Disease Cluster and Hotspot Map
Click on a dot to see information about that cluster, or scroll down to find information about all these clusters, arranged alphabetically by state.
Material on this page was originally developed by the Trust for America’s Health and is reprinted here with permission. Ongoing updates are done by NDCA.
The Centers for Disease Control and Prevention (CDC) define a cluster investigation as, “a review of an unusual number, real or perceived, of health events (for example, reports of cancer) grouped together in time and location.” Cluster investigations seek to confirm cases of the disease; establish whether the reported cases represent an unusually high occurrence of the disease; and explore potential causes when possible.1
Sometimes “health events” are identified by surveillance efforts, but more often they are brought to light by concerned residents.2
The Disease Cluster and Hotspot Map above depicts areas that have been investigated by government agencies and/or by private entities, which may include academicians, science-based organizations, or independent epidemiologists, as well as areas in which residents have raised concerns about unexpectedly high rates of disease. Areas represented by red dots are areas that are being or have been formally investigated by government agencies. Areas represented by yellow dots are areas that are being or have been investigated by private entities. Areas represented by blue dots are areas in which residents have raised concerns about unexpectedly high rates of disease in their communities, but those concerns have not yet been investigated.
Map Glossary of Terms
Disease Cluster – An unusual aggregation, real or perceived, of health events that are grouped together in time and space and that are reported to a health agency.3 For the purposes of this map, an area which has been formally investigated by a public health agency.
Disease Hotspot – An area which is being or has been investigated by private entities, which may include academicians, science-based organizations, or independent epidemiologists, OR an area in which residents are raising concerns about unexpectedly high rates of disease.
1 Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry. Agency for Toxic Substances and Disease Registry Glossary of Terms. Retrieved August 12, 2004 from http://www.atsdr.cdc.gov/glossary.html#G-A-
2 Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report. (1990, July 27). Guidelines for Investigating Clusters of Health Events/ Retrieved August 12, 2004 from http://www.cdc.gov/mmwr/preview/mmwrhtml/00001797.htm.
3 Ibid. (Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report. (1990, July 27). Guidelines for Investigating Clusters of Health Events/ Retrieved August 12, 2004 from http://www.cdc.gov/mmwr/preview/mmwrhtml/00001797.htm.)
Anniston, Calhoun County, Alabama
Residents have reported cancerous, non-cancerous, thyroid, and neurodevelopmental effects that they believe may be linked to releases of various chemicals, including nerve gas, rat poison, and polychlorinated biphenyls (PCBs) since the 1970s from a nearby chemical manufacturing company. In addition to the releases of chemicals in landfills, a stream, and drainage ditches, soil collected in 1999 also tested positive for extremely high lead levels. A health consultation by the Agency for Toxic Substances and Disease Registry (ATSDR) released in July 2003, concluded that: “(a) exposures to PCBs in some residential soils present a public health hazard; (b) 500 of the 2,712 persons tested had elevated blood PCB levels; (c) exposures to PCBs in the air are an indeterminate public health hazard; and (d) further sampling and evaluation were needed to assess fully the scope of environmental contamination and to determine the important exposure pathways. Biomonitoring in these residents may have picked up unhealthy levels of toxicants long ago and could have diminished the magnitude of the health crisis in the years since.
US EPA Anniston Website
Eastern Shore of Mobile Bay, Baldwin County
A 2008 Alabama Department of Public Health study concluded that Baldwin County experienced a childhood cancer cluster from 2000 through 2004, as well as elevated levels of leukemia, lymphoma, bladder, kidney and ovarian cancer in recent years. The state public health agency expected 4.0 cases of leukemia per year for this population of children under the age of 20 years and observed 6.8 cases per year in this period. Alabama state health officials interviewed 56 of 90 people with rare cancers in Baldwin County before dropping the study in 2008,citing their own inability to perform the assessment and arguing that most of the rare cancers that had been elevated were no longer “statistically significant.” The only cancer statistical trend found to be worth consideration was for bladder cancer. From 2001 through 2005, the incidence rate for bladder cancer among Baldwin County residents was 18 percent higher than the rest of Alabama, the state acknowledged. A final report on the state’s incomplete findings, which was promised in 2008, has not yet materialized. Nevertheless, community members continue to gather rare cancer data as well as information about neurological diseases not reported to any disease registry. Community members believe the local prevalence of Amyotrophic Lateral Sclerosis (Lou Gehrig’s disease) is at least five times higher than the national average. Independent researchers from the University of Arizona are analyzing tree core samples from the area and community members continue to work towards forming partnerships with university scientists for environmental research.
Maryvale, Maricopa County, Arizona
Residents of Maricopa County worried about environmentally related health problems in their community after a documented pediatric leukemia outbreak in the late 1980′s. According to a Phoenix Times report in 1993, from 1965 to 1986, children in that west Phoenix community died of leukemia twice as often as children in other parts of the country. However, a Public Health Assessment from the Agency for Toxic Substances and Disease Registry released in 2000 documented that, “there also was no statistically elevated incidence of total cancers or leukemia for ages zero to 19 years in the Goodyear area when compared to the same age group nationwide during 1965 to 1986.” This same report concludes, with respect to more current health concerns in the area, that “the Arizona Department of Health Services found no apparent public health hazard existed as a result of ingestion, dermal, or inhalation exposures by residents to the contaminated groundwater at the Phoenix Goodyear Airport North site given the current data.”
Sierra Vista, Cochise County, Arizona
Sierra Vista currently has three times the incidence of childhood leukemia expected in a town its size. Out of a total populatiohttp://www.atsdr.cdc.gov/HAC/PHA/litchfield/laan of about 40,000, 12 children have been diagnosed; two have died. After vigorous lobbying by Cochise County and Representative Jim Kolbe, the Centers for Disease Control and Prevention announced in 2004 that it would collect biological samples in Sierra Vista. The testing has yet to begin, and analysis of the samples will take up to two years. Residents are concerned about this rate of cancer, and wonder whether it might be linked to the fact that the town is home to two military bases. A jet fuel pipeline runs under the town as well. Biomonitoring would help find a common agent, if any, that may be contributing to the cancer among these residents.
Prairie Grove, Washington County, Arkansas
In October 2001, the Arkansas Department of Health began investigating a potential cluster of testicular cancer in Prairie Grove. From 1997 to 2001, five cases of the cancer had been diagnosed, which is about five times the national rate. The results of the study were released in 2002, which concluded that children were not being exposed to soil contaminants from their elementary school at levels that could cause adverse health effects. Fifty families have hired their own attorneys because they believe the cancers may be related to environmental factors. The town lies near a now-closed nuclear reactor, a low-level radioactive landfill, and a poultry plant.
Daly City, San Mateo County, California
Residents of a housing project worry that the contaminated soil upon which their building was constructed may be the cause of genetic defects and various illnesses being reported. In 1990, state officials and San Mateo County first notified residents that the ground beneath Midway Village was laden with toxic polynuclear aromatic hydrocarbons, known as PNAs, which have been linked to cancer and other maladies. The housing project is also located next to a former Superfund site, the PG&E Martin Service Center. Without adequate tracking of these substances and human health, it is difficult to determine whether the environment is linked to these illnesses.
