Mapping Mortality in Western Pennsylvania – Part 2

The Pittsburgh Post-Gazette recently completed an amazing series of reports on the cancer clusters in Western Pennsylvania. Here is a sample from Day 2 of their 8-day series.

In many places around Western Pennsylvania residents see clusters of death and clusters of people sickened by cancer or heart and lung diseases.

And, like Lee Lasich, a Clairton resident, they’re frustrated that government health and environmental agencies don’t see them too, don’t do something about the problems and don’t take a tougher stance on enforcement of air pollution regulations.

* * *

The Pittsburgh Post-Gazette’s analysis of Pennsylvania Department of Health mortality data from 2000 through 2008 found that 14,636 more people died from heart and respiratory disease and lung cancer in 14 Western Pennsylvania counties than national rates would predict, or 12,833 after adjusting for excess smoking in the region. And the yearlong investigation found numerous people throughout the region who talked about what seemed like unnatural and unexplained clusters of illnesses and death in their communities.

This overlap of high mortality rates and pollution raises questions about whether there is a causal relationship. The question has not been definitively answered, but for the people who live among these clusters, the connection seems clear.

More . . .

When it comes to particulate pollution, what you can’t see can hurt you.

“The stuff now is more insidious but much harder to perceive,” said Lester B. Lave, the Carnegie Mellon University economics professor who pioneered pollution mortality research in the 1970s. “There is no rotten egg smell. There is no dirt. It is less easily perceived. People are usually astonished that Pittsburgh still is one of the worst, but air pollution is continuing.”

Studies estimate that pollution kills 20,000 to 60,000 each year in the United States. Even at the lower range, pollution deaths would equal the nation’s annual rate of homicides.

The upper range would equal traffic fatalities and suicides combined and rank pollution as the nation’s eighth leading cause of death, just behind diabetes — another disease pollution has been linked with — and just ahead of the combined category of influenza and pneumonia.

And what’s true about pollution deaths holds true about particulate pollution: Both remain largely imperceptible to the general public.

Science to the rescue

For the past 40 years, science time and again has implicated particle pollution as a major killer.

In 1970, Dr. Lave and Eugene B. Seskin for the first time calculated health damage from pollution. Their subsequent book, “Air Pollution and Human Health,” published in 1977, found not only “a close association between air pollution and mortality,” but determined the relationship to be substantial.

Drs. Lave and Seskin’s work stirred such controversy that it prompted an effort to get Dr. Lave fired from his teaching position. But their science stood the test of time and helped inspire major epidemiological studies in subsequent decades.

More . . .

• A PG multimedia display tells the human side of the effects of air pollution
• PG interactive maps show disease rates and major pollution sources
• See an index to the series

Can The Law Go Upstream?

Roger Magnusson, Lawrence O. Gostin, and David Studdert recently posted their paper, “Can Law Improve Prevention and Treatment of Cancer?” on SSRN:

The December 2011 issue of Public Health (the Journal of the Royal Society for Public Health) contains a symposium entitled: Legislate, Regulate, Litigate? Legal approaches to the prevention and treatment of cancer. This symposium explores the possibilities for using law and regulation – both internationally and at the national level – as the policy instrument for preventing and improving the treatment of cancer and other leading non-communicable diseases (NCDs). In this editorial, we argue that there is an urgent need for more legal scholarship on cancer and other leading NCDs, as well as greater dialogue between lawyers, public health practitioners and policy-makers about priorities for law reform, and feasible legal strategies for reducing the prevalence of leading risk factors. The editorial discusses two important challenges that frequently stand in the way of a more effective use of law in this area. The first is the tendency to dismiss risk factors for NCDs as purely a matter of individual ‘personal responsibility’; the second is the fact that effective regulatory responses to risks for cancer and NCDs will in many cases provoke conflict with the tobacco, alcohol and food industries. After briefly identifying some of the strategies that law can deploy in the prevention of NCDs, we briefly introduce each of the ten papers that make up the symposium.

You can download the paper for free here.

“Something in the Environment”

From The Baltimore Sun:

Randy White had just buried a daughter, dead at 30 with a brain tumor. Now his other daughter had been diagnosed with growths in her abdomen.

