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Train Derailment in NJ: More of the Same – No Cause for Alarm



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Paulsboro train derailment.



How many times have we heard the same refrain from government leaders and scientists involved in community wide exposures such as the recent train derailment in Paulsboro, NJ that released 23,000 gallons of vinyl chloride into the air? “There’s no cause for alarm, we have everything under control.”

If only this were true. Instead, many of the hundreds of people in the 27 block area that was evacuated remain frustrated by the lack of answers to their questions about health effects and accountability. This frustration is driven by how government leaders and scientists evaluate health risks and by the many uncertainties about what is known about the short and long term health effects of being exposed to vinyl chloride or other chemicals. Scientists can estimate risks and give their opinions, but we simply don’t know what’s going to happen to the health of the people who were exposed to vinyl chloride in the aftermath of this accident. Yet this is exactly what people want to know – what’s going to happen to their health or to the health of their children as a result of this accident?

Here’s what we do know. We know that vinyl chloride is a human carcinogen and that it damages the liver and central nervous system; that more than 200 families within a half mile of the accident site were evacuated; that the Coast Guard and other authorities acted swiftly in evacuating the homes immediately surrounding the site of the accident; that the train pulling 84 cars derailed on a bridge over Mantua Creek; that seven rail cars derailed; 4 contained vinyl chloride; one ethanol; three fell into the creek; and one ruptured releasing vinyl chloride into the air (see photo).  We also know that 10 days later most people are back in their homes with assurances from the local authorities that everything is fine.

This is not surprising because it’s the practical thing to do. But what was the scientific basis for this decision? Air samples taken by EPA on December 8th and 9th from throughout the surrounding neighborhood found vinyl chloride in every sample taken. Eight of the nine samples exceeded the EPA’s one-in-a million cancer risk value (EPA’s trigger level for action). Yet people are back in their homes. EPA’s interpretation of this data is that is that the results are within the agency’s “acceptable” risk range, which varies by a factor of 1,000. This is a ridiculously large risk range that has no meaning in protecting public health.

So the stalemate is set up between government leaders and scientists telling people that everything is fine and a frustrated community that has no answers. Given this dynamic, it’s not surprising that 54 residents filed suit this week against Conrail and CSX for damages. What they want is medical screening for early detection of life threatening medical conditions linked to vinyl chloride. This is actually a reasonable response to the many uncertainties that exist in the scientific understanding of what will happen to the health of the people exposed to toxic chemicals such as vinyl chloride.

Had the government leaders and scientists in Paulsboro recognized the scientific uncertainties and more honestly acknowledged how little is known about chemical exposures and health outcomes, there may have been a more satisfying resolution. A resolution that might have included practical steps forward such as medical screening for early detection of medical conditions linked to vinyl chloride. Testing that should be paid for by the companies responsible for the accident and who own the chemicals.

As long as decision makers continue to protect the companies responsible for area-wide chemical exposures such as what occurred in Paulsboro, this scenario will continue to play out as it has since the days of Love Canal more than 30 years ago. Isn’t it time we publicly acknowledge what we don’t know about exposures to toxic chemicals and stop deluding ourselves that using risk estimates that define “acceptable” exposures is the best way to manage toxic chemicals? There is no acceptable exposure if you‘re the one being exposed.

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Backyard Talk

NY PTA Passes Resolution to Phase-out PVC in Schools

The New York State Parents Teachers Association (PTA) voted last week at their annual meeting in Saratoga Springs, NY to pass a resolution calling for a phase out of the plastic PVC in schools. The resolution, called “Reducing & Phasing Out the Purchase of Polyvinyl Chloride (PVC) Plastic in New York Schools,” acknowledged the serious harm posed by PVC throughout its lifecycle, releasing toxic chemicals such as phthalates during use in products such as school supplies and building materials; releasing toxic chemicals such as vinyl chloride and ethylene dichloride during manufacture; and generating toxic chemicals such as dioxins during disposal when burned.