Lassen County, California
Residents downwind of a local weapons depot suspected that the high cancer rates in their community might be linked to the depot’s open burning and detonation of munitions. While the depot’s operations ceased in 2001, munitions burning had occurred for 50 years at the depot and no one knew if the smoke was harmful to human health. In 2000, a Nevada senator petitioned the Centers for Disease Control and Prevention to evaluate the public health implications of potential exposures to air contamination from the Sierra Army Depot (SIAD). The health consultation, released by the Agency for Toxic Substances and Disease Registry (ATSDR) in November 2003, concluded that inhalation exposures were not an apparent public health hazard and recommended that if waste treatment operations resumed at Sierra Army Depot, the Army should conduct routine air sampling in at least one residential location downwind from the installation. Further, ATSDR concluded that the descriptive cancer registry did not suggest evidence of excess cancers based on the cancer types analyzed for census tracts surrounding SIAD. However, the exception to this finding was a slight excess of leukemias (all types combined) in the Susanville area for the period 1988 through 1997. This is a case where biomonitoring would help determine whether the smoke is adversely affecting human health. (http://www.atsdr.cdc.gov/HAC/PHA/sierraarmy/sad_p1.html) (http://www.atsdr.cdc.gov/HAC/PHA/sierraarmy/sad_p2.html#conc)
Simi Valley, Ventura County, California
Former employees of the Rocketdyne Laboratory and their families have been stricken with various cancers at higher than normal rates. In February 2004, the Los Angeles Times reported that experts had testified that 120 area residents (the plaintiffs in a six year lawsuit) were exposed by inhalation to a number of hazardous substances, including hexavalent chromium, radionuclides, trichloroethylene and a “toxic chemical cloud containing multiple human carcinogens” that caused at least 83 plaintiffs to contract cancer. The experts concluded that the plaintiffs’ exposure to hazardous substances released from Rocketdyne’s facilities “in reasonable medical probability, was a substantial factor in contributing to the risk of developing their injuries or cancer.” These results confirm a study by the state health department in 1991 that detected an elevated rate of bladder cancers in areas within five miles of the Rocketdyne facility.
California Department of Health Services Study
Hamden, New Haven County, Connecticut
In 2001, a Connecticut Department of Health investigation was initiated over concerns about a cancer cluster at Hamden Middle School. The school was built upon a former landfill, and while it is currently considered safe, tests had shown trace levels of lead, methane, and polycyclic aromatic hydrocarbons (PAHs) in the soil beneath the school. The study concluded that any exposures that may have occurred were not great enough to have caused health effects. If the U.S. had a Nationwide Health Tracking Network, cases of disease could be investigated and measures to prevent future cases established.
North Haven, New Haven County, Connecticut
Researchers have doubled the scope of their investigation into brain cancer cases at a jet-engine manufacturing company and are requesting another two years and an additional $4 million to complete the work. This study was prompted by the deaths of at least several dozen workers from the same rare, very fast-growing form of brain cancer. The study initially had been expected to look at the medical and work records of about 100,000 current and former workers. But that number increased to 200,000 during routine searches of company records, said a biostatistician at the University of Pittsburgh who is conducting a portion of the research. The due-date for the study is 2008, but researchers now want to push back the completion deadline to 2010.
Escambia and Santa Rosa Counties, Florida
In February 2001, The Pensacola News Journal reported that rates for several kinds of cancer, rates for birth defects, and rates for low birth weight babies were all elevated in Escabmia and Santa Rosa counties as compared with national rates. The article reported that federal regulators suspect arsenic, dioxin, lead, mercury and other substances from contaminated Superfund sites and manufacturing plants, Escambia Treating and Agrico, are to blame. Without adequate tracking of these substances and human health, it is difficult to determine whether the environment is linked to these elevated cancer rates.
The Acreage, Palm Beach County, Florida
This rural town in Loxahatchee Florida near West Palm Beach has had 13 cases of pediatric brain tumors and cancers in children and teenagers from 1993 to 2008, with an elevated rate primarily in girls. Florida Department of Health staff investigated and determined there was a statistically significant increase in the brain cancer rates for children in this area as compared to children in other parts of Florida. There is no known cause yet. Pratt & Whitney has been named in one lawsuit as a possible liable source of environmental contaminants. As in many communities facing elevated rates of disease or higher exposure to disease causing contaminants, there is considerable concern about property values in this area.
Researchers at the Nemours Center for Childhood Cancer Research and the University of West Florida concluded that, from 2000 to 2007, portions of South Florida had a statistically significant 36 percent higher risk of childhood cancer compared with the rest of the state. South Florida children, the study says, are twice as likely to develop brain or central nervous system cancer. (Epidemiologic mapping of Florida childhood cancer clusters.Amin R, Bonhert A, Holmes L, Rajasekaran A, Assanasen C.Pediatr Blood Cancer 2010;54:511–518)
Port St. Lucie, St. Lucie County, Florida
Between 1981 and 1997, 30 children in St. Lucie County and 12 in Martin County were diagnosed with rare brain and nerve-cell cancers. St Lucie County Health Department, along with the Florida Department of Health, Centers for Disease Control and Prevention, Agency for Toxic Substances & Disease Registry and several other national agencies, began an epidemiological study in 1998 which was ongoing as of July 2004. The agencies have been unable to uncover what might be causing this high number of childhood cancers. This case highlights the necessity of collecting comprehensive exposure data in humans.
Moreland, Bingham County, Idaho
In November 1993, a concerned resident of Bingham County reported a potential brain cancer cluster to the Idaho Division of Health, focusing on a one-mile radius circle surrounding an abandoned dump site in Moreland. The Idaho Division of Health evaluated people in 6 southeastern counties, including Moreland, and found a high rate of cancer in the most recent data. Biomonitoring in residents around the landfill could have helped determine what contaminants residents have been exposed to.
Nez Perce County, Idaho
Nez Perce County has one of the highest lung cancer rates in the state and rates of bronchial, female kidney, and prostate cancers are all above the state average. In fact, the Cancer Data Registry of Idaho reported in 2003, that statistically there were significantly more cases of cancer in Nez Perce County than expected, based upon rates in the rest of the state. Similarly, the Agency for Toxic Substances and Disease Registry’s (ATSDR) 2003 Health Consultation reported that data analysis indicates more total cancer cases (12%) than expected for this area compared to the remainder of Idaho. While the Idaho Division of Health had previously determined that the Potlatch pulp mill was a hazardous waste site of potential public health concern, due to the release of chloroform into the air, the 2003 ATSDR report concluded that it was not possible to determine if past exposure to chloroform was associated with the increased cancer incidence.
Fact Sheet from Cancer Data Registry of Idaho
Shoshone County, Idaho
Shoshone County residents report higher than normal rates of certain cancers. In fact, a Cascadia Times article in November 2000, reported that, “Shoshone County ranks first in Idaho for cancers associated with arsenic poisoning, including cancers of the bladder, kidney, colon and larynx.” The Agency for Toxic Substances and Disease Registry completed a study in the county in 2000, which documented that the toxic wastes at the Bunker Hill Mining And Metallurgical site were a current public health hazard and that people living in the vicinity of the Bunker Hill site were exposed to metals that can produce adverse health effects in the long term.
Cascadia Times News Article: Out of the Earth, Into Our Lungs EPA Health Consultation: Note: ATSDR State Facts Sheet refers to consultations for Shoshone-Bannock Indian Tribe but this tribe lives in Southeast Idaho (CARIBOU COUNTY) near the Southeast Idaho Phosphate Resource Area (SEIPRA)
Chicago, Cook County, Illinois
In the summer of 2000, residents in the Chicago area reported the presence of mercury in their homes. A gas company had been replacing old, indoor mercury regulators with new, outdoor regulators and found that during the replacement process, mercury had been spilled in some of the homes. According to an Agency for Toxic Substances and Disease Registry report in 2001, over 200,000 homes might have been at risk for up to 11 years. Currently, more than 200,000 homes have been inspected, and mercury has been found in more than 1,000 of these homes. If a system had been established for tracking health and environmental exposures, the duration of exposure and the number of people affected by this incident could have been drastically reduced.
