Thursday, March 18, 2010

Journal article reports on research planned around local polycythemia vera cluster

The International Journal of Environmental Research and Public Health has published an article about the cluster of the blood cancer polycythemia vera that's centered around the Hometown area. It notes that this is the first identified cluster of a so-called myeloproliferative neoplasm, a group of diseases that also includes chronic myelogenous leukemia, essential thrombocytosis and primary idiopathic myelofibrosis.

The study outlines the research that's supposed to take place regarding the cluster. Among the organizations involved are Drexel University School of Public Health, the University of Pittsburgh Cancer Institute, the Geisinger Clinic, Mt. Sinai School of Medicine, the Centers for Disease Control and Prevention and its Agency for Toxic Substances and Disease Registry, and the Pa. Department of Environmental Protection.

"This research agenda represents a unique and important opportunity to demonstrate that cancer cluster investigations can produce desirable public health and scientific outcomes when necessary resources are available," the abstract states.

The research to be done includes environmental testing around the cluster area's three waste coal cogeneration plants, which also burn waste diesel and fuel oil. An excess risk of polycythemia vera has been found in persons exposed to solvents, benzene, petroleum refineries and low doses of radiation.

In addition, the specific genetic mutation found in people with polycythemia vera is known to be associated with polycyclic aromatic hydrocarbons, and most notably the PAH benzo(a)pyrene. Formed during the burning of coal, oil, gas and organic substances, PAHs are a pollutant of concern with the fluidized bed combustion systems used in waste coal plants.

To read the article, titled "A Multidisciplinary Investigation of a Polycythemia Vera Cancer Cluster of Unknown Origin," click here.

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Friday, November 20, 2009

Mapping Hometown's toxic threats

I came across these useful maps today while wandering the Internet, at the website My McAdoo Home. They show various sources of toxic pollution in the area around Hometown, Pa., including coal ash dumps, Superfund sites, industrial operations and waste coal-burning co-generation plants.

The maps are not completely comprehensive -- for example, they don't include acid mine drainage sites, or gas stations where leaking underground tanks contaminated groundwater. But they do give a good sense of the scale of the environmental health problem facing the area, where a consultant recently told local residents that he hadn't before seen a community that's suffered so many different "environmental insults."

Click on map to see a larger version:





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Monday, November 2, 2009

Polycythemia vera and the price of death

The same evening the first meeting of the Community Action Committee took place in Hometown, Pa. for the U.S. Agency for Toxic Substances and Disease Registry's polycythemia vera cluster investigation in Schuylkill, Luzerne and Carbon counties, I attended a lecture at the University of North Carolina at Chapel Hill given by my friend Bob Del Tredici, a Montreal-based photographer who specializes in documenting the nuclear industrial complex and founder of the Atomic Photographers Guild.

I had hoped to attend the CAC meeting, but my travel plans were scuttled due to my getting a bad case of the flu. Getting to hear Bob talk was a wonderful consolation prize, though.

I already had a copy of Bob's book "The People of Three Mile Island", which features the photographs he took in the immediate aftermath of the 1979 meltdown at the nuclear power plant near Middletown, Pa. That book serves as a powerful witness of how what really happened at TMI was covered up by an official story that denies anyone was hurt by the radiation released during that disaster.

Last week I got a copy from Bob of another one of his books, "At Work in the Fields of the Bomb," which won the 1987 Olive Branch Book Award for its contribution to world peace.

As I was paging through it, I was particularly struck by one of Bob's photographs, which had special resonance for me given where my heart was at last Wednesday:



Posted here with Bob's permission, it's a photograph taken on Aug. 5, 1983 at the Aiken Community Hospital in South Carolina that shows George Couch, who worked for 22 years as a maintenance worker at the Savannah River Site, a nuclear materials processing center near Augusta, Ga. Bob writes in the caption:
Shortly before retirement, [Couch] contracted polycythemia vera, a rare form of blood cancer associated with radiation exposure. He was fired without compensation.

"There is no way of telling how many people have already died from polycythemia vera. The only way to know would be to check your people while they're living, except they say it's very expensive. But what is the price of death? How much is a person's life worth?"
To see more of Bob's photos from "At Work in the Fields of the Bomb," click here.

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Update on polycythemia vera research in Hometown area

I was hoping to be back home in Pennsylvania last month to attend the Oct. 24 public meeting in Tamaqua organized by the federal Agency for Toxic Substances and Disease Registry updating the community on research happening around the cluster of the blood cancer polycythemia vera in Schuylkill, Luzerne and Carbon counties.

