers told epiNewswire Thursday.

Flowers works for National Institute of Environmental Health Sciences (NIEHS), which publishes the journal.

“At the time, the data didn’t indicate benzene was a risk factor for childhood leukemia specifically,” Flowers said. “I think there’s a distinction to be made between saying benzene’s a human carcinogen and saying benzene’s linked to childhood leukemia.”

Strangely, while the summary and “risk factors” section no longer list benzene as a childhood leukemia risk, the paper’s conclusion section continues to do so:

In general, benzene and ionizing radiation are two environmental exposures strongly associated with the development of childhood AML or ALL.

The correction and removal of benzene from the review’s summary came as a surprise to NIEHS’s top leukemia researcher, James Huff.

“I do not know what this means,” Huff said. “Of course benzene in our experiments and now others does cause leukemia (and) lymphoma in mice, correspondent with humans.”

Infante also questioned the decision to remove benzene from the review of childhood leukemia risk factors. He was quick to say the CDC authors were free to change their opinion and ask for their paper to be changed.

But the rationale offered by Flowers — that there is or was insufficient evidence tying benzene to childhood leukemia — “doesn’t make sense scientifically,” Infante told epiNewswire.

There are large studies tying fetal and childhood exposure to benzene to childhood leukemia risk, he said. In-utero exposures to paint, which contains benzene, is a risk factor for childhood leukemia, Infante added.

Moreover, Infante questioned the scientific basis for assuming children are not susceptible to benzene’s carcinogenicity.

Benzene is best established as a risk factor for Acute Myeloid Leukemia (AML), Infante said.

“Why would children be any different than adults,” he asked. “Children aren’t a different species. So you have to demonstrate benzene causes AML in children? There are hardly any studies of leukemia in people over 75. Do you have to have evidence it (benzene) specifically causes leukemia in patients in that age group, too?”

Removing mention of benzene from the list of significant risk factors in the EHP review was not a trivial move, Infante said.

“It’s unfortunate in terms of public health that they would not include benzene,” Infante said. “It’s not informing people about the hazards their children may be having.”

Children’s exposures to benzene are frequently preventable, Infante said — if parents know about the risks.

The assumption that benzene is not carcinogenic in children is “lacking in mental rigor,” Infante said.

The EHP correction notification describing the removal of benzene was noticed by Terry Nordbrock, executive director of the National Disease Clusters Alliance (NDCA), who brought it to the attention of epiNewswire’s Bryant Furlow.

By Bryant Furlow

The Medical Muckraker

Earlier this month, I got an interesting e-mail from Terry Nordbrock, executive director of the National Disease Clusters Alliance (NDCA).

Terry pointed out a curious “correction” in the monthly government scientific journal Environmental Health Perspectives. (EHP is the flagship journal of the National Institutes for Environmental Health Sciences.)

EHP had added a “correction” to a 2007 CDC review of risk factors for acute childhood leukemias, Terry noticed.

Whereas the authors had originally reported that both benzene and ionizing radiation were risk factors for childhood leukemia, the correction indicated that benzene was not, after all, a leukemia-associated carcinogen:

In the Abstract and in the section “Risk Factors,” the sentences “Only two environmental risk factors (benzene and ionizing radiation) have been significantly linked to ALL or AML” in the original manuscript published online have been changed here to “Only one environmental risk factor (ionizing radiation) has been significantly linked to ALL or AML.”

That’s a hell of a shift in thinking to be buried, unexplained, in a correction note.

I’ve contacted all three authors of the corrected review, as well as leading leukemia epidemiologists, for some insight into what’s going on.

Benzene’s carcinogenicity is one of the best-established epidemiological ‘truths’ in the field.  A consensus that benzene’s not a significant carcinogen after all would be tantamount to epidemiologists deciding cigarettes might not cause cancer after all.

That would be huge news.

But given the petrochemical industry’s concerted efforts over the years to downplay benzene’s carcinogenicity, one also has to consider whether or not there may be more to the story.