Christian County, Illinois
In the mid-to-late 1980′s, seven children were diagnosed with neuroblastoma, a rare nervous system cancer, in Taylorville, Illinois, when only one case would have been expected. In a Summer 2000 report, the Ilionois Deparment of Public Health labeled these cases a cancer cluster. Officials noted that coal tar released during the cleanup at a nearby utility plant might have played a role. Certain residents filed a lawsuit which, after six years, was settled in favor of the plaintiffs against the utility plant. Without adequate tracking of these substances and human health, it is difficult to determine whether the environment is linked to these elevated cancer rates.
Illinois Department of Public Health Report – this is a report-didn’t find website
DuPage County, Illinois
In Spring 2001, the Illinois Environmental Protection Agency (Illinois EPA) requested that the Illinois Department of Public Health (IDPH) evaluate residential well water for contaminants in Downers Grove, Illinois. The IDPH study, released in March 2003, concluded that about 200 wells contained trichloroethylene (TCE) and tetrachloroethylene (PCE) at levels greater than the USEPA drinking water standard of 5 µg/L for each chemical. The IDPH determined, therefore, that exposure to contaminated groundwater in Downers Grove was a public health hazard. IDPH also concluded that while long-term exposure to contaminated well water could pose a very low increased cancer risk, no health studies were available definitively associating an adverse health effect in animals or humans exposed to the levels of TCE and PCE observed in Downers Grove.
Naperville, DuPage County, Illinois
In August 1999, CNN reported that a three-year investigation found that occupational hazards may have contributed to the development of brain tumors in as many as 19 employees at a BP Amoco Corp. research facility in Naperville, Illinois. But BP Amoco said that the study — conducted by investigators from the University of Alabama at Birmingham and Johns Hopkins University — could not identify a specific cause of the cancer. The study found that two agents commonly used in experiments — ionizing radiation and n-hexane — may have contributed to six cases of glioma, an often deadly form of brain cancer. Five of those six scientists had died at the time the study was released. This cluster highlights the necessity of collecting comprehensive exposure data in humans.
Hammond, Lake County, Indiana
A parents’ group called IRATE, Illiana [Illinois-Indiana] Residents Against Toxiocarcinogenic Emissions, was concerned that more than 30 children with various types of cancer had been found in a 31-mile radius around a local chemical company. IRATE worried that the pediatric cancers may have been caused by the release of 1,2-dichloroethane (ethylene dichloride, or EDC) and vinyl chloride (VC) from the plant during the Pyro-Chek manufacturing process. A public health assessment by the Agency for Toxic Substances and Disease Registry, released in June 2001, concluded that contaminants detected in samples from an air monitoring station 1.5 miles from the site were not at levels of health concern and that the site was not a public health hazard. Indiana State Department of Health concurrently released its findings in a health consultation and concluded that rates of childhood cancer were not elevated for Lake County or for the community surrounding the Keil Chemical Company. This cluster highlights the necessity of collecting comprehensive exposure data in humans.
Middletown, Des Moines County, Iowa
In 2002, Hawk Eye News reported a study of cancer among former Iowa Army Ammunition Plant (IAAP) workers that showed a pattern of lung and some other cancers several times higher than that found in the rest of the state. In addition, patterns for some forms of cancer, including cancer of the liver, mouth and eye areas, are higher among some residents of Middletown and West Burlington, excluding IAAP workers, than they are for the rest of the state, according to a study by the State Health Registry of Iowa. By contrast, a Health Consultation by the Agency for Toxic Substances and Disease Registry released in January 2004, found that the environmental releases of beryllium and depleted uranium (DU) from the plant and from the Burlington Atomic Energy Commission Plant in Burlington, Iowa were not at levels that would result in adverse human health effects to facility residents or to those living nearby. Tracking of environmental releases and use of preventive measures could have protected both employees’ and residents’ health.
EPA Website Report –report –didn’t find website
Paducah, McCracken County, Kentucky
Hundreds of former employees at a gaseous diffusion plant were exposed to unsafe levels of radiation, some of whom got cancer. According to a Department of Energy report in 2000, employees previously worked in dangerous conditions often without protective equipment or proper training. Indeed, CNN reported that employees told the House Commerce oversight and investigation subcommittee that for years managers withheld from them information that they were being exposed to plutonium, telling them the uranium powder that contained traces of the dangerous metal was “safe enough to eat.” The subcommittee was examining allegations of widespread health, safety and environmental violations at the plant. Tracking of environmental releases and use of preventive measures could have protected employees’ health from cancer-causing radiation.
Mossville, Calcasieu Parish, Louisiana
Calcasieu Parish is the site of a large number of companies that produce petroleum-based chemicals, chlorinated hydrocarbon solvents, and other organic chemicals. In 1998, the Enviromental Protection Agency asked the Agency for Toxic Substances and Disease Registry (ATSDR) to review the results of blood tests for several residents of Calcasieu Parish. After 28 residents were found with elevated levels of dioxin in their blood, which can cause a number of adverse health effects, ATSDR expanded its exposure investigation. The two follow-up ATSDR studies concluded that: blood dioxin levels between people who live in the Calcasieu Parish and Lafayette Parish, which is the comparison group, are similar; no difference in blood dioxin levels exists in people who live close to or far from industry; and most of the people tested have blood dioxin levels similar to those in ATSDR’s comparison group. A nationwide health tracking network would provide such data.
Vermilion Parish, Louisiana
Residents in Vermilion Parish are concerned that the high level of arsenic in their drinking water could be causing the large number of cancer cases in their community. Some residents said that they sent water to be tested and the arsenic measured between 70 and 100 parts per billion, above the Environmental Protection Agency’s allowable 50 parts per billion. Volunteers are going door-to-door to find out exactly how many people in the community have been diagnosed with cancer. For instance, more than half the residents that live on Daby Road have been diagnosed with cancer over the last 5 years. Biomonitoring in these residents could help determine whether pollutants in the drinking water are a contributing factor in these cancers.
Fairfield Center, Somerset County, Maine
Residents of Fairfield, Maine petitioned the Agency for Toxic Substances and Disease Registry (ATSDR) regarding concerns of potential exposure to contaminants from the Central Maine Disposal Landfill (CMD) and an increased incidence of brain cancer within their community. In 2000, the Maine Bureau of Health requested that ATSDR conduct a health assessment of the CMD Landfill. The study concluded that, according to past and current sampling data reviewed, the landfill does not pose a public health hazard. No adverse health effects would be expected to result from people drinking water from private wells that were sampled. A system that tracks environmental exposures and health effects could have helped to identify what is causing these cancers.
Frederick, Frederick County, Maryland
Community members in Frederick have been very concerned about cancer rates, especially around Fort Detrick. Maryland Cancer Registry data show that the number of all cases of cancer observed in the 3 census tracts near Fort Detrick was statistically greater than the number expected based upon the Maryland rate for all cancers. The state cancer registry shows that Frederick County has the highest cancer rates in the state of Maryland, at 525 cancers per 100,000 people as compared to the statewide average of 461 cancers per 100,000 people. Fort Detrick is on the National Priority List (Superfund). The U.S. Army tested Agent Orange at Fort Detrick between 1944 and 1963. Tetrachloroethene (PCE) and trichloroethene (TCE) have been detected in off-site wells.