When doctors told White in 2009 that their conditions were likely caused by something in their environment, the Frederick native thought of Fort Detrick. His children had grown up near the Army base.

Detrick was home to the nation’s biological weapons program from the 1940s through the 1960s. It remains a key center for medical research.

“Anybody that lives in Frederick knows all the rumors,” White says. “It’s kind of like, ‘Fort Detrick, they created anthrax, we knew that, smallpox …’ It just clicked for me.”

For decades, Frederick residents had speculated about the possible effects of the experiments at the base on the health of the surrounding community. But it took a grieving father with scientists, lawyers and money — White says he has spent more than $1 million so far — to drag questions about contamination and cancer out into the open.

White hired epidemiologists and toxicologists to monitor the air, soil and water around Detrick. He asked neighbors about their health histories and paid for lab tests to measure the toxins in their blood. He shared his findings with government officials.

The county and state health departments are now studying the cancer rate within a two-mile radius of the base. The Army has released details of Agent Orange testing. And local, state and federal officials are meeting regularly with the community to discuss their progress.

“Without him standing there shaking his hands and dancing around, it would not have gotten this much attention,” says Jennifer Peppe Hahn, a survivor of Hodgkin’s lymphoma, growths on her pancreas and thyroid, and breast cancer.

“When Randy came forward about his daughter’s death,” she says, “somebody had enough money and enough passion at that point that nobody could ignore it.”

White, a former evangelical pastor and a businessman who first contacted officials last year, is demanding information about activities at Fort Detrick past and present, an apology to the people he believes were sickened, and a congressional hearing “so this never, ever happens again in the United States of America.”

He also has filed a mass tort lawsuit. He has been joined by more than 100 fellow plaintiffs.

“I didn’t want to fight, but the fight kind of came to me,” says White, 53. “I had lost my daughter, and then my other daughter was so sick. Our whole motive behind this thing was just to bring resolve and full disclosure.”

The Army says it has no indication that Fort Detrick is currently contaminating its surroundings, and it is responding to the community’s concerns.

State health officials, who are studying the incidence of cancer in the area during the last two decades, say they have found no evidence of a cluster.

But White says the state’s cancer registry is incomplete and out of date. He says his own scientists have found continuing contamination.

“Everything I say is backed up by scientific fact,” he says. “It’s not something we just dream up. … We just want the truth.”

Fort Detrick is a 1,200-acre campus in northern Frederick that today is home to a variety of military and civilian organizations involved in medical research and development, including a National Cancer Institute facility. For years, it was known primarily for its work on biological warfare agents, including anthrax and smallpox.

Scientists developed and tested biological agents there from World War II until 1969, when President Richard Nixon banned research into offensive biological warfare. Since then, researchers have focused on defending against biological attack.

More.

TCE More Dangerous than We Knew

From Los Angeles Times:

One of the most widespread groundwater contaminants in the nation is more dangerous to humans than earlier thought, a federal agency has determined, in a decision that could raise the cost of cleanups nationwide, including large areas of the San Fernando and San Gabriel valleys.

The final risk assessment for trichloroethylene by the Environmental Protection Agency found that the widely used industrial solvent causes kidney and liver cancer, lymphoma and other health problems. That lays the groundwork to reevaluate the federal drinking-water standard for the contaminant: 5 parts per billion in water, and 1 microgram per cubic meter in air, officials said.

Paul Anastas, assistant administrator for the EPA’s office of research and development, said toxicity values for TCE reported in the risk assessment released this week may be used to establish new cleanup strategies at 761 Superfund sites, as well as in aquifers supplying drinking water to millions of residents in the San Gabriel and San Fernando valleys.

The risk assessment had been subject to more than a decade of delays. A 2001 draft assessment that suggested a strong link between TCE and cancer was opposed by the Defense Department, the Energy Department and NASA.

The Pentagon had demanded greater proof that industrial substances cause cancer before raising cleanup costs at more than 1,000 polluted sites.