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Unfortunately, I got seriously ill with what my doctor thinks was swine flu and couldn't make the meeting. Fortunately, the local press covered the story extensively.

The ATSDR didn't release the results of the first round of genetic testing at the Oct. 24 gathering but is waiting until the second round of testing is completed early this month, according to the Republican Herald. Of the $5.5 million in federal funding allocated so far to study the cluster, $3.753 million will go to other organizations for various projects, the Times News reported:

* The Myeloproliferative Disorder Research Consortium -- a nonprofit funded by the National Cancer Institute to conduct research on the genetic and cellular mechanisms of blood cancers -- will set up a tissue bank for polycythemia vera patients. That project will be led by Dr. Rona Weinberg, a professor at the Mount Sinai School of Medicine.

* Dr. Ronald Hoffman and Dr. Ming Xu of the Mount Sinai School of Medicine will conduct genetic analyses and a toxicology study.

* Under the leadership of Dr. Paul Roda, the Geisinger Clinic will look at patterns of the disease, educate area physicians about polycythemia vera, and look at clinical outcomes for patients with the disease. It will also study the prevalence of polycythemia vera in the Danville and Selinsgrove areas to compare to rates in the tri-county area.

* Dr. Arthur Frank at Drexel University's School of Public Health in Philadelphia will conduct a case-control study of polycythemia vera rates in the tri-county area.

* The Pennsylvania Department of Health will get funding to continue to monitor blood cancer in the area and to work with the University of Pittsburgh to conduct a comparison study, while the state Department of Environmental Protection will examine potential environmental causes.

* Funds will also go to the new Community Action Committee (CAC), which will be coordinated by Dr. Henry Cole of Henry S. Cole and Associates in Upper Marlboro, Md., with Joe Murphy of Hometown serving as the lead local representative. The group will serve as an "information conduit" between the agencies and the community.

Another $1.746 million will go the ATSDR itself for what's being called an "exposure investigative team" environmental and geospatial analyses, technical support and oversight of the outside researchers, and efforts to improve reporting by doctors of polycythemia vera and other so-called myeloproliferative disorders.

The Times News also reported on the first meeting of the CAC, which took place on Wednesday, Oct. 28 at the Hometown Fire Co. The group will be working with an advisory panel of scientific and legal experts that includes:

* Attorney Tom Gowen of the Locks Law Firm, who with Murphy was involved in an effort to bring a civil lawsuit over contamination at the McAdoo Associates Superfund site. That former abandoned mine-turned-waste dump is located near the polycythemia vera "ground zero" on Ben Titus Road in the Still Creek community where numerous cases of the disease first came to light. In 2006, the Locks firm concluded that it did not have a legal basis for proceeding with a civil action due to a lack of evidence that poisons dumped at the site have migrated to nearby wells or the Still Creek reservoir, which provides drinking water for the Hometown-Tamaqua area.

* Water contamination and public health expert G. Fred Lee of G. Fred Lee and Associates in El Macero, Calif.

* Robert Martin, the former ombudsman for the U.S. Environmental Protection Agency who resigned after the Bush administration tried to silence him for raising questions about former administrator Christine Todd Whitman's financial ties to the owner of a Denver Superfund site and a firm that provided insurance around the World Trade Center in lower Manhattan. The EPA under Whitman falsely assured Manhattan residents that they didn't need to worry about environmental contamination after the towers collapsed on 9/11.

According to the Times News, Cole told attendees of the CAC meeting that in his 40 years of working in his field, he might not have seen a community that had suffered so many different "environmental insults." Cole also said that it was very rare for the government to actually acknowledge a cancer cluster.

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Thursday, October 15, 2009

Public meeting on polycythemia vera cancer cluster set for Oct. 24 in Tamaqua, Pa.

The federal Agency for Toxic Substances and Disease Registry will hold a public meeting on Saturday, Oct. 24 in Tamaqua, Pa. to discuss efforts underway to address the unusually high rate of the blood cancer polycythemia vera in Schuylkill, Luzerne and Carbon counties in northeastern Pennsylvania's anthracite coal region.

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The meeting will take place from 10 to 11:30 a.m. at the Tamaqua Area High School Auditorium at 500 Penn St.