Frederick County Health Department Cluster Investigation Status
Cape Cod, Barnstable County, Massachusetts
In 1993, Cape Cod was first identified as having elevated breast cancer rates by the Massachusetts Department of Public Health. Further study found that breast cancer incidence was about 20% higher on Cape Cod than in the rest of Massachusetts, for 1982-1994. A state study of all cancers on the Cape, from 1986-1994, indicated that cancer rates were elevated for prostate, breast, and for melanoma. Currently, Silent Spring Institute is investigating exposures to pollutants over the past 40 years using a geographic information system (GIS), environmental and biological sampling, and interviews with 2,100 women.
A 2007 Massachusetts Department of Public Health study found 7 cases of Ewing’s sarcoma diagnosed in children between the ages of 0-19 in the years 1995-2004, whereas only two cases would have been expected in a population of this size. Residents have concerns about emissions from PAVE PAWS radar facility, though this study concluded that it is unlikely that PAVE PAWS played a primary role in the incidence of Ewing’s sarcoma on Cape Cod. Residents believe the cluster is growing, with several new cases, and they would like to see a more comprehensive health study.
Massachusetts Department of Public Health
Middleborough and Weymouth, Massachusetts
Residents suspect that a cluster of amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease) and Multiple Sclerosis (MS) may be linked to toxic waste from local industries. Middleborough, has metal plating and organic solvent wastewater sites, as well as agricultural activities that use pesticides and herbicides. Weymouth surrounds the South Weymouth Naval Air Station Superfund site; heavy metals, solvents, and pesticides are the contaminants of concern for this community. State health officials are currently identifying cases of ALS and MS, which will then be mapped out to determine whether there are clusters near hazardous waste sites. The study is expected to be completed by fiscal year 2005. Without adequate tracking of these substances and human health, it is difficult to determine whether the environment is linked to these elevated disease rates.
Saugus, Essex County, Massachusetts
Residents in the Central Street neighborhood of Saugus, MA are concerned about the four cases of multiple myeloma (a rare blood cancer) that have been diagnosed there. One of the four people died in 2000. There were eight cases of the cancer between 1993 and 1997 in Saugus, slightly higher than what would be expected. Scientists do not know yet what causes the disease, but some research suggests that exposure to certain chemicals or pollutants may increase the risk of getting multiple myeloma. Residents wonder if pollution from an old chemical plant may be the cause. The Department of Public Health planned to investigate as of 2001. Without adequate tracking of human health and potentially related environmental hazards, it is difficult to determine whether the environment is linked to elevated disease rates.
Scituate, Plymouth County, Massachusetts
Residents suspected a cancer cluster in the Third Cliff neighborhood of Scituate, Massachusetts and were concerned about the quality of their drinking water. Residents requested that the Massachusetts Department of Public Health (MDPH) conduct an investigation. In August 2001, a report released by MDPH and the Agency for Toxic Substances and Diseae Registry evaluated residents’ concerns with respect to five types of cancer (leukemia, breast, kidney, testes, and liver). The report concluded that cancer incidence from 1987-1997 was no greater than expected, though rates of breast cancer and leukemia did occur in greater than expected numbers. The final conclusion was that the municipal water supply in Scituate posed an Indeterminate Public Health Hazard for the past and future, but presently posed No Public Health Hazard. A nationwide health tracking network would be valuable in helping to provide such data.
South Boston Neighborhood, Suffolk County, Massachusetts
An unexpectedly high number of cases of scleroderma and lupus have been diagnosed in residents of South Boston. Residents wonder if environmental contaminants such as hazardous waste, leaking oil or jet fuel exhaust from the airport can be linked to their autoimmune diseases. The Massachusetts Department of Public Health is currently investigating. Without adequate tracking of these substances and human health, it is difficult to determine whether the environment is linked to these elevated disease rates.
Great Lakes Region, Michigan
There have been efforts for the last thirty years to monitor the health of humans and animals living in the Great Lakes region. Fish advisories have been issued periodically warning residents about polychlorinated biphenyls (PCBs), mercury, pesticides and other chemicals in the lakes that are associated with cancer, birth defects and learning disabilities. In 2004, President Bush signed an Executive Order creating the Great Lakes Interagency Task Force. Under the Environmental Protection Agency’s leadership, the Task Force brings together ten Agency and Cabinet officers to work on restoring the great Lakes. In addition, the President directed the creation of a regional collaborative process.
Midland, Saginaw, and Bay Counties, Michigan
Disease: Breast Cancer
Cluster status: confirmed
Researchers found a cluster of breast cancer in Midland, Saginaw, and Bay counties between 1985 and 2002. High levels of dioxins and other contaminants in soil and higher-than average body burdens of dioxins in local residents, particularly those who lived in the region prior to 1980, have also been found in the city of Midland and the Tittabawassee and Saginaw River flood plains in Michigan. A 2008 study found increased breast cancer incidence was spatially associated with dioxin contamination. Researchers believed that the source of dioxins in the river came from industrial processes at the Dow Chemical Company Midland plant.
“Spatial Variations in the Incidence of Breast Cancer and Potential Risks Associated With Soil Dioxin Contamination in Midland, Saginaw, and Bay Counties, Michigan, USA”. Dajun Dai and T.J. Oyana, Environmental Health 2008, 7:49.
White Lake, Muskegon County, Michigan
Cluster status: Unconfirmed, under investigation
In Muskegon County, White Lake was listed as an area of concern in 2008 by the Agency for Toxic Substances and Disease Registry. Four hazardous waste sites were identified in the area, and each was categorized as an “Indeterminate Public Health Hazard.”
Concerned residents and Muskegon County Health Department officials are conducting a study of residential and occupational history in people with cancer in the White Lake area. Companies such as Hooker/Occidental Chemical, DuPont and the Whitehall Leather tannery have previously contaminated White Lake with heavy metals and volatile organic compounds.
“Cancer Crisis? Muskegon County Group Seeks Answers in White Lake”, by John Hausman, Muskegon Chronicle, Sept. 10, 2010,
ATSDR Studies on Chemical Releases in the Great Lakes Region”. Agency for Toxic Substances and Disease Registry
Local advocacy group:
Cancer in White Lake
Minneapolis, Hennepin County, Minnesota
Workers at a manufacturing plant for asbestos products were exposed to levels of asbestos in excess of current occupational standards for much of the time the plant was in operation (from 1936 to 1989), and cases of asbestos-related disease have been reported in former workers. Approximately 260 properties around the former plant have been identified as contaminated with asbestos-containing wastes from the site. The Environmental Protection Agency has since removed asbestos-contaminated soil from these properties and adjoining alleys. Low levels of asbestos have been detected in some air samples collected around the site. The Agency for Toxic Substances and Disease Registry released a health consultation in 2003 and concluded that past exposure to asbestos is a public health hazard for workers in the plant, children who played on the piles of waste materials or vermiculite, and residents who lived near the site. Had a tracking network been in place to monitor environmental exposures in these employees, this tragedy may have been avoided.
Jackson County, Mississippi
Numerous residents were exposed to the pesticide, methyl parathion, after a pest-control operator illegally sprayed indoors. In November 1996, residents had to be temporarily relocated and nearly 500 homes and businesses had to be decontaminated. While no one died or was seriously injured in the short term, many of the early victims were misdiagnosed with the influenza virus — a fact that only underscores the need for a nationwide health tracking network to monitor environmental threats.