“This risk assessment is a big deal because it will strengthen protections for people who live and work above TCE plumes — and there are a lot of them — and could force serious rethinking about the extent of cleanup efforts,” said Lenny Siegal, executive director of the Mountain View, Calif.-based Center for Public Environmental Oversight, which posted a letter Monday signed by activists across the country, demanding that the final risk assessment be released. It was released Wednesday.

Jennifer Sass, senior scientist at the Natural Resources Defense Council, said the decision “launches new arguments about what the safety standards should be. In the meantime, people impacted by this pollution can now link their disease to it in litigation with more confidence because the science is no longer in dispute. TCE causes cancer.”

TCE has been discovered in nearly every state but in none more widely than California. Military bases including Camp Pendleton and Edwards Air Force Base have Superfund sites with TCE contamination.

The Los Angeles metropolitan area overlies a checkerboard of underground plumes of TCE, and has high ambient levels of the chemical in the air. More than 30 square miles of the San Gabriel Valley lie in one of four Superfund sites that contain TCE. The San Fernando Valley overlies a large plume grouped into three separate Superfund sites. The former Marine Corps Air Station El Toro in Orange County sits over a plume several miles long.

More.

Photo by Jeremy Brooks.

The Risks of Indoor Swimming

From CNN Health:

Catherine Garceau doesn’t go to the pool anymore. The former Olympic swimmer has trained at many fitness centers over the years that smelled strongly of chlorine. While most would assume that means the water is clean, Garceau now knows it’s just the opposite.

After winning bronze in 2000 with the Canadian synchronized swimming team in Sydney, Australia, Garceau was a “mess.” Her digestive system was in turmoil, she had chronic bronchitis and she suffered from frequent migraines.

Garceau retired in 2002 and began looking into holistic medicine. Experts suggested detoxifying her body to rid it of chemicals, including what fellow teammates used to jokingly refer to as “eau de chlorine — the swimmer’s perfume.”

“As part of my journey to determine the factors that affected my health, I delved into the possible effects of chlorine and discovered some shocking facts,” Garceau writes in the appendix of her upcoming book, “Heart of Bronze.”

Outdoor pool season is ending in many parts of the country, and competitive swimmers are heading indoors for their workouts and team meets. But how safe are the waters they’re diving into? Researchers are examining the longterm effects of the chemicals in pool water.

Chlorine inactivates most disease-causing germs within a fraction of a second. That’s why it’s found in our drinking water as well as 95% of pools in the United States, said Dr. Tom Lachocki, the CEO of the National Swimming Pool Foundation.

As Lachocki points out, access to clean water is what often separates first and third world countries. Without chlorine, swimmers are at risk of contracting many dangerous waterborne illnesses. But the chemical compounds formed in pools have some scientists worried.

“When you open up a tap and pour yourself a glass of water, you don’t normally put someone’s backside in it,” Lachocki said. “But in a pool there are people getting into that water. Every time a person gets in they’re adding contaminants.”

Those contaminants — sweat, hair, urine, makeup, sunscreen, etc. — combine with chlorine to form chloramines, said pool consultant and researcher Alan Lewis. Chloramines are what bathers smell when they enter a pool area; a strong smell indicates too many “disinfectant byproducts,” or DBPs, in the water.

Indoor pools create an additional a danger because of the enclosed atmosphere. Volatile chemicals from the water are transferred, often via vigorous activity like a swim team’s kicks, to the air. Without a proper ventilation system, the chemicals can hang around to be inhaled by coaches, lifeguards or spectators.

Some DBPs, like chloroform, are known as trihalomethanes, and are considered carcinogenic, Lewis said. They’ve been linked specifically to bladder and colorectal cancer.

Dr. Alfred Bernard is a professor of toxicology at the Catholic University of Louvain in Brussels and one of the world’s leading researchers on aquatic environments. He has published a series of studies documenting the effects of chlorine and its byproducts in swimming pools.

In June, Bernard published a study in the International Journal of Andrology linking chlorine with testicular damage. Swimming in indoor, chlorinated pools during childhood was shown to reduce levels of serum inhibin B and total testosterone, both indicators of sperm count and mobility. Bernard notes in the study summary that the “highly permeable scrotum” allows chlorine to be absorbed into the body.