Evidence for some of the seemingly most clear-cut cases of benzene’s carcinogenicity are buried away from epidemiologists’ eyes in court settlement documents regarding an occupational cancer cluster in Cincinnati, Ohio and a residential lymphoma cluster near Waller, Texas.

I’m heading up to Santa Fe now to cover state regulation of health insurance rates for The New Mexico Independent.

But I’ll be digging into the curious EHP correction and reporting what I learn at epiNewswire, later this week.

Thanks for the interesting tip, Terry!

New Bill Introduced Today Seeks to Reduce Toxic Chemical Exposure and Ensure Safety

(Washington, DC) – Congressmen Bobby Rush (D-IL) and Henry Waxman (D-CA) today introduced a groundbreaking bill to overhaul U.S. chemicals policy in the House Energy & Commerce Committee.  The “Toxic Chemicals Safety Act of 2010” is intended to overhaul the 1976 Toxic Substances Control Act (TSCA), which has failed to regulate chemicals in consumer products – even those that have known links to cancer, learning disabilities, asthma, reproductive disorders, and other serious health problems.

“Today’s legislation will reduce chronic disease in this country, a burden that scientists have increasingly linked to toxic chemicals found in our homes and places of work,” said Andy Igrejas, Director of Safer Chemicals, Healthy Families, a coalition of 250 environmental and public health groups.  “It will also give American manufacturers and retailers the tools they need to compete in a world demanding safer products.  We applaud Chairman Rush and Chairman Waxman for leading the way.”

The House legislation would significantly strengthen public health protections from toxic chemicals. For the first time, the chemical industry would be required to demonstrate that chemicals are safe, rather than the EPA having to prove they are unsafe. In a major shift the legislation would require chemical manufacturers to provide basic health and safety information for all chemicals as a condition for them remaining on or entering the market and to make that information public.

Other elements of the legislation would require:

*Chemicals to meet a health standard to enter or remain on the market.

*EPA to identify and restrict the most toxic chemicals that build up in our food chain and in our bodies, such as brominated flame retardants.

*Populations most vulnerable to toxic chemicals, including pregnant women, infants and children, and those living in environmental ‘hot spots’, to have extra protections from toxic chemicals.

*EPA to rely on the National Academy of Sciences’ recommendations to incorporate the best and latest science when determining the safety of chemicals.

Today’s bill, introduced in the House, follows a similar bill introduced in the Senate in April by Senator Lautenburg (D-NJ) called the “Safe Chemicals Act of 2010”.  For the past three months Congressmen Rush and Waxman have been meeting with key stakeholders including industry representatives, health and environmental advocates and the EPA to come up with a balanced bill.

“Right now our nation is bearing the brunt of decades of lax to non- existent federal oversight and the harm to consumers is immeasurable,” said Congressman Rush in a recent article about the bill.

Just this year the President’s Cancer Panel reported that “the true burden of environmentally induced cancers has been grossly underestimated.”

“People have been led to believe that chemicals are proven safe before added to products we use every day, but the law doesn’t offer that protection,” said Igrejas.  “Today’s legislation gives EPA both the authority and a mandate to begin making up for 34 years of neglect.  Congress should seize this opportunity immediately.”

#   #   #

Safer Chemicals, Healthy Families is a broad coalition of groups, including major environmental organizations like the Natural Resources Defense Council and the Environmental Defense Fund, health organizations like the Learning Disabilities Association, Breast Cancer Fund, and the Autism Society, health professionals and providers like the American Nurses Association, Planned Parenthood Federation of America, and the Mt. Sinai Children’s Environmental Health Center, and concerned parents groups like the 1 million-member MomsRising. For more information visit our website at www.saferchemicals.org.

Op Ed, Boston Globe
By Teresa Heinz Kerry, Terry Collins and John Warner | July 10, 2010

THE PRESIDENT’S Cancer Panel recently issued a stunning report on the role of environmental factors in causing cancer. For those wondering why America has yet to win the war against cancer, the panel minces no words: “The true burden of environmentally induced cancers has been grossly underestimated.’’ If you ignore the cause, how can you prevent cancer and really win the war?