Herculaneum, Jefferson County, Missouri
Children have excessively high blood lead levels in Herculaneum. Residents are concerned that the lead comes from a nearby lead smelter not complying with federal air pollution standards. The smelter has been in operation for more than 100 years, and screening conducted by the Missouri Department of Health and Senior Services (MDHSS) and the Agency for Toxic Substances and Disease Registry (ATSDR) in 2002 determined that 28% of children in the area had elevated blood-lead levels. This represents an urgent public health hazard. In March 2003, MDHSS, in cooperation with ATSDR, presented preliminary results of all known blood-lead data collected from Herculaneum residents in 2002 to the Herculaneum Community Advisory Group. A health consultation released in August 2003, further evaluated those data and compared them to the 2001 blood-lead data. The blood lead data reviewed indicate that exposures have occurred, are occurring, and are likely to occur in the future and that these exposures may have an adverse impact on human health.
Sugar Creek, Jackson County, Missouri
Residents of Sugar Creek, a small community near Kansas City that is adjacent to an Amoco oil refinery, have indicated their concern about the rate of multiple sclerosis (MS) in their community. Anecdotal information suggested a twofold to fourfold elevation in MS prevalence above the U.S. figures. The Jackson County Health Department entered into a cooperative agreement with the Agency for Toxic Substances and Diseaes Registry in September 2000, to more fully explore MS prevalence in the area. This research activity includes the development of methods for case ascertainment and case confirmation and the estimation of MS prevalence for Sugar Creek and the surrounding community of Independence. If MS had been tracked, health officials would have known when cases first started appearing and started investigating.
Libby, Lincoln County, Montana
Countless deaths and illnesses have occurred in mine workers and their families as a result of asbestos exposure from the nearby vermiculite mine. The Agency for Toxic Substances and Disease Registry prepared a mortality review, in cooperation with the Montana Department of Public Health and Human Services, to develop accurate information about deaths potentially associated with asbestos exposure in Libby. The report concluded that, when compared to Montana and U.S. mortality data, there was a 20 percent to 40 percent increase in malignant and nonmalignant respiratory deaths in Libby from 1979 to 1998. Tracking of asbestos-related illnesses might have caught this much sooner and allowed preventive measures to be established.
Fallon, Churchill County, Nevada
Sixteen children have been diagnosed in Fallon with leukemia since 1997. Three have died; two relapsed in the summer of 2004. An investigation by the Centers for Disease Control and Prevention concluded in 2003 that there are no links between environmental contaminants and the leukemia cases in Fallon. However, biomonitoring tests conducted by CDC found residents in Fallon had elevated levels of arsenic and tungsten in their urine. Arsenic is a known carcinogen, but has not been linked to leukemia. Little is know about the health effects of tungsten–it is currently being studied by the National Toxicology Program. A tracking network that collects data on environmental exposures and health effects could have helped discover the cluster earlier and aided health officials in their investigation.
Reno, Washoe County, Nevada
Seven current and former employees at Traner Middle School have been diagnosed with cancer since November 2000. The school has 25 teachers and staff. Officials were concerned that the cancers might be related to asbestos or radon in the school. The state conducted an epidemiological investigation and concluded that there were not elevated rates of cancer in the school. Biomonitoring would help find a common agent, if any, that may be contributing to the cancer among these people.
Farmington, Strafford County, New Hampshire
Residents living in a mobile home park next to an industrial waste site worry that chemicals dumped at the site may be associated with birth defects and cancer in their community. A public health assessment was performed in 2001 by the Agency for Toxic Substances and Disease Registry and the New Hampshire Deparment of Health and Human Services, and the site was deemed a past public health hazard due to groundwater contamination. In 2002, residents filed a law suit against the former owners of the waste site and the owners of the mobile home park, charging that the company did little to stop the migration of the contaminants and did not warn residents of their exposure. Mercury, known to cause birth defects and developmental disabilities, has been identified as one of the chemicals at the waste site.
Brick Township, Ocean County, New Jersey
In February 1998, the Agency for Toxic Substances and Disease Registry (ATSDR) and the Centers for Disease Control and Prevention (CDC) were contacted by a local parents group, U.S. Senator Robert Torricelli, and U.S. Representative Christopher Smith with a request to investigate concerns about a possible excess of children with autism and other developmental disorders in Brick Township, New Jersey. They also asked that ATSDR assess whether community members may have been exposed to hazardous chemicals in the environment. The study was completed, and while the prevalence of autism in Brick is high relative to previously published studies in other countries, it is difficult to determine if the Brick cases constitute a “cluster” since the true rate of autism is not known. The study also concluded that these cases were not linked to a local landfill, the local river, or the drinking water. By tracking autism and other developmental disabilities via a nationwide health tracking network, this baseline data can become available.
Toms River, Ocean County, New Jersey
Health officials have confirmed that they have found a link between exposure to certain water and air pollution and childhood leukemia in the town. In the 2003 New Jersey Department of Health Report on Cancer Incidence, excess childhood cancer incidence over the years 1979 to 1995 was reconfirmed in Dover Township for all cancers combined and leukemia, and in Toms River for all cancers combined, brain and CNS cancer and leukemia. In Toms River this incidence was almost exclusively in children under age five. For Toms River in the 1996-2000 period of study, the small number of cancer cases indicates that the rate might be declining. Tracking of environmental exposures could have caught the cluster much sooner and allowed preventive measures to be established.
Albuquerque and San Jose, San Miguel County, New Mexico
Private wells supplying drinking water to the community of San Jose were contaminated by organic solvents from a nearby Superfund site, according to a 1995 fedeal health study. The wells were decommissioned and a new municipal water well was built. Still, the community has concerns about rates of cancer among residents. Of note is the fact that the San Jose area is home to three different Superfund sites, numerous Brownfields sites, and 36 polluting industries.
Organ, Dona Ana County, New Mexico
Soil and dust in and around homes near a now-inactive silver mine have been found to contain levels of lead and arsenic high enough to be considered a public health concern by the Agency for Toxic Substances and Disease Registry. One clean up was completed, but county officials have formally requested that the Environmental Protection Agency (EPA) take further steps to remediate the area given concerns about local health. This formal request of EPA was sent in 1991, but the county has received no response to their request.
Buffalo, Erie County, New York
Residents in the Hickory Woods subdivision suspect that the illnesses they suffer may be linked to the contaminated land upon which their neighborhood was built. Hickory Woods was built on top of soil that contains waste from a nearby former steel and coke plant. The New York Department of Health and the Agency for Toxic Substances and Disease Registry conducted two studies in 2000 and 2001, one sampling the soil of the subdivision and the second taking an exposure survey of residents’ health. The soil study confirmed higher than usual background levels of contaminants but not exceeding public health hazard levels; the exposure survey results suggested that more thyroid conditions might exist among Hickory Woods residents than among the general U.S. population. Based on the predisposing conditions of those with thyroid disease, the state determined that no further investigation was warranted. This is a situation where the public’s right to know about health risks from their community environment was not considered.
Elmira, Chemung County, New York
In August 2000, state health officials began investigating a high incidence of cancers in current and former students of Southside High School in Elmira, NY. The school was built on land that was once occupied by various industries. In fact, petroleum tanks have been found buried on school grounds. The study found no excess of cancer among students at the high school; however, an excess of testicular cancer was diagnosed between 1997 and 2000 among males 15-19 years of age living in the area served by the school. A follow-up study was released in 2001 and again in 2003, which found no excesses of any type of cancer in the area. Community residents are still concerned about chemical exposures.
Hillcrest, Broome County, New York
Six children under the age of 14, living within blocks of each other, were diagnosed with various cancers from 1980-1988. Hillcrest residents raised concerns with county health officials, and a study of childhood cancer incidence was conducted by the New York State Department of Health. This detailed review of the cancer cases was released in 1999, but no explanation was found for the unusual pattern of the cancers. However, the investigation did report that the cancers could not have occurred due to chance alone. This same area came under state investigation again in 2003, when trichloroethylene vapors, TCE, were found in soil gas samples. TCE has been linked to cancer. The state will investigate whether vapors from the soil have entered the air in residents’ homes.