Bernard has also substantiated previous studies’ claims of a link between swimming in indoor chlorinated pools and the development of asthma and recurrent bronchitis in children. His 2007 study showed airway and lung permeability changes in children who had participated in an infant swimming group.

More.

The Emergence of Pesticides

From The Corporation.

Cancer and Farming

From News.Scotsman:

Children who grow up on farms where animals are kept are much more likely to develop cancer, according to a new study.

Youngsters raised on chicken farms are three times more likely to develop blood cancers later in life, claims the research.

The overall risk of diseases such as leukaemia, multiple myeloma and non-Hodgkin’s lymphoma is 22 per cent higher for those raised on any type of livestock farm.

Scientists say exposure to particular types of virus in childhood may alter the immune system response – so increasing the risk of blood cancer as an adult.

Dr Andrea Mannetje, of Massey University in Wellington, New Zealand, and colleagues said: “It has repeatedly been observed that work as a farmer is associated with an increased risk of haematological cancers, but it is not known whether growing up on a farm also plays a role.

“The results of this mortality study indicate that growing up on a farm is associated with an increased risk of haematological cancer in adulthood; this association was present for growing up on a livestock farm, but not for growing up on a crop farm, and was not explained by having had an occupation as a farmer.”

The study, published online in Occupational and Environmental Medicine, analysed 3,000 blood cancer deaths in New Zealand out of more than 114,000 death certification records from 1998 to 2003 for those aged between 35 and 85 to identify a link with growing up on a livestock farm.

Poultry farms carried the greatest risk, while those growing up on an crop farm had an almost 20 per cent lower risk of developing a blood cancer. However, crop farming as an adult was associated with an almost 50 per cent increased risk.

More.

Cancer Cluster at DuPont

From the Charleston-Gazette:

Workers at DuPont Co.’s Wood County plant who were exposed to the chemical C8 were more likely to die from kidney cancer and other kidney diseases, according to the latest findings from a three-scientist panel studying C8’s potential health effects.

The C8 Science Panel found “significantly increased rates of death among the more highly exposed workers compared to low-exposed workers” for kidney cancer and nonmalignant, chronic kidney disease.

In a summary report made public Tuesday, the scientists said the increased deaths “could possibly be due to” C8 exposure because the kidney is one part of the body where the chemical is found.

Science Panel members issued two other reports Tuesday: One found that increased C8 levels in the blood of Mid-Ohio Valley residents were associated with increases in a liver enzyme that can be an indicator of liver disease. The other discovered a potential link between C8 exposure and pre-eclampsia, or diabetes among pregnant women.

More.

Ogden Superfund Site

From the Utah News:

Ling Seager is dead.

So is Jim Sproul, who sat next to her in an office in the Utah National Guard’s Joint Language Training Center. And so is Chris Jensen, who sat beside Sproul.

Across from Seager sat Mike Chen; he survived a brain tumor. A few feet away was Mark Hepper; he’s dying.

Megan Cate, Scott Forman, Jackie Leedy, Andy Swatsenbarg — all of them worked in the same small office. All of them are sick. None of them knows why.

Utah National Guard leaders say it’s just a “weird coincidence” that so many people who worked in the same office at the center have died or become debilitatingly ill. Their investigation into environmental conditions at the facility, located at a sprawling industrial park in northern Utah, concluded that the office was safe for its workers — even as engineers continue to remove toxic chemicals from the ground surrounding the building in the middle of an Environmental Protection Agency Superfund site.

Swatsenbarg, a career Army officer who fell ill in 2007, isn’t impressed with the military’s self-examination.

“So the National Guard checked itself out and says everything is fine? Well, that’s a big surprise,” he says. “I wonder if Procter & Gamble could get away with that. Or how about Dow Chemicals or DuPont?”

Swatsenbarg and other veterans of the language center say they simply want to know that a serious effort has been made to ascertain whether their sicknesses are linked to their service. And that, they say, will take an investigation from someone outside of the Guard.

More.

Chemicals, Cancer, & Sperm

From BBC:

Sperm quality significantly deteriorated and testicular cancers increased over recent years, a Finnish study says.

The study in the International Journal of Andrology looked at men born between 1979 and 1987.

The University of Turku research suggests environmental reasons, particularly exposure to industrial chemicals, may be behind both trends.