The panel urges strong actions to reduce people’s widespread exposures to carcinogens. It says the prevailing regulatory approach used in the United States is “reactionary, not preventive.’’ It concludes that US regulation of cancer-causing chemicals is ineffective for several reasons, including inadequate funding, weak laws, and undue industry influence.

This report is not the result of a liberal panel following the lead of the Obama administration. Both panel members were appointed by President George W. Bush and the panel’s public hearings were conducted before Bush left office.The report identifies a series of actions that can be taken to win the war against cancer.

First, it recommends that a prevention-oriented approach should replace the current reactionary system, and that this should become the cornerstone of a new national cancer prevention strategy.

It finds that government agencies responsible for protecting Americans from cancer need more tools, and that a more integrated and transparent system — one driven by science and free from political or industry influence — must be developed to protect public health.

Among its many recommendations, we were especially encouraged to find this: “ ‘Green chemistry’ initiatives and research . . . should be pursued and supported more aggressively. . .’’ Green chemistry offers a path forward that leads both to a healthier America and a wave of positive chemical innovations that can strengthen our economy.

World markets want safe materials. Green chemistry will be able to provide them, but only if it gets the resources it needs to flourish. Other countries, including Germany, India, and, China, are investing far more in green chemistry than the United States does. As demand grows for safer materials because of the compelling science that show how chemicals in wide use today are undermining our health, America’s chemical industry needs to become the leader.

What’s holding us back? Lack of financial support for green chemistry research and innovation. But just turning on the funding spigot won’t be enough. We also need to reinvent how chemistry is taught in US colleges and universities.

Green chemistry equips chemists with the knowledge to ask tough questions about potential hazards when they are thinking about making a new chemical. As they make choices early in new chemical design, this simple step could dramatically reduce the chances that new chemicals would be toxic.

In the past, chemists have rarely been trained to ask these questions. It’s as if a course in driver’s education never taught students about traffic accidents. Perhaps not surprisingly, students as well as potential employers are creating demand for this change.

Green chemistry has a long way to go to develop a full toolkit of chemical methods that can replace more classic approaches. But the path is clear, a “prevention-oriented’’ design strategy that can do honor to the President’s Cancer Panel’s insistence that “new products must be well-studied prior to and following their introduction into the environment. . .’’

Invigorating green chemistry is a win-win solution. Americans will become healthier because the materials in their homes, the air, and water will be safe by design, and the chemical industry will be better positioned to compete in world markets that care about chemical safety.

Teresa Heinz Kerry is chairman of the Heinz Family Philanthropies. Terry Collins is a professor of green chemistry at Carnegie Mellon University. John Warner is president of the Warner-Babcock Institute for Green Chemistry.

read online

The dirty truth behind the new natural gas.

Related: A V.F. video look at a town transformed by fracking.

By Christopher Bateman•
Vanity Fair

WEB EXCLUSIVE June 21, 2010

A shale-gas drilling and fracking site in Dimock, Pennsylvania.

Early on a spring morning in the town of Damascus, in northeastern Pennsylvania, the fog on the Delaware River rises to form a mist that hangs above the tree-covered hills on either side. A buzzard swoops in from the northern hills to join a flock ensconced in an evergreen on the river’s southern bank.

Stretching some 400 miles, the Delaware is one of the cleanest free-flowing rivers in the United States, home to some of the best fly-fishing in the country. More than 15 million people, including residents of New York City and Philadelphia, get their water from its pristine watershed. To regard its unspoiled beauty on a spring morning, you might be led to believe that the river is safely off limits from the destructive effects of industrialization. Unfortunately, you’d be mistaken. The Delaware is now the most endangered river in the country, according to the conservation group American Rivers.