Long Island, New York
The Long Island Breast Cancer Study Project, a joint effort by the National Institutes of Health, state and local health officials, and the Columbia School of Public Health, was initiated in 1993 when residents raised concerns about the high rates of breast cancer in their community. The major findings of the study were reported in 2002, and showed no increases in the rates of illness among area women who might have been exposed to organochlorine pesticide compounds. However, researchers said that it is possible that breast cancer risk in some individuals may be associated with organochlorine exposures because of individual differences in metabolism and ability to repair DNA damage, and they are continuing to investigate these possibilities. The researchers also found that exposure to one type of organochlorine, polycyclic aromatic hydrocarbons (PAHs), was associated with a modest increased risk for breast cancer.
Staten Island, Richmond County, New York
The Fresh Kills Landfill was one of the largest municipal landfills operating in the nation from 1948-2001, and was investigated by federal health officials numerous times. Residents near the site have complained of respiratory illnesses, reproductive difficulties, and elevated cancer rates. Health officials reported consistent results from their various exposure studies; contaminants in groundwater, soil, and fish posed no health hazard to residents while contaminants released into the air may have posed a past public health hazard, but do so no longer.
Tonawanda, Erie County, New York
Cancer cases around a former uranium processing plant where radioactive waste was dumped are being investigated to determine whether they can be labeled as a cluster. Residents fear that exposure to radiation, carried either through the air or soaked into groundwater, may be linked to their illnesses. The New York State Department of Health confirmed in December 2001, what many had feared for a long time: there are unusually high cancer rates in this post-World War II working-class community surrounded by industrial properties. Specifically, the study found cancer rates about 10 percent higher than expected in neighborhoods near the Linde/Praxair site. Even more telling were the results of the health studies on workers in this plant. A 1987 study, done in response to legal pressure from the union representing Linde employees, found that workers in the uranium operation suffered respiratory illnesses at rates up to 200% above the U.S. average, and that workers died of cancer at a rate 18% higher than the general population. This case highlights the need for tracking health effects and environmental exposures to help determine if a link exists.
Camp Lejeune, Onslow County, North Carolina
Residents report that birth defects, stunted growth, and cancers may be linked to contaminated drinking water at this military base. In the early 1980′s tests conducted by a private firm found that water wells on the base contained cancer-causing chemicals such as trichloroethylene (TCE) and tetrachloroethylene (PCE), but the wells were not shut down until 1985. A study was announced in 2003 called “Exposure to Volatile Organic Compounds in Drinking Water and Specific Birth Defects and Childhood Cancers at United States Marine Corps Base Camp Lejeune, North Carolina.” Residents would like the study, currently being conducted by the Agency for Toxic Substances and Disease Registry, to be expanded. A tracking network that collects data on environmental exposures and health effects could have helped determine whether chemicals in the water were associated with these health problems.
Clyde, Sandusky County, Ohio
The Ohio Department of Health and Sandusky County Health Department found that cancer may be occurring in the childhood population at a higher than expected rate in the city of Clyde, as well as parts of Fremont and the Green Creek Township area. The analyses found that brain and other central nervous cancer to be the most common among the childhood population. State and local agencies are continuing to investigate the cause of the higher than expected number of childhood cancer diagnoses in Eastern Sandusky County.
Lorain County, Ohio
More than 200 residents were exposed to the pesticide, methyl parathion, after an unlicensed pest-control operator illegally sprayed indoors. In November 1994, Ohio officials reported a pesticide operator who had applied pesticides for 17 years to hundreds of residences. The Environmental Protection Agency sampled more than 800 homes, tested more than 500 people, and decontaminated 232 homes. Further, the Agency for Toxic Substances and Disease Registry initiated a study in 1999 of long-term effects of methyl parathion exposure in children in Ohio. A nationwide health tracking network that tracks pesticide exposures could have caught this crisis much sooner and helped to decrease the public health impact on the community.
Marion, Marion County, Ohio
River Valley High School was built in the early 1960’s on top an Army depot that had been used for the cleaning and repair of vehicles and heavy machinery. The Ohio EPA discovered that several carcinogenic substances at the site at levels that posed a potential danger to public health. A study from the Ohio Department of Public Health concluded that the rates of leukemia and esophageal cancer were significantly elevated among high school graduates. The school has since been relocated, and a new school was built for the district. Tracking of environmental exposures could have identified this elevated cancer rate much sooner and allowed preventive measures to be established.
Middletown, Butler County, Ohio
Since 2004, 11 people in Middletown have been diagnosed with glioblastoma brain cancer. The Ohio Department of Health is currently investigating whether or not this is a cancer cluster. Dick’s Creek in Middletown was found to be contaminated with presence of polychlorinated biphenyls (PCBs) and AK Steel is currently cleaning up the site.
Wellington, Lorain County, Ohio
A study completed by the Ohio Department of Health and Lorain County Health Department concluded that members of the community were 3.7 times more likely to develop multiple sclerosis (MS), a neurodegenerative disease, than the rest of the country. Data has indicated that there has been a release of generally low levels of some chemical contaminants to the environment in the immediate vicinity of the former Sterling Foundry facility, the former LESCO facility, and the currently operating Forest City Technologies plants. However, no significant contaminants of concern were identified in human exposure pathways at concentrations that would likely cause adverse health effects. Although the causes of MS are unknown, the disease is believed to be caused by a combination of genetic and environmental factors. If MS had been tracked, health officials would have known when cases first started appearing and started investigating.
Bartlesville, Washington County, Oklahoma
A smelter site was labeled a public health hazard in 1995 because nearby residents were being exposed to cadmium, lead, and zinc surface soil contamination at levels that could result in adverse health effects. Residents expressed concerns regarding elevated rates of cancer, birth defects, and childhood behavioral problems. Blood lead studies funded by Agency for Toxic Substances and Disease Registry (ATSDR) and performed by Oklahoma State Department of Health (OSDH), (now ODEQ), in 1991 and 1992 indicated that approximately 14% of the children in the contaminated area had elevated levels of blood lead. Approximately 1,000 residential properties contaminated with heavy metals were remediated. A more recent federal study reported that children in the area did not have elevated blood lead levels for the years 1998-2001. No studies as yet have been able to determine whether the cancers and birth defects are related to the environmental contamination.
Cyril, Caddo County, Oklahoma
A resident wanted to determine whether there was a connection between past operations of the Oklahoma Refining Company, contamination in Gladys Creek, and the occurrence of brain cancer in her husband and his male friend. The men lived close to Gladys Creek, downstream of the refinery site, and often swam in the creek. The refinery had directly discharged effluent into the nearby Gladys Creek. Contaminants of concern at and near the refinery include hydrogen sulfide, benzene and other organic compounds, and heavy metals such as arsenic, barium, beryllium, and lead. ATSDR concluded that residents swimming in Gladys Creek downstream of the refinery site during refinery operations are likely to have been exposed to contaminants in surface water and sediments, but they were unable to determine if this exposure caused the cancers. Concerns raised by this investigation lead to actions to prevent future exposures to contaminants at and near this site, such as fencing, signage, netting to keep wildlife out of open-air sludge pits, and remediation.
