USA Today Reports on the Fallon Cancer Cluster

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http://www.usatoday.com/news/health/2001-04-12-cancer-town.htm

04/12/2001 - Updated 12:14 PM ET

Cancers haunt town, defy science

By Ritter, USA TODAY

FALLON, Nev. - When 3-year-old Gross came down with leukemia in 1999,

it caused barely a ripple here. When the disease struck a second child that

year and nine more last year, health authorities were stunned.

This desert town of 8,200 and its surrounding county 60 miles east of Reno

should have no more than one childhood leukemia case every five years, based

on national averages.

The cluster of cancer cases has thrown Fallon into turmoil. Parents fear

that their children will be stricken next. Health officials face accusations

that they responded too slowly. Politicians are trying to balance support

for the sick children with damage control for a civic black eye.

Despite extensive testing, the leukemia's cause remains a mystery.

" They need to be more aggressive because our environment is changing all the

time, " says Gross, 's mother. " I'm afraid things will change

too much, and they'll never find a link. "

Today, the Senate Environment and Public Works Committee will hold a hearing

in Fallon and may urge legislation to give federal health officials a role

in cancer clusters similar to the Federal Emergency Management Agency's role

in responding to disasters.

" We have to have a more aggressive posture, " says Sen. Harry Reid of Nevada,

the committee's ranking Democrat.

Sen. Hillary Rodham Clinton, D-N.Y., a committee member, will attend because

of her interest in several unexplained cancer clusters in New York,

including an outbreak of breast cancer on Long Island.

Twelve childhood leukemia cases have been identified in Fallon and Churchill

County, a prime Nevada farming region with irrigated fields of alfalfa and

Hearts O' Gold cantaloupes. The children, including one who had moved from

the area, ranged in age from 1 to 19 when diagnosed. Three older cases from

1990 and 1992 are not officially part of the cluster.

Despite several suspected causes - among them the highest arsenic levels in

any U.S. municipal water supply - investigators aren't close to solving the

case. They admit that, as with virtually every other cancer cluster studied

in the past 40 years, a cause may never be found.

From 1961 through 1982, the federal Centers for Disease Control investigated

108 cancer clusters but found no obvious cause for any. " Those are real

discouraging statistics, especially if you're in my shoes, " Nevada state

epidemiologist Randall Todd says. The CDC stopped initiating cluster

investigations after 1982 and now assists local probes when asked.

Sinks, associate director for science of the CDC's environmental

health center, says that in a handful of instances since 1982, preventable

causes have been found, but they involved extremely rare cancers or known

carcinogens. Nearly 80% of all clusters involve leukemia, the most common

childhood cancer and the No. 1 disease killer among children.

Critics say the government's standards of proof are impossibly high. " Part

of the reason they never make a link is they have to be 95% sure first, "

says Lois Gibbs of the non-profit Center for Health, Environment and Justice

in Falls Church, Va. Federal agencies are afraid of being sued by large

corporations or even state and local governments, Gibbs says.

The Fallon cluster is unusual, experts say, because all 12 cases involve

acute lymphocytic leukemia (ALL). The disease causes patients to produce too

many immature white blood cells, weakening the body's immune system and

hampering the blood's ability to clot and carry oxygen. Nationally, four of

five children survive ALL, and there have been no deaths among the Fallon

children.

Clusters usually include both ALL and acute myeloid leukemia (AML), a

deadlier type more likely to be associated with exposure to toxic chemicals.

If environmental contaminants are causing Fallon's cluster, as many

residents here believe, experts also would expect to see AML cases.

Many suspect the city's water, but a panel of cancer experts discounted the

theory because high levels of naturally occurring arsenic had been present

in the groundwater for at least 60 years before the cancers appeared.

Arsenic has been linked to bladder, lung and skin cancers but not leukemia.

Some parents blame a combination of exposures. " I believe it's benzene from

jet fuel dumped by the Navy pilots, either by itself or a mixture with the

arsenic that's already here, " says Matt Warneke, whose daughter stacia

was diagnosed last July. Fallon Naval Air Station, home of the " Top Gun "

flight school, lies east of town.

The Navy says its pilots rarely dump fuel. Todd, the state epidemiologist,

says jet-fuel chemicals have not been found in city water, and even if

dumped fuel evaporated, prevailing winds would carry the vapors away from

Fallon. He says another popular theory, that soil and water harbor radiation

from a 1963 underground nuclear test nearby, seems unlikely for the same

reasons: prevailing winds and the fact that the water has tested negative.

Yet Todd, like the families, isn't willing to attribute 12 cancer cases to

coincidence. " The chance of a statistical aberration is probably less than

5%, " he says.

The Environmental Protection Agency has ordered the city to reduce arsenic

levels from the current 100 parts per billion to 10 by 2003. The Bush

administration has said it will try to relax that national standard, adopted

in the waning days of the Clinton administration.

Arsenic-removal technology would cost about $10 million, the city estimates.

Many longtime residents oppose it because water bills would quadruple. " The

majority sentiment is not to fix the arsenic, " Mayor Ken Tedford says. " They

had a public vote in the 1970s on whether to treat the water, and I think 19

people voted to treat. "

State officials have tested water from wells that half the leukemia families

use instead of municipal water. Results are expected later this month. A

team from the federal Agency for Toxic Substances and Disease Registry

arrives next week to look for other contaminants and explore how residents

might have been exposed to them.

The leukemia families want the Legislature to approve $1 million that their

assemblywoman, Marcia de Braga, is seeking for more tests, but lawmakers

haven't acted. The parents want investigators to ramp up their efforts, and

they want no delays in cleaning up the water, even if arsenic isn't the

culprit.

" I feel like we're paying for poison, " says Eusebio r, whose 2-year-old

daughter, Gladys, was diagnosed six months ago.

Mayor Tedford says the focus for now must be on the children, but at some

point the city will have to address a tarnished image. " How do you tell a

nation you had 12 leukemia cases and it's over, when you don't know if it's

over? " he says. " How do you tell a nation you had 12 leukemia cases and

found a reason, when you may never find a reason? "