The PTA’s resolution recognized that chronic health problems and conditions in children linked to environmental exposures are on the rise, including learning and developmental disorders; that children are uniquely vulnerable to harm from toxic chemicals such as those released by PVC; that PVC materials and products contain toxic additives, including volatile organic compounds (VOCs) and phthalates, that may be released into the indoor environment, posing hazards to human health including asthma and developmental problems and that children are at greatest risk of exposure; that PVC is commonly found in office supplies and building materials used in schools; that safer, cost-effective alternatives to PVC products are readily available for schools; and that the U.S. Green Building Council provides incentives for schools to avoid PVC and phthalates in “green schools.”

The NYS PTA resolution calls for the following actions:

  • Resolved that the New York State Congress of Parents and Teachers, Inc. seek and support legislation that would reduce and phase out the use of PVC products at all New York State school facilities; and be it further
  • Resolved that the New York State PTA urge school districts and the New York State Education Department (NYSED) to develop green procurement policies to reduce and phase out the use and purchase of PVC building materials and office and education supplies in school facilities where safer cost effective alternatives are available; and be it further
  • Resolved that the New York State PTA and its constituent units educate parents and community members about the potential health effects of PVC and work to eliminate PVC products at all PTA-sponsored events; and be it further
  • Resolved that the New York State PTA forward this resolution to the National PTA for its consideration.

This resolution adds to the growing movement for PVC-free schools and follows similar resolutions enacted by the American Public Health Association (APHA), the “oldest and most diverse organization of public health professionals in the world,” last year and by the New York State United Teachers (NYSUT) union that represents more than 600,000 employees and retirees from New York State schools, colleges, and healthcare facilities, this past summer. The full PTA resolution can be read at the following link: http://chej.org/wp-content/uploads/NYS-PTA-PVC-Resolution.pdf.

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Backyard Talk

Great Lakes Are Improving from Legacy Chemicals but Fracking May Change That

Environmental Health News recently reported that,

“The Great Lakes hold 20 percent of the world’s fresh surface water. The good news is that legacy contaminants are decreasing more quickly than previously reported in three of the Great Lakes, but have stayed virtually the same in two other lakes, according to new research… Polychlorinated biphenyls (PCBs), the pesticide DDT and other banned compounds dropped about 50 percent in fish in Lakes Michigan, Ontario and Huron from 1999 through 2009, although there were no significant changes in Lakes Superior and Erie fish, according to the study to be published this month in the journal Science of the Total Environment.

“These are very positive results. The lakes are improving and slowly cleaning themselves up,” said Thomas Holsen, co-director of Clarkston University’s Center for the Environment and co-author of the study . “Even with the decreases, it will be 20 to 30 years until the decades-old contaminants in Great Lakes fish decline to the point that consumption advisories can be eliminated,” Holsen said.”

All good news, except as we clean up the old chemicals like Polychlorinated biphenyls (PCBs), the pesticide DDT and other banned compounds they are being replaced by newer ones, such as flame retardants that are building up in fish and wildlife and chemicals we are not yet even looking for from oil and gas development.

Today corporations are beginning hydro-fracturing (fracking) all around the Great Lakes to extract gas. It is against the law to frack under the lakes but there are no laws about fracking near streams, creeks, rivers that empty into the lakes. This is insane. Hundreds of very toxic chemicals are injected under pressure into the ground to fracture the shale formation. Not all of these chemicals are retrieved after the fracking is done. In fact the common gas well leaves behind about 30% of the chemicals, radioactive materials and brine. It’s unbelievable, hundreds of chemicals injected all around our fresh water lakes that both the U.S. and Canada have worked for decades to clean up.

This destructive activity is a prime example of governments’ tunnel vision. Oil and Gas development moves forward, cleanup of the lakes moves forward, air deposited of chemicals from many sources continues – – – it’s like shoveling the sidewalk in a blizzard, it won’t be cleaned until the snow stops falling. There is no sign of the chemical blizzards retreat.

I grew up near the lakes in Buffalo and understand their beauty and value. My sister and brother-in-law were active in advocating the cleanup of the lakes in the 1970’s. Our family vacationed on the lakes. It was exciting back then to hear that a serious effort from both sides of the boarder would advance to make the lakes swimmable, the fish safe enough to eat and so many other promises. Now over 35 years later reports are praising the cleanup of historical chemical deposits while at the same time new chemicals are allowed to enter the lakes without protest.