Ardmore, Carter County, Oklahoma
The Imperial Refining Company was added to the National Priorities List (Superfund) in 2000. One resident lives on a street one block from Refinery Road and relayed concern that of 14 houses, there were at least 6 cases of cancer, including breast, lung, prostate, and tumors in the pelvic and tailbone areas. Another resident reported events involving strong odors with evidence of flammable gas releases from the site. The cancer registry was unable to determine if Ardmore’s cancer rates were higher than normal because cancer data has only been collected since 1997. Contaminants measured on site include arsenic, lead, methylnaphthalene and polycyclic aromatic hydrocarbons. Imperial Refining Company was a crude oil refinery which operated on the site from 1917 to 1934.The site is now well vegetated with trees and moderate underbrush, except in several impacted areas which are covered with asphalt- or tar-like waste piles. At least one waste area also contains several abandoned, partially crushed 55-gallon drums. Ponds on the site could have been highway fill “borrow pits” or reservoirs during operation of the refinery. Access to the site is unrestricted. Hunting is common on the site, people fish in the ponds on the site, and that children play on the site. Approximately 130 workers and residents are within 200 feet of contaminated areas.
Cushing, Payne County, Oklahoma
Residents concerned about high numbers of cancers in the area wondered if it was attributable to the Kerr-McGee site. The Kerr-Mcgee Refinery Site operated as a petroleum refinery from 1917 until 1972 and also processed nuclear materials for Atomic Energy Commission. ATSDR has found evidence of past, current and future exposures for workers, site visitors and nearby residents. There are five unlined acid pits on site. Uranium processing activities left radioactive wastes such as carbon crucibles and HEPA filters. Thorium processing left wash water and a nitric acid pickling solution which was released into the soil. Kerr-McGee has already conducted substantial removal of contaminants, such as spreading radioactive soil on farmlands, and intends further remediation. About 1990, four residences were removed from the property.
Picher, Cardin, Quapaw, Commerce, and Miami, Ottawa County
Acid mine drainage and heavy metals from mine tailing chat piles impacted five communities in the Tar Creek area of Oklahoma and led to its establishment as a Superfund Site in 1983. In 1996, data showed that 45% of tested children living in Picher and Cardin had blood lead elevations over 10 micrograms/deciliter. Children are the most sensitive population for lead exposures. Chronic exposure can harm the immune system, blood system, nervous system, and kidneys. Harmful effects include premature births, smaller babies, decreased mental ability in the infant, learning difficulties, and reduced growth in young children. The EPA has plugged 83 wells, remediated 2295 lead-contaminated residential yards, 105 Native American properties and 8 schools. There has been considerable progress decreasing the number of children with lead-blood levels over 10 micrograms/deciliter but the area still is well above average Oklahoma rates. Lead and zinc have also seeped into groundwater, ponds, and lakes, many of which still are used by children for swimming. In 2004 the state began a voluntary relocation program for families with children under 7 years of age.
Midwest City, Oklahoma County, Oklahoma
The ATSDR issued a public health assessment for the Superfund Site at Tinker Air Force Base that found a public health hazard for people who were exposed to volatile organic compounds, such as TCE and PCE in their well water. Primary sources of contamination at Tinker include leaks from on-base storage tanks and pits, discharge from industrial outfalls, contaminant spills, and runoff from runways and industrial facilities. ATSDR was unable to answer concerned residents questions about cancer rates and birth defects rates, because of limited health tracking with the Oklahoma cancer registry and birth defect registry.
Dewey, Washington County, Oklahoma
The original incident occurred on January 23, 2001 when St. Francis Hospital, Tulsa, Oklahoma notified the National Response Center that a 2-year old child had been diagnosed with acute mercury poisoning. The poisoning resulted from contamination of the parent’s bedroom with mercury. A previous tenant of the apartment had brought home over one pound of mercury from work, played with it and spilled it. According to Oklahoma law it is a felony to possess over one pound of mercury. The child’s symptoms started with a rash but soon grew very serious. She was tested for a variety of illnesses, but no one discovered mercury poisoning until 2.5 months later when she was in critical condition. EPA supervised the decontamination of the apartment and the families’ possessions, many of which were disposed of. While this incident only harmed one family, it still sheds light on the need to educate medical professionals to diagnose environmental causes of diseases, as well as the need for safety education related to mercury.
Ponca City, Oklahoma
Concerned residents noted that people living around the Conoco Oil Company plant had unusual rates of cancer (especially leukemia), birth defects, skin rashes, breathing problems, and other illnesses. Conoco, by allowing toxic chemicals to leak from storage tanks, had contaminated the ground water around their homes. Test showed benzene, toluene and xylene in the ground water. In 1990 a lawsuit by residents was settled when Conoco agreed to buy 400 homes near the refinery so the people could afford to move away. Under the terms of the agreement, Conoco paid the full market value of the houses adjacent to the plant – an estimated total of $18 million. In addition, the company set
up a $5 million fund for distribution to families in surrounding neighborhoods.
Bucks County, Pennsylvania
Elevated levels of trichloroethylene (TCE), a probable human carcinogen, have contaminated the groundwater in Bucks County. The contamination was first noticed in 1994, and other sites were labeled contaminated in 2000 and again in 2004. Residents are concerned about the safety of their drinking water. The Pennsylvania Department of Health and the Agency for Toxic Substances and Disease Registry are evaluating the most current exposures, and are taking action to reduce those exposures.
Butler and Armstrong Counties, Pennsylvania
Drinking water in the Petroleum Valley of Pennsylvania was contaminated by several toxicants, including resorcinol, sulfonic acids, and calcium petronates, which was thought to have leaked into the water system at former industry waste disposal sites. Since mid-2001 and continuing as of September 2004, more than 900 homes, schools, and businesses have depended on state-supplied water from the Pennsylvania Department of Environmental Protection. The Agency for Toxic Substances and Disease Registry conducted an investigation and found that the water surrounding Bear Creek Chemical Area posed an indeterminate public health hazard, while surface contaminants, in soil and sediment, were deemed not an apparent public health hazard.
Note: The Bear Creek Area Chemical Site includes at least 17 locations where historical industrial-waste disposal either has been documented or is suspected. The disposal areas include Fairview, Park and Concord Townships in Butler County and Perry Township in Armstrong County
King of Prussia, Montgomery County, Pennsylvania
In King of Prussia a hazardous waste site containing volatile organic chemicals and metals was labeled a public health hazard in 1995 by federal health agencies. Groundwater and surface water at the site had been contaminated with these and other toxic chemicals. There were approximately 200 residences within one-half mile of the site, and those residents raised concerns regarding the safety of the drinking water supply.
Throop, Lackawanna County, Pennsylvania
In 1991, a high number of residents in Throop were found to have elevated blood lead levels. Federal health officials believe that the exposure may be due to waste from a nearby battery disposal site. In 1999, the Pennsylvania Department of Health and the Agency for Toxic Substances and Disease Registry released their health consultation evaluating the impact of past exposure to lead on the community.
Worman, Berks County, Pennsylvania
A metals manufacturing facility was labeled a public health hazard by federal health officials in 1993. Residents of Worman Township near the site had been exposed to groundwater contaminated with site-related volatile organic compounds (VOCs). Residents expressed fears regarding the safety of private well water supplies, and the Environmental Protection Agency took the lead in remediating the contaminated wells.
Vieques, Puerto Rico
For 60 years the US Navy used the small island of Vieques off the coast of Puerto Rico for bombing practice. After departing in 2003 they have left behind bomb fragments, unexploded ordnance, contaminated soil and polluted water supply. The people of Vieques have high disease rates including cancers and asthma.
ATSDR Press Release:
South Kingston, South County, Rhode Island
The University of Rhode Island closed the Chafee Social Sciences Building, Kingston Campus, in 2000 due to concerns over contaminated window caulking that left chemicals in the building air and dust. High levels of polychlorinated biphenyls (PCBs) were discovered indoors and outdoors, and university officials hired private epidemiologists to investigate whether exposure to PCBs was associated with cancer cases among employees. After an 18-month closure for remediation, the Chafee Building was re-opened in 2002. If the U.S. had a Nationwide Health Tracking Network, cases of disease could be investigated and measures to prevent future cases established.
