Cancer Clusterings: Environmental Pollution?

James Stark, MD, of Stark Oncology

James Stark, MD, of Stark Oncology

Shortly after moving to Hampton Roads in the late ‘70’s I had dinner with a neighbor who was a reporter for the Virginian Pilot.  He was investigating a possible series of cases of aplastic anemia (total bone-marrow failure) in children living in the Ocean View section of Norfolk.  He was concerned that an unreported nuclear or chemical accident on Naval Station Norfolk adjacent to Ocean View might have been the cause.  Despite his efforts no link was ever established.

In 1996 Jonathan Harr published A Civil Action about an epidemic of childhood leukemia in a suburb of Boston.  The lawyer for several families, Jan Schlichtmann, tried to link the leukemia cases to the dumping of trichloroethylene into the town’s water supply by a local chemical company.  Most people familiar with the facts agree that the town’s water supply was contaminated and that the excess leukemia was linked, but the legal process bankrupted Schlichtmann and the families got very little money.  The site of the dumping was eventually declared polluted by the government and superfund money was used to clean up the area.

In 2009 children in The Acreage, an exclusive real estate development in Palm Beach County, Florida, began developing brain tumors at an alarming rate.  After some investigation, several local news reporters discovered that Pratt and Whitney aircraft had dumped chemicals into the surrounding land.  Several large personal injury law firms have agreed to help the affected families.  The investigation is still ongoing and it is not clear whether Pratt and Whitney had anything to do with what the Florida Health Department is now calling a Pediatric Cancer Cluster.

Last month the St. Clair County Health Department in Battle Creek, Michigan began investigating a cluster of Wilms (pediatric kidney) tumors in children in Marine City.  Only 500 cases of Wilms Tumor occur in the United States annually, and there had been five cases in St. Clair County in four years.  As reported in the Battle Creek Enquirer last week, the investigation is ongoing.  Marine City is on the St. Clair River, 10 miles downstream from a chemical plant located just across the Canadian border; however, no toxic exposure has been uncovered yet.

Children are particularly prone to injury from environmental or toxic exposures because they are growing, and dividing cells are particularly sensitive to chemical injury.  All the excess thyroid cancer cases after the Chernobyl nuclear reactor incident were in children,  so it is not surprising that one would see children primarily affected by environmental pollution.  Of all the stories cited above, however, only the Massachusetts cases have been clearly linked to a toxin.

It is difficult for the government to police everything that industry does that might pollute the environment.  You can’t monitor what you don’t recognize as a problem.  Perhaps only the clumsy and expensive process of litigation will uncover sources of environmental contamination.  As our planet becomes more crowded and more industrialized we as a society need to be ever vigilant in the protection of the environment.  Unfortunately by the time clusterings become known much damage has already been done.

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