Fallon leukemia cluster study released

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http://www.rgj.com/news2/stories/news/984204599.html

Fallon leukemia cluster study released

X. Mullen Jr.

Reno Gazette-Journal

March 9th, 2001

Viral infections, unknown environmental pollutants and random chance are the

three top suspects in the dozen childhood leukemia cases in Fallon,

according to a state report released Thursday.

The report by an expert panel formed by the Nevada State Health Division

also recommends further study of leukemia cases, pollution sources and

population movements in the Fallon area. The panel also recommended the

reduction of arsenic in the town's well water.

Floyd Sands, whose daughter, , 21, is among the 12 cases of acute

lymphocytic leukemia linked to the Fallon area, said he believes there is an

environmental cause for the disease outbreak and that bad luck has nothing

to do with it.

" It defies logic that it can be random, " he said. " If you flip a coin 12

times and come up heads, that's a 50-50 chance each time you flip it. But

the odds of 12

ALL cases in such a small area are more than astronomical. It's impossible

without a cause. "

Sands, who now lives in Pennsylvania, said the families of the 12 patients

must maintain pressure on officials to seek a cause for the cluster and for

another case of bone-marrow disease in Fallon. A suspected 13th case of ALL

turned out to be a Fallon-area boy suffering from aplastic anemia.

None of the victims, who ranged in age from toddler to 19 when diagnosed,

has died.

The viral or bacterial theory listed by the panel is based on " population

mixing, " an " unusual mixing of people, often in relatively isolated rural

areas. " In those areas, exposure to infection could " trigger an unusual and

rare reaction that affects a very small number of children, " the report

states.

The theory originated from an English researcher who studied more than a

dozen leukemia clusters in

Britain, most near nuclear processing or power plants.

The theory assumes chromosomes are damaged by infections, and the damage

leads to cell abnormalities such as ALL.

The experts who wrote the Fallon report said that to test the theory, the

rate of occurrence of ALL should be calculated in other rural areas which,

like Fallon, have a lot of " population mixing. "

The scientists said they can't rule out chance, but admitted the cluster isn

't likely to be random.

The report also states the absence of acute myeloid leukemia cases, a type

of the disease most closely associated with toxic chemical exposure,

suggests the Fallon cases aren't the result of pollutants in the air, water

or ground.

Recommendations from the panel include collecting biologic specimens for

future analysis and getting more information on population movements in the

Fallon area from 1990 to 2000.

While the panel's experts doubt that Fallon's high levels of arsenic in

groundwater could explain the ALL cases, they said federal arsenic standards

should be met as soon as possible.

The arsenic level in the Fallon area, 10 times recommended federal

standards, is " a human health hazard regardless of its relationship to the

excess of ALL, " the report states.

The panel included Dr. Robison of the University of Minnesota Cancer

Center; Dr. Sinks of the Centers for Disease Control and Prevention;

Dr. Allan of the University of California, Berkley; and Dr. Malcolm

of the National Cancer Institute.

Nevadans on the panel were Guinan, state health officer; state

epidemiologist Randall Todd; Dr. L.D. Brown of the state Health Laboratory;

and Dr. Burton Dudding of the University of Nevada School of Medicine.