That’s because large swaths of land—private and public—in the watershed have been leased to energy companies eager to drill for natural gas here using a controversial, poorly understood technique called hydraulic fracturing. “Fracking,” as it’s colloquially known, involves injecting millions of gallons of water, sand, and chemicals, many of them toxic, into the earth at high pressures to break up rock formations and release natural gas trapped inside. Sixty miles west of Damascus, the town of Dimock, population 1,400, makes all too clear the dangers posed by hydraulic fracturing. You don’t need to drive around Dimock long to notice how the rolling hills and farmland of this Appalachian town are scarred by barren, square-shaped clearings, jagged, newly constructed roads with 18-wheelers driving up and down them, and colorful freight containers labeled “residual waste.” Although there is a moratorium on drilling new wells for the time being, you can still see the occasional active drill site, manned by figures in hazmat suits and surrounded by klieg lights, trailers, and pits of toxic wastewater, the derricks towering over barns, horses, and cows in their shadows.

read full article

The Ecologist
15th June, 2010

Research is the first attempt to quantify the higher cancer risk faced by men and women working in construction and doing shift work, but cancer charities say study is outdated?

Carcinogenic substances and demanding shift-work practices may be linked to more cancer fatalities in Britain than previously thought, according to new research.

While UK campaigns have traditionally focussed on higher profile cancer risks such as smoking and diet, a study published in the British Journal of Cancer, suggests that not enough is being done to prevent thousands of potential cases of workplace related cancer every year.

Construction and maintenance workers dealing with asbestos in fire proofing and old buildings and women working night shifts were most at risk, according to the findings.

Asbestos contributed to nearly half of the cancer deaths in the study, but other substances, such as silica found in construction, particles from diesel engine exhausts, and paints and mineral oils in painting and decorating work were all found to present a serious health risk.

Shift work risks

The study is the first attempt to quantify cases of cancer linked to occupation. It found that an estimated 8,019 cancer deaths were ‘attributable to occupation’ in 2005, approximately 5 per cent of the total cancer deaths in Britain.

The researchers also found that 54 per cent of women diagnosed with work related cancer, especially breast cancer, worked night shifts in sectors such as healthcare and aviation. Disturbance to our natural sleep patterns and fatigue problems are all associated with night shifts and may contribute to the higher cancer risk.

The study noted that in 2009 Danish courts began paying compensation to night shift workers who developed breast cancer, recognising it as an occupational disease.

The findings follow a report published by the US National Cancer Institute last month which said the cancer risk associated with environmental hazards, such as chemicals commonly found in the workplace, had been greatly underestimated.

Lead author Dr Lesley Rushton, of Imperial College London, said while carcinogen exposure levels have fallen over the years, more than one million people in the UK are still thought to be exposed to cancer-causing substances in their workplace.

The study pointed out the risk of low-level exposure and said that for many of the carcinogens a major contribution to the burden was made by a large number of workers exposed at ‘low levels and low risk’, for which our quantitative risk estimates are inevitably uncertain.

‘Our study has highlighted the fact that many workers may potentially be exposed to several carcinogens and that these may affect multiple cancer sites,’ said the study.

Study outdated

However, cancer charities say the study may be outdated as chemical exposure in the workplace would have been ‘considerably higher’ in the years from which the study drew its data in comparison to today’s levels.

Dr Joanna Owens, Cancer Research UK’s science information manager, also said the link between shift work and breast cancer was still uncertain.

‘When it comes to shift work and breast cancer, it’s still not known whether it can actually cause the disease, or whether shift workers are more prone to other things that increase their risk. Known breast cancer risks include lack of exercise, being overweight and drinking alcohol,’ she said.

read online

Useful links
Study in full: Occupation and cancer in Britain

MARILYNN MARCHIONE
AP Medical Writer

June 14, 2010

We fret about airport scanners, power lines, cell phones and even microwaves. It’s true that we get too much radiation. But it’s not from those sources ˜ it’s from too many medical tests.