ATSDR officials will provide an update on the voluntary screening that's underway to area test residents for the JAK2 genetic mutation linked to polycythemia vera, a condition in which the body produces too many blood cells. In July, the agency announced that it would make free JAK2 testing available after an earlier study found a statistically significant cluster of the disease in an area bordered roughly by Hazleton to the north, Tamaqua to the south and Gilberton to the west. (Click on map above for a larger version.)

The researchers involved in that study have said that the close proximity of the cancer cluster to known sources of hazardous pollution "raises concerns that such environmental factors might play a role in the origin of polycythemia vera."

While the agency has not yet officially released any findings from the genetic testing program, a source close to the investigation tells Hometown Hazards that the results offer cause for concern, with the JAK2 mutation occurring locally an at incidence far above the expected one or two cases of the disease per 100,000 population.

Also at the Oct. 24 meeting, representatives from ATSDR, the Centers for Disease Control and Prevention, the Pennsylvania Department of Health, the Pennsylvania Department of Environmental Protection, the Mount Sinai School of Medicine, the Geisinger Clinic, and the Myeloproliferative Disease Research Consortium will present overviews of their current polycythemia vera research projects. Attendees will also hear more about a community group that will work with investigators.

Earlier this year, Congress allocated $5.5 million for further study of the polycythemia vera cluster.

While the ATSDR is focusing its current efforts on polycythemia vera, that is not the only cancer occurring at an unusually high rate in the tri-county area. The Pa. Department of Health's own study of local cancer rates from 1996 to 2002 also found statistically significantly elevated rates of other cancers:

* In Schuylkill County, buccal cavity and pharynx cancer for males and overall; colon and rectal cancer for males, females and overall; liver cancer overall; pancreatic cancer for females and overall; bronchus and lung cancer for females; cervix and uterine cancer; prostate cancer; and Hodgkin's lymphoma overall.

* In Luzerne County, stomach cancer for males, females and overall; colon and rectum cancer for males and overall; larynx cancer for males and overall; bronchus and lung cancer for females and overall; uterine cancer; thyroid cancer for females and overall; and leukemias for males, females and overall.

* In Carbon County, melanoma of the skin overall.

Though residents of Pennsylvania's anthracite coalfields don't typically think of themselves as part of Appalachia, the area is officially in the Appalachian region -- and the higher rate of illnesses and premature deaths in Appalachian mining communities has been documented by Michael Hendryx, associate director of the West Virginia University Institute for Health Policy Research in the school's Department of Community Medicine.

In a study released in July, Hendryx and Melissa Ahern of Washington State University documented how coal mining areas in Appalachia experience almost 11,000 more deaths each year compared with comparable areas elsewhere in the nation, with approximately 2,300 of those deaths related to environmental factors such as air and water pollution.

"Those who are falling ill and dying young are not just the coal miners," said Hendryx. "Everyone who lives near the mines or processing plants or transportation centers is affected by chronic socioeconomic weakness that takes a toll in longevity and health."

Another possible environmental factor contributing to the elevated cancer rates in the anthracite coal region is the area's high concentration of waste-coal-burning power plants, which release more cancer-causing polycyclic aromatic hydrocarbons than conventional burners. PAHs have been associated with the specific genetic mutation involved in polycythemia vera.

In addition, coal ash waste from these plants is being used to fill the area's numerous abandoned mines, creating the potential for contamination of groundwater with the ash's toxic components, which include arsenic, lead, mercury and radioactive elements as well as PAHs. Many residents of the largely rural anthracite region get their drinking water from wells, creating another potential pathway for toxic exposure besides air pollution.

The anthracite region is also home to numerous Superfund and other toxic waste sites as well as actively polluting industrial facilities.

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Wednesday, July 8, 2009

A comment on local cancer rates and the environment

The Times News has a story in today's paper titled "Rare blood disease hits home" about one man's experience with polycythemia vera and the public meeting slated for July 9 in Tamaqua about the plans for more research on the local cluster of that disease. I shared a comment at the paper's website that I also wanted to share with Hometown Hazards readers. Here it is in full.

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Thanks to Mr. Wertman for having the courage to talk publicly about his illness, to Donnie Serfass for his reporting, and to the Times-News for publishing this story, which helps give a human face to a serious problem affecting the anthracite coal region.

I'd like to share my thoughts about one particular point, to wit: "Some believe the problem is based on industrial pollution, past or present. At the very least, environmental factors are considered a suspect."

That's true. But it's important to keep in mind who that "some" includes, because it's not only those of us who've lived in the area with open eyes and basic common sense who believe environmental pollution is a likely factor behind the unusual cancer patterns. The independent and government scientists who studied the local incidence of the disease also reached that conclusion.