Fracking is not yet widespread around the great lakes. Yes there are some wells in PA, OH, MI but we can stop widespread fracking that would further contribute chemicals to our beautiful lakes by taking a stand and insisting that regulations are put in place and bans where necessary to protect this amazing gift of nature. It is up you and me to make it happen. For more information about the recent study of the Great Lakes, click here.

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Backyard Talk

Using Blood Lead Levels to Set Cleanup Goals

Lead smelter in Kellogg, ID.The creativity of our government regulators never ceases to amaze me. I’ve seen a lot of incredibly stupid and callous decisions in my time, but this one is right up at the top. The US environmental Protection Agency (EPA) Region 10 and the Idaho Department of Environmental Quality somehow thought it was a good idea to use Blood Lead Levels in children to establish a remedial action objective (RAO) at the Bunker Hill Superfund site in Kellogg, ID. According to a recent peer reviewed paper published in the American Journal of Public Health, this decision is codified in EPA’s 1991 Record of Decision for the Bunker Hill site (1).

According to the authors, “the 1991 ROD for the Bunker Hill mine defined the EPA RAOs for child blood lead levels and stipulated the following criteria measures: (1) less than 5% of tested children should have blood lead levels greater than 10 micrograms per deciliter and (2) less than 1% of tested children should have blood lead levels greater than 15 micrograms per deciliter.” You got that. As long as no more than 5% of the children in Kellogg have blood lead levels greater than 10 micrograms per deciliter (ug/dl) and no more than 1% had levels great than 15 ug/dl, then the site cleanup efforts could be considered “successful” (1).

What was EPA thinking when they decided to use lead levels in children to define the effectiveness of a cleanup? And then, to accept that some children will have blood lead levels that exceed the recommended criteria is unconscionable. Even if this factor was not the sole criterion used to make decisions about the effectiveness of the cleanup, it is still unethical to use the children of Kellogg in this way.

The adverse health outcomes of exposure to lead are well understood. Earlier this year the Centers for Disease Control (CDC) revised its guidelines for lead lowering the blood lead level for protecting children’s health from 10 to 5 ug/dl. At the time CDC’s Advisory Committee for Childhood Lead Poisoning Prevention whose recommendations led to this change made it clear that no safe blood lead level in children has been identified.

Lead was mined at the Bunker Hill site for more than 100 years and at one time this was the home of the largest lead smelter in the United States. When the mine shut down in 1981, it left behind a toxic legacy of huge waste piles and residual contamination everywhere. Blood lead testing in children as earlier as 1976 found that 99% of Kellogg children living within 1 mile of the smelter who were tested had blood lead levels greater than 40 ug/dl (2). Today it is much less clear what the blood lead levels are because so few children are tested.

It is an injustice for EPA to treat the residents of Kellogg in this way. The residents In Kellogg have suffered disproportionately not only from lead exposure which continues to this day, but also from social disparities that include unemployment, poverty, and limited educational opportunity. Although there has been substantial cleanup at the site, it remains unclear whether there has been a corresponding improvement in community health and wellbeing. So much more needs to be done. This of course will never be achieved in communities like Kellogg, so long as decision makers think there’s nothing wrong with using the children as canaries in the mine fields.

1. Moodie, SM and Evans, EL. Ethical Issues in Using Children’s Blood Lead levels as a Remedial Action Objective. American J Public Health 2011 101(S1): S156-S160.

2. Landrigan PJ, Baker EL Jr, Feldman RG, et al. Increased lead absorption with anemia and slowed nerve conduction in children near a lead smelter. J Pediatrics 1976 89(6):904-910.

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Backyard Talk

Health Effects Associated with Natural Gas Extraction using Hydraulic Fracturing or Fracking

Perhaps the most intense public health issue to hit the east coast in the past five years is the extraction of natural gas using hydraulic fracturing, more commonly referred to as fracking. This process involves mixing more than a million gallons of water, sand and proprietary toxic chemicals and injecting this mixture at very high pressure into horizontally drilled wells as deep as 10,000 feet below the surface. This pressurized mixture causes the rock layer to crack creating fissures or passage ways in the rock. These fissures are held open by the sand particles so that natural gas from the shale can flow back up the well. This technique has proven so effective at reaching previously hard-to-reach oil and gas reserves that it has spurred a boom in natural gas production around the country.