Americans get the most medical radiation in the world, even more than folks in other rich countries. The U.S. accounts for half of the most advanced procedures that use radiation, and the average American’s dose has grown sixfold over the last couple of decades.

Too much radiation raises the risk of cancer. That risk is growing because people in everyday situations are getting imaging tests far too often. Like the New Hampshire teen who was about to get a CT scan to check for kidney stones until a radiologist, Dr. Steven Birnbaum, discovered he’d already had 14 of these powerful X-rays for previous episodes. Adding up the total dose, “I was horrified” at the cancer risk it posed, Birnbaum said.

After his own daughter, Molly, was given too many scans following a car accident, Birnbaum took action: He asked the two hospitals where he works to watch for any patients who had had 10 or more CT scans, or patients under 40 who had had five ˜ clearly dangerous amounts. They found 50 people over a three-year period, including a young woman with 31 abdominal scans.

When other radiologists tell him they’ve never found such a case, Birnbaum replies: “That tells me you haven’t looked.”

Of the many ways Americans are overtested and overtreated, imaging is one of the most common and insidious. CT scans ˜ “super X-rays” that give fast, extremely detailed images ˜ have soared in use over the last decade, often replacing tests that don’t require radiation, such as ultrasound and MRI, or magnetic resonance imaging.

Radiation is a hidden danger ˜ you don’t feel it when you get it, and any damage usually doesn’t show up for years. Taken individually, tests that use radiation pose little risk. Over time, though, the dose accumulates.

Doctors don’t keep track of radiation given their patients ˜ they order a test, not a dose. Except for mammograms, there are no federal rules on radiation dose. Children and young women, who are most vulnerable to radiation harm, sometimes get too much at busy imaging centers that don’t adjust doses for each patient’s size.

That may soon change. In interviews with The Associated Press, U.S. Food and Drug Administration officials described steps in the works, including possibly requiring device makers to print the radiation dose on each X-ray or other image so patients and doctors can see how much was given.

The FDA also is pushing industry and doctors to set standard doses for common tests such as CT scans.

“We are considering requirements and guidelines for record-keeping of dose and other technical parameters of the imaging exam,” said Sean Boyd, chief of the FDA’s diagnostic devices branch.

A near-term goal: developing a “radiation medical record” to track dose from cradle to grave.

“One of the ways we could improve care is if we had a running sort of Geiger counter” that a doctor checked before ordering a test, said Dr. Prashant Kaul of Duke University.

He led an eye-opening study that found that U.S. heart attack patients get the radiation equivalent of 850 chest X-rays over the first few days they are in the hospital ˜ much of it for repeat tests that may not have been needed.

How much radiation is risky?

It’s hard to say. The best guess is based on the 1986 Chernobyl nuclear power plant accident and studies of Japanese atomic bomb survivors who had excess cancer risk after exposures of 50 to 150 millisieverts (a measure of dose) of radiation.

A chest or abdominal CT scan involves 10 to 20 millisieverts, versus 0.01 to 0.1 for an ordinary chest X-ray, less than 1 for a mammogram, and as little as 0.005 for a dental X-ray. Natural radiation from the sun and soil accounts for about 2 millisieverts a year.

A big study last year estimated that 4 million Americans get more than 20 millisieverts a year from medical imaging. Two percent of people in the study had high exposure ˜ 20 to 50 millisieverts.

Another study by Columbia University researchers, published in 2007, estimated that in a few decades, as many as 2 percent of all cancers in the U.S. might be due to radiation from CT scans given now. Since previous studies suggest that a third of all tests are unnecessary, 20 million adults and more than 1 million children are needlessly being put at risk, they concluded.

Just because a scan didn’t find anything wrong doesn’t mean a test wasn’t needed. Scans are useful for many diagnoses. But many studies suggest people are getting too much imaging now. For example, Mayo Clinic researchers reviewed the medical records of 251 people given heart scans in 2007 and found that only a quarter of them were clearly appropriate.