A UK expert said chemicals may affect the development of male babies.

Finnish men were studied as they have previously been shown to have some of the highest sperm counts in the world.

But scientists were never sure if this was because of their genetics or because they were exposed to fewer harmful chemicals.

‘Danger chemicals’

The researchers looked at three groups of men who reached the age 19 between 1998 and 2006.

Men who were born in the late 1980s had lower sperm counts than those who were born in the beginning of the decade.

Total sperm counts were 227m for men born in 1979-81, 202m for those born in 1982-83 and 165m for men born in 1987, respectively.

In addition, the researchers observed that there was a higher incidence of testicular cancer in men born around 1980 compared with men born around 1950.

More.

X-rays and CT scans may pose cancer risk

From Edinburgh Scotsman:

CARRYING out X-rays on pregnant women and babies could increase the risk of childhood cancers, research suggests.

A study published in the British Medical Journal said the potential risk – although small – meant doctors should take extra care when using X-ray and CT scans on this group.

The results back up what has long been suspected by clinicians, which means women are always asked about the possibility of pregnancy before images are taken.

The researchers, from the University of York and the National Cancer Institute in the United States, are more concerned about the potential effects from CT scans, which use much higher doses of radiation than X-rays.

The team looked at 2,690 children with cancer and 4,858 healthy children, all born between 1976 and 1996. They found 305 children received 319 radiographic examinations while in the womb, while 170 children received 247 X-ray examinations in early infancy.

Overall, the researchers found the risk of cancer was potentially increased by 14 per cent in children exposed to X-rays in the womb, and 16 per cent for those exposed as young babies. The strongest risk appeared to be for lymphoma.

But the researchers warned that the small number of cancer cases the results were based on meant more research was needed. The study found no increased risk caused by ultrasound scans.

More.

Dr. Sandra Steingraber and Ellen Crowley Discuss Upstream Causes of Cancer

The close linkage between environmental pollution and cancer is discussed by biologist Dr. Sandra Steingraber (author of Living Downstream: An Ecologist Looks at Cancer and the Environment) and Ellen Crowley.

Cancer Cluster at Camp Lejeune

From St. Petersburg Times:

It seemed as if everyone had a story about illness or death. They filled the room.

Men and women with breast cancer. Prostate cancer. Bladder cancer. Disorders of the nervous system. The parents of babies who died days after birth. Husbands and wives who recalled the agony of a loved one.

The one thing they shared other than illness brought them to Tampa Saturday:

They had all lived at Camp Lejeune, a Marine Corps base in North Carolina.

Up to 250 people, mostly Tampa Bay residents, gathered at the Tampa Marriott Westshore for an informational meeting about what scientists think is one of the worst incidents of drinking water contamination in the nation’s history.

The meeting was organized by a law firm seeking clients.

But it was two of the leading advocates for the alleged victims of that tainted water who presented the case that the corps ignored stark warnings about pollution and waited four years to close those wells.

The advocates said they suffered, too. Former Marine drill instructor Jerry Ensminger’s daughter was conceived at Lejeune and died of leukemia at age 9. Mike Partain, an officer’s son, was born at the base in 1968 and is one of 67 men who lived at Lejeune and were later diagnosed with rare breast cancer.

Both men told the crowd to urge Florida’s congressional delegation to get involved to help Lejeune’s ill and dying.

“These are the people who lost a loved one to cancer or who had cancer or are dealing with cancer,” Partain said after the meeting. “These are the people who loved and trusted the corps and now feel a sense of betrayal.”

More . . .

Upstream Radiation and Downstream Breast Cancer

From whenvironments:

An excerpt from the award-winning documentary “Exposure: Environmental Links to Breast Cancer” about the effects of radiation. Featuring Olivia Newton-John, Dr. Rosalie Bertell and Dr. Susan Love.

Sarah Janssen on BPA

From livingecho:

NRDC (Natural Resources Defense Council) Staff Scientist Sarah Janssen is interviewed by Ken Spector of LivingECHO.com about BPA (Bisphenol A) in plastics. – Warning – linked to asthma, cancer – Part 1 is above, and Part 2, below.