This boom in natural gas production has also spurred a boom in community activism in areas targeted for drilling such as the Marcellus Shale, a layer of sedimentary rock that spans nine states including NY, PA, and OH.  Drilling in these areas has brought controversy and anger to the impacted communities.

People who live next to these drilling sites are reporting a wide range of adverse health effects including respiratory difficulties, skin rashes, digestive disorders, and neurological problems. There are complaints of foul odors, water pollution, incessant noise and 24 hours per day production.

This past week-end I heard first hand about these problems, as CHEJ conducted two training workshops in western PA. The first workshop was in Dubois, in north western PA in Clearfield County. The host group was Pennsylvania Alliance for Clean Water & Air (PACWA). They shared a “List of the Harmed,” a report describing 565 people with adverse health and environmental problems related to fracking sites. This is an incredible collection of first hand accounts of the impacts of fracking that covers the entire country.There was more of the same the next day in Butler.

In preparing for a presentation on the health impacts of fracking, I searched the published literature for papers that addressed this issue. I found none, though my search led me to a colleague who is presenting a paper on this very topic at the annual meeting of the American Public Health Association this week in San Francisco. She alerted me to a paper in the published literature by Michelle Bamberger and Robert Oswald, researchers at Cornell University in NY. This paper, “Impacts of Gas Drilling on Human and Animal Health,” published this year in the journal New Solutions, was  the only paper that she had found.

This paper includes 24 case studies that describe animal health effects and some human health effects in 6 states. Owners of livestock were interviewed who had suspected water and air exposures associated with living near natural gas extraction wells. The livestock had suffered a variety of adverse health effects including reproductive, skin, digestive, urological, respiratory and neurological problems, and in some cases sudden death. The owners in many cases experienced health effects as well. These effects included respiratory and neurological problems, skin rashes and digestive problems. These findings are similar to what PACWA reported in their List of the Harmed.

Another excellent summary on the human health risks posed by fracking was prepared by scientists for the Grassroots Environmental Education organization. This paper, “Human Health Risks and Exposure Pathways of Proposed Horizontal Hydrofracking in New York,” was presented at a meeting with state officials in Albany, NY earlier this month.

At this time, there are very little scientific data (one paper) documenting adverse human health effects resulting from the extraction of natural gas using hydrologic fracturing. Meanwhile, grassroots activists are organizing and collecting their own data documenting adverse health effects in people living near natural gas drilling sites. It’s clear that a number of hazardous and toxic chemicals are used in and produced by the fracking process. It’s also clear that a number of very realistic and in some cases documented routes of human exposure exist. But without additional information, including on the proprietary chemicals mixed in with the drilling fluids, the public health risks of natural gas extraction from hydrologic fracturing will be difficult to quantify.

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Backyard Talk

Halloween Nightmare

I dreamed that just as I entered a Halloween haunted house the first monster I ran into was Frackenstine.  Just like the book Frankenstein written by Mary Shelley about a creature produced by an unorthodox scientific experiment I noticed that the Frackenstine that stood before me was also made up by combining many parts.  Frackenstines legs turned out to be the Ohio legislature that gave the monster his legs to make his way around Ohio, his torso was made of the Ohio oil and gas industry, his arms were the different state agencies that gave the monster the strength to strong-arm Ohio communities by not allowing citizens or local government to have any say into whether or not they wanted this massive industrial process to destroy their community.  The Frackenstine monster was so big I was having a hard time seeing who or what made up the head  but as I moved farther away from the monster I could see that the monsters head was Ohio’s own governor, Governor John Kasich who has become the mouthpiece and cheerleader for industry.

Down a long dark hallway I came to a closed door, as I opened the door I saw a room full of bubbling cauldrons.  As I looked around the room I saw thousands of Material Safety Data Sheets with all of the toxic chemicals blacked out.  There was also a flashing sign that warned of radiation.  While trying to read all of the signs I was suddenly approached by someone dressing in a hazardous materials moonsuit telling me that bubbling brew was safe and not to worry.  Even though he was dressed in protective garb he informed me that I was not allowed to know what was in the bubbling toxic brew and the door was quickly closed in my face.  As the door closed I could hear the sinister laugh of a crazy person who had spent too much time inhaling the toxic vapors of the bubbling cauldrons full of fracking fluid.