Charleston, Charleston County, South Carolina
A cluster of pleural cancer (cancer of the lining between the lung and chest) in Charleston was identified in 1997. Nineteen cases were diagnosed in little more than one year, and 12 of those worked at the nearby naval shipyard or naval base, according to a South Carolina Department of Health and Environmental Control study. Because occupational risk is very strongly associated with pleural cancer, state health officials believe that exposure to asbestos in shipbuilding may have played a role in the development of the cancers. However, without tracking occupational exposures and health effects, it is difficult to reach conclusions.
Sioux Falls, Minnehaha County, South Dakota
A chemical disposal pit was labeled a public health hazard in 1992, and placed on the Superfund list after nitrates were found in nearby water wells and chemical vapors were reported in the air at a nearby school. The Agency for Toxic Substances and Disease Registry report noted that exposure to high levels of nitrates in water can cause methemoglobinemia (“blue-baby” syndrome) in children less than six months old. Residents had also expressed concern about the rates of learning disabilities in children that attended the elementary school. This site was deleted from the Superfund list in 1999.
Oak Ridge, Anderson County, Tennessee
More than 100 residents of Oak Ridge may have suffered from thyroid cancer, brain damage, and other illnesses from past exposure to toxic releases at a nearby nuclear weapons complex. According to the Tennessean News, scores of men and women who live near the Oak Ridge nuclear reservation, but never worked there, are suffering from patterns of illness their doctors cannot explain. The state health department, the National Institute for Occupational Safety and Health, and other agencies have studied the nuclear complex but have found conflicting results. Tracking of environmental releases and health effects could have identified health problems earlier and allowed preventive measures to be established.
El Paso, El Paso County, Texas
In 1997, the Agency for Toxic Substances and Disease Registry provided a grant to the Texas Department of Health to investigate a report of elevated Multiple Sclerosis (MS) prevalence among a cohort of elementary students whose school was in close proximity to a smelter facility. This study of more than 5,000 former students included a review of the medical records of study participants who reported having MS. Past environmental sampling data indicated high levels of metals in the area. The investigators found a two-fold increased risk for MS among this cohort and recommended a multi-site case control study be done to examine metals exposure as a potential risk factor for MS.
San Antonio, Bexar County, Texas
Several former workers from Kelly Air Force Base (AFB) and community members residing near the base have expressed concern about a possible cluster of amyotrophic lateral sclerosis (ALS or Lou Gehrig’s Disease). Health officials are investigating the base to determine whether exposure to various toxic chemicals is linked to the disease, and conducting a health survey to better understand risk factors for ALS. Reports of higher rates of other health problems such as birth defects, cancer, and learning disabilities have also been identified outside the base in nearby communities. These communities have also been affected by groundwater contamination from toxic releases at the AFB. Biomonitoring in these residents could help determine whether pollutants from the AFB are a contributing factor in these health problems.
South Weber, Davis County, Utah
Evidence of a brain cancer cluster was discovered in May 2001. A study requested by residents near a garbage incinerator found nine cases from 1997-2000, which the Davis County Health Department labeled statistically significant. No association between the incinerator and the cancer cases has been established, but the incinerator was found to exceed federal emissions standards for dioxin, a known human carcinogen. Dioxins are a byproduct of incineration.
A medical student investigated what appears to be an elevated number of cases of the neurological disorder, Lou Gehrig’s disease (Amyotrophic Lateral Sclerosis or ALS) to see whether they may be linked to occupational or environmental factors. Three of the six people afflicted in Vermont were dairy farmers. ALS is so rare that fewer than two people per 100,000 are affected, however residents know of six in their town of little more than 1,000 who have had ALS in the past or have it presently.
Chesterfield, Chesterfield County, Virginia
Residents of Chesterfield worried that living near a military supply center might be linked with their seemingly high rates of cancer, as well as lupus and diseases of the liver, kidney, nervous system and lungs. Toxic chemicals, including trichloroethene (a known human carcinogen), were stored at the center and were known to have leaked into the soil and groundwater. The State Health Department conducted interviews in the Rayon Park area to determine whether there were unusually high rates of illnesses, and then requested that the Agency for Toxic Substances and Disease Registry (ATSDR) investigate whether the contamination could be linked to the health problems. In a health consultation released in April 2002, ATSDR concluded that no current human health hazard exists from exposure to surface water in the creeks.
Hanford, Benton County, Washington
Hanford is the name of a former nuclear weapons production site located in south central Washington state. Established in 1943, Hanford released radioactive materials into the air, water and soil. Many employees, as well as those who lived in the areas downwind from Hanford or who used the Columbia River downstream from Hanford, received doses of radiation. Those doses may have caused health problems or might cause them in the future. The Agency for Toxic Substances and Disease Registry has been conducting studies of the surrounding communities since 1994.
Port Angeles, Clallam County, Washington
Residents fear that exposure to dioxins, PCBs, heavy metals and other toxic chemicals are linked to the high number of deaths from cancer and respiratory disease, among others in their community. These contaminants have been found in drinking water and soil both in and around a nearby pulp mill and the mill’s landfill. According to a 2001 article in the Seattle Post Intelligencer the state health study concluded that the rates of illness and death were elevated, but that the state was a long way from assigning a cause. Biomonitoring in these residents could help determine whether pollutants from the mill are a contributing factor in these health problems.
Shoalwater Bay Indian Reservation, Pacific County, Washington
Health officials investigated what appeared to be a high number of miscarriages and stillbirths among the Shoalwater Bay Indian women. In a 1999 study of Shoalwater pregnancies, the Centers for Disease Control and Prevention found a miscarriage rate of up to 67 percent–much greater than the expected rate. In a more recent study by the state of Washington, the study concluded that the percent of pregnancies ending in unintended loss between 1996 and 2001 in Shoalwater, “was not significantly different from that reported in a similar national survey, of 19.5 percent.” A nationwide health tracking network that collects such information would help shed light as to why so many pregnancies ended in an unitended loss.
Northeast, Washington, DC
Residents worry that the trash transfer station or the nearby power plant may be the cause of a number of Alzheimer’s cases, deaths from cancer, and asthma cases being reported in the neighborhood. A Public Health Assessment by the Agency for Toxic Substances and Disease Registry released in July 2004, found that, “insufficient health outcome data exist to evaluate whether increased rates of respiratory effects or cancer are present in the River Terrace community.” This same assessment noted, however, that “the maximum detected levels of ozone, sulfate and particulate matter may aggravate pre-existing respiratory diseases such as asthma, emphysema and chronic bronchitis.” Local activists continue to advocate for removal of trash transfer stations from residential neighborhoods.
Milwaukee, Milwaukee County, Wisconsin
In April 1993, the bacterium, Cryptosporidium parvum, made 400,000 people sick and killed more than 100 in Milwaukee, Wisconsin. The outbreak was investigated by the Milwaukee Department of Health as well as the Wisconsin Division of Health. Since then, Milwaukee has made extensive overhauls to its water treatment system to improve filtration. Because cryptosporidiosis (an officially reportable disease) is tracked in Wisconsin, health officials were alerted early on and rapidly responded by testing the water treatment plant.
Emerging Infectious Diseases Article: Cost of Illness in the 1993 Waterborne Cryptosporidium Outbreak, Milwaukee, Wisconsin
CNN News Article: Milwaukee learned its water lesson, but many other cities haven’t