Reasons for overuse:

˜Accuracy and ease of use. Scans have become a crutch for doctors afraid of using exams and judgment to make a diagnosis. Some think a picture tells more than it does. Imaging that shows arthritis in a knee or back problems doesn’t reveal how to make it better, said Dr. Richard Baron, a primary care doctor in Philadelphia.

“Physical therapy for an orthopedic injury is always the first choice,” yet doctors rush to order tests, he said. “The question you should be asking when you do sophisticated imaging is, ‘Is there something I can fix with an operation?’”

˜Malpractice fear. A missed heart attack or a burst appendix could be devastating for a patient ˜ and mean a lawsuit.

“I have great sympathy for the ER physicians because of the responsibility placed in their hands with strangers that come in off the street,” said Louis Wagner, chief physicist at the University of Texas in Houston. “They have to make a decision that could mean life or death for a patient, and the fastest way to find out is CT.”

˜Patient pressure. People urge doctors to “do something” to figure out what’s wrong, and “often, doctors feel that the way to demonstrate that they’re doing something is to order tests,” said Dr. Christopher Cassady, a radiologist at Texas Childrens Hospital and the American Academy of Pediatrics’ expert on this topic.

At his hospital, doctors first do an ultrasound on suspected appendicitis cases instead of rushing into a CT scan. Ultrasounds require no radiation.

˜Health care chaos. One doctor may not know that another has ordered the same test. If a patient is referred to a specialist, “it’s often easier for him to order another study than to figure out how to get the one that was done somewhere else,” Baron said.

˜Insurance issues. X-rays often are required by insurers to prove health, or for students to study abroad.

˜Availability. Rural hospitals may not have an ultrasound technologist on duty in the wee hours, but imaging machines are always there.

˜Treatment choice. A quick fix for chest pain ˜ artery-opening angioplasty ˜ requires far more imaging and radiation than bypass surgery does. The same is true of “virtual colonoscopy” instead of the standard version.

Which tests are overused? A scientific group, the International Commission on Radiological Protection, cites routine chest X-rays when people are admitted to a hospital or before surgery; imaging tests on car crash victims who don’t show signs of head or abdominal injuries; and low-back X-rays in older people with degenerative, but stable, spine conditions.

Even when tests are justified, they often include more views than needed and too much radiation. Top offender: chest CT scans looking for clogged arteries and heart problems. Cardiologists are increasingly aware of this risk and are seeking solutions.

At Columbia University, a study on dummies by Dr. Andrew Jeffrey Einstein found two dose-modifying techniques could lower the needed radiation dose by 90 percent without harming image quality.

Another cardiologist and radiation safety expert, Dr. Gilbert Raff, showed the same in real life. A study he led of nearly 5,000 patients at 15 imaging centers in Michigan found that radiation dose could be cut by two-thirds with no loss of quality.

What should patients do?

“You should question everything ˜ what’s the dose, why am I getting it? You should be an informed consumer,” said Dr. Fred Mettler, radiology chief in the New Mexico Veterans Administration health care system. He led a study of health effects after the Chernobyl accident and is a U.S. representative to the United Nations on radiation safety.

He advised challenging “big ticket” tests like CT scans that deliver a lot of radiation to the chest and abdomen ˜ places where cancer is likely to develop. “You shouldn’t get too excited about feet and knee X-rays,” Mettler said.

Questions to ask about radiation scans:

˜Is it truly needed? How will it change my care?

˜Have you or another doctor done this test on me before?

˜Are there alternatives like ultrasound or MRI?

˜How many scans will be done? Could one or two be enough?

˜Will the dose be adjusted for my gender, age and size? Will lead shields be used to keep radiation away from places it can do harm?

˜Do you have a financial stake in the machines that will be used?

˜Can I have a copy of the image and information on the dose?

Mettler suggests bringing a blank CD or thumb drive with you.

“You should have all of your stuff digitally on something,” he said. “I keep mine on my laptop.”

___

Online:

Consumer information: www.radiologyinfo.org