As I continued down the dark hallway I turned a corner and was face to face with a Vampire with blood dripping from his fangs. NO wait, it wasn’t blood dripping, I realized his fangs are drilling rigs that were dripping oil and he is hungry for more and more.  He can’t get enough; he is sinking his rigs into hundreds of thousands of acres of Mother Earth just to see if he can find more oil or gas to feed his needs.  I thought if I can just hold out until dawn the sun would destroy this vampire, but I was so wrong.

As I was about to exit the haunted house I heard the screams of the banshee foretelling the death of life as we know it.  No longer will we have local communities where we can cross the street without worrying about being hit by one of the thousands of trucks or being harassed by out of state workers that have no since of pride for the community.  We face industrial facilities in places where they have no business being in.

But wait, I suddenly realized I was not asleep, I was not having a nightmare.  What I had thought was a horrible nightmare was indeed reality for many communities in Ohio and across the nation that are faced with the nightmare known as fracking.

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Backyard Talk

Our Children's Schools Matter – When We Fail-They Fail

It is sad that across the country as new youngsters are entering school they are placed in harm’s way. Their emotions are mixed worried about leaving their home, daily environment and routine, while at the same time excited about their new experiences.  But toxic dangers in the air or nearby are not part of their mantra.

Yet in schools across the country parents are concerned that the location of the school building will threaten the health of their children and possible their children’s ability to lean. For example, in Richmond, Virginia there is a petition, asking the Richmond School Board to ensure the preschoolers of Norrell Elementary, near a landfill are being educated in a safe environment.  Although the petition has gained some national attention to an issue, there hasn’t been any resolution to longstanding concerns to Richmond, Virginia residents.  It hasn’t provided the pressure yet to force authorities to answer parents questions.

It has with 27,370 signatures created awareness about schools on landfills across the country and beyond. And, signatures on this petition has provided energy to beleaguered city residents who feel like they’ve been disregarded and disrespected by authorities.  A new round of testing has been committed of the school building grounds near the landfill but there is no evidence of safety.

“Local resident Kim Allen said, these developments have empowered us as we’ve come to know ourselves as people who make a difference in our community.  I, and other private citizens like me, are lending a voice to concern for the safety of children, children like my four-year-old nephew Malachi. We speak on behalf of ourselves and our families. Being a private citizen is a privilege and a powerful place to stand when addressing the safety of the children who attend Norrell Elementary school.

The question I asked myself was, Would I be okay with Malachi being in the Norrell School building for 6 hours a day, 5 days a week?  My answer . . . I don’t know. Given that concern and the urgent nature of the matter, I helped to initiate the petition.”

Despite working for over thirty years at CHEJ I’m still shocked by the blatant disregard for children’s health year after year.  Schools continue to be built on or near dumpsites like Ms. Allen speaks about or the school built in Detroit literally on top of a Superfund site. Most of these schools, not surprisingly, serve low wealth and communities of color.

Further harming everyone in the school family, when the children fail at the standardized testing it is the parents or the teachers fault — not the fault of the chemicals that inhabit their ability to learn or cause them to be sick and absent too often from school to keep up.

In Houston, Texas their recently built high school, which houses 3,500 students, is encircled by a dozen chemical facilities.  So close that if there is an accident or release at any of them, the children are trapped, left only to put wet paper towels along the window sills.  Yet, the releases from these facilities are constant and as children enter, leave or go outdoors for recess or sports they are exposed to air pollution daily.  Like the other schools when these young people fail at meeting the goals of standardized testing their parents and teachers are blamed.

It is time for all Americans to stand up and speak out about putting our children in harm’s way.  It is our tax dollars that are building these schools and we should have laws that compel schools authorities to build places of learning in safe environments.  Enough is enough.  Our children matter and are the future of our country.

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Backyard Talk

Protect Your Grandchildren Today – Eat Fat Free – Less Dioxin

A few years ago a study conducted by the NY State Department of health on former Love Canal residents identified two very important facts.  First the rate of birth defects in Love Canal children (those who were children living in the area during the crisis) is as high as it was for adults during exposures while living at Love Canal (56% of children were born with birth defects). The second finding was that there were statistically more girls than boys born to Love Canal children.  Generally it is believed that that change in normal ratio of male/female children is an indicator of exposures to hormone disrupting chemicals.

You may have already heard about these health outcomes in our newsletter or other communications.  It was the recent news about a study of dioxin and rats that reminded me of  the Love Canal studies.  At Love Canal there were 20,000 tons of chemicals buried in the center of the community and one of the chemicals identified in backyards was dioxin.

When I read the recent animal studies around dioxin and how exposures impacts children across generations, I was worried again.  Not only about my family, friends and former neighbors but for all the communities like Time Beach, Mo, Pensacola, FL, the ones people may have heard about but also communities not in the news in Texas, Georgia, Louisiana, Washington and every other community with a paper mill, wood treatment facility and pesticide sprayers.

Here is the scary news. “Pregnant rats exposed to an industrial pollutant passed on a variety of diseases to their unexposed great-grandkids.” Washington State University scientists found that third-generation offspring of pregnant rats exposed to dioxin had high rates of kidney and ovarian diseases as well as early onset of puberty. They also found changes in the great-grandsons’ sperm. The great-grandkids – the first generation not directly exposed to dioxin – inherited their health conditions through cellular changes controlling how their genes were turned on and off, the researchers reported. The dioxin doses used in the study were low for lab rats, but are higher than most people’s exposures from the environment. The study raises questions that won’t be easy to answer about people’s exposure to dioxins from food and industrial sources.

Dioxin builds up in the body and has up to a decade-long half-life in humans, so scientists say a woman who becomes pregnant even 20 years after exposure is at risk of transmitting the consequences of her exposure to later generations.  Most human studies of dioxins have focused on the direct exposure in adults and fetuses. A study of a 1976 industrial accident in Anshu Seveso,  Italy, documented health defects in the grandchildren of women that conceived as long as 25 years after exposure to dioxin. No human studies have investigated how a person’s dioxin exposure will affect their great grandkids.

So what does this mean for the millions of people directly exposed dioxin and almost everyone eating dioxin contaminated foods daily?  The average American is at 77% of the level below which exposures are considered to be safe.  That level is set for adults not babies and small children.  Children have different eating habits than adults. They tend to eat more dairy products that are high in dioxin. Dioxin is prevalent in foods that are high in saturated fat, primarily meat and dairy.

This information really reaffirms that everyone needs to eat foods with little animal fats and fat free dairy to protect our great, grandchildren.  It also should send an urgent message to EPA to get industries to clean up and stop producing dioxin pollution now.  We can’t wait nor can our grant grand babies.  Read more:

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Backyard Talk

Petrochemical America: Picturing Cancer Alley

Last month, when news outlets around the country covered our press event revealing toxic phthalates in children’s Back To School supplies, we were proud of the work we’d done. Tens of thousands of Americans had been educated about how to avoid real risks to their children’s health.

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Abandoned trailer, Mississippi River, Near Dow Chemical Plant, Plaquemine, LA, 1998. From Petrochemical America, photographs by Richard Misrach, Ecological Atlas by Kate Orff (Aperture 2012).

But as so often happens, absent from the coverage were the stories of the people who live near the chemical plants that produce the vinyl, whose land, air, and water has been harmed for decades by some of the most profitable companies in the world.

This month, CHEJ is proud to help present those stories in a way they have never been presented before.

Petrochemical America: Picturing Cancer Alley is a groundbreaking new collaboration by photographer Richard Misrach and landscape architect Kate Orff, debuting at Aperture Gallery and Bookstore in NYC tonight. Through haunting photographs and innovative composite images employing ecological and sociological data, gathered over the course of 14 years on the banks of the Mississippi river in Louisiana, the book and gallery exhibition provide a moving and deeply informed portrait of the American “sacrifice zones” upon which our use of plastics, oil, and gas depends. Read more about Plaquemine, LA, pictured above.


For those in New York City, we invite you to attend two free, upcoming gallery events:

  • Tuesday, Sept. 25th, at 6:30pm: A panel discussion with our own Mike Schade, joined by Ms. Orff and Wilma Subra of the Louisiana Environmental Action Network.
  • Tuesday, Oct. 2nd, at 6:30 pm: A talk and screening of the excellent and darkly comic film Blue Vinyl, with author David Rosner and landscape designer Gena Wirth.

Both events are free and include access to the exhibit. They will take place at Aperture Gallery and Bookstore, 547 West 27th Street, New York, NY.



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Human mismanagement is turning lush cypress trees into ghostly poles, jeopardizing Louisiana’s bayou ecologies, local economies, and cultures. Requiem for a Bayou. From Petrochemical America, photographs by Richard Misrach, Ecological Atlas by Kate Orff (Aperture 2012).


For our supporters around the country, we encourage you to explore the content of the book and consider purchasing a copy. Aperture Foundation is nonprofit, and book sales help sustain its exhibitions, books, and magazine.

As we continue to advocate in New York City to get PVC out of new construction, renovation, and school supplies in our public schools, projects like Petrochemical America help us and our supporters keep in mind the full scale of what’s at stake in shifting to a safer, more sane, and more just material economy.

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Backyard Talk

Identifying Disease Clusters – What Comes Next?

It’s hard to say how many disease clusters have been identified. The website of the National Disease Cluster Alliance (NDCA) which held a national conference last week has a map that identifies 73 clusters. Several people attending the meeting pointed out that their cluster was not on the map and there are no doubt many others not on the map. While identifying clusters is an important step, knowing how to respond and what steps to take once a disease cluster (even a suspected disease cluster) has been identified is, perhaps, more important. This and other questions about disease clusters were discussed at a National Disease Cluster Conference held in Washington, DC last week by the NDCA.

It was clear from several presentations that no guidelines exist for what action steps a government agency should take once a disease cluster has been identified. This is a big problem, especially since most health agencies typically close their investigation once a cluster has been identified, concluding that they could not determine the cause of the cluster. This is not the time to walk away from a community that is struggling to determine not just whether a disease cluster exists, but what‘s causing it as well.

There are plenty of examples of communities where a disease cluster was identified. There is the cleft palate cluster in Dickson, TN, increase cancers in Clyde, OH, and childhood cancers in Toms River, NJ, Sierra Vista, AZ and Fallon, NV to name a few (see NDCA map). There are few examples, however, of agencies being able to identify the cause of the cluster. Woburn, MA is the exception as the state health department was able to identify contaminated drinking water wells as the cause of a childhood leukemia cluster.

No doubt determining the cause of a disease cluster is a difficult question to answer. It took the MA state health department over 10 years to conclude that the contaminated drinking water wells were the cause of the cluster in Woburn. But because it’s difficult is not reason enough for public health agencies to walk away. This is unconscionable and irresponsible. Public health agencies need to come up with an action plan for how to follow-up the finding of a cluster. Part of the response needs to include an environmental investigation into what may be causing the cluster. In addition, the community would likely benefit from the distribution of educational materials about the disease in question and the methods used to investigate clusters and their causes. Whatever follow-up occurs, the government needs to include from the very beginning of the process the affected community as part of the planning group directing the investigation.

One example highlighted at the conference was the work of Dr. Paul Sheppard from the University of Arizona who conducted an environmental investigation following the identification a childhood leukemia cluster in Fallon, NV. Between 1997 and 2004, 17 children living in Fallon were identified with leukemia, three of them died. For three years Sheppard studied heavy metals in air, especially tungsten which had been identified as increased in Fallon. Sheppard used tree leaves and tree rings to measure tungsten and found a high concentration of tungsten in the center of Fallon, the home to a tungsten refinery and a tungsten plant since the 1960s.

Although Sheppard was unable to prove that exposure to tungsten caused the increase in leukemia, his work has clearly related the two. His work provides a model for how to follow-up finding a disease cluster. Investigating environmental exposures in a community with a cluster makes perfect sense. Now we need to convince the public health agencies that they need to include this step in as part of their responsibilities. For more about the conference, see www.clusteralliance.org.