"The close proximity of this cluster to known areas of hazardous material exposure raises concern that such environmental factors might play a role in the origin of polycythemia vera," the researchers said in their published study.

And that was not an easy thing for them to say. As study author Dr. Ronald Hoffman of the Mount Sinai School of Medicine revealed in his sworn testimony earlier this year during a U.S. House subcommittee hearing, ATSDR's management first tried to discourage that research and then tried to prevent the publishing of findings suggesting an environmental connection.

"My sense is that if the agency was left to itself, it would have preferred to ignore the problem," he said.

Hoffman also told Congress that ATSDR misrepresented the study's findings at the October 2007 community meeting in Hazleton (a meeting that lead ATSDR researcher Dr. Seaman missed because his bosses had dispatched him to Africa not long before), demanded that Hoffman not exhibit the maps showing a geographic relationship between PV cases and pollution sources at a national hematology meeting and -- when he refused -- pestered him with repeated phone calls demanding that he either withdraw the abstract of his research, tell the conference that the agency disagreed with him, or present an abridged version of the data.

He called it an "obvious attempt at intimidation."

Also keep in mind that polycythemia vera is not the only cancer that occurs in the tri-county area at an unusually high rate: The Pa. Department of Health Study of cancer rates from 1996 to 2002 also found statistically significantly elevated rates of other cancers:

* In Schuylkill County, buccal cavity and pharynx cancer for males and overall; colon and rectum for males, females and overall; liver cancer overall; pancreatic cancer for females and overall; bronchus and lung cancer for females; cervix and uterine cancer; prostate cancer; and Hodgkin's lymphoma overall.

* In Luzerne County, stomach cancer for males, females and overall; colon and rectum cancer for males and overall; larynx cancer for males and overall; bronchus and lung cancer for females and overall; uterine cancer; thyroid cancer for females and overall; and leukemias for males, females and overall.

* In Carbon County, melanoma of the skin overall.

Some of those cancers could probably be blamed on unhealthy lifestyle choices, sure -- but not all of them. The fact is, too many people in this area are suffering from serious diseases because of the unhealthy choices of polluters and the government.

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Monday, July 6, 2009

Federal officials to hold Tamaqua public meeting July 9 about polycythemia vera research plans

The U.S. Agency for Toxic Substances and Disease Registry, the troubled Centers for Disease Control and Prevention subdivision that's investigating a Hometown-area cluster of the rare blood cancer polycythemia vera, will hold a public meeting this Thursday, July 9 to discuss how it plans to spend the $5.5 million Congress allocated for the official study into the problem, which researchers believe is environmental in origin.

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The meeting will take place from 7 to 9 p.m. at the Tamaqua Area High School auditorium. The ATSDR's press release about the event, posted below in full, says it will provide "an overview of the PV research and other activities that will be funded by a special appropriation. In addition, the principal investigators of three already-identified projects will be on hand for more detailed discussions of their work. The projects include: the Drexel epidemiological study, the McAdoo Superfund Site Water Outflow Study, and the ATSDR JAK2 screening project."

Please note that while the headline says the test indicating whether a person has the JAK2 genetic mutation associated with polycythemia vera is "to be available for area residents," blood draws will in fact be done in August and not at this week's meeting.

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ATSDR Slates July 9 Public Meeting on Polycythemia Vera Issues - JAK2 Testing to Be Available for Area Residents

Carbon, Luzerne, Schuylkill County County, Tamaqua, Pennsylvania

Tuesday, June 30, 2009


ATLANTA - The federal Agency for Toxic Substances and Disease Registry (ATSDR) will hold a public meeting in the Tamaqua High School auditorium, 500 Penn St, Tamaqua, PA., on Thursday, July 9, 2009 from 7:00 to 9:00 p.m. to inform area residents of recent efforts regarding polycythemia vera (PV).

At the meeting ATSDR officials will present an overview of the PV research and other activities that will be funded by a special appropriation. In addition, the principal investigators of three already-identified projects will be on hand for more detailed discussions of their work. The projects include: the Drexel epidemiological study, the McAdoo Superfund Site Water Outflow Study, and the ATSDR JAK2 screening project.

The JAK2 genetic marker was discovered in 2004 and found to occur in more than 95% of PV patients. Many experts believe people with PV and related blood disorders may test positive for the JAK2 marker for a number of years before ever exhibiting symptoms of PV. It is not known at this time if the JAK2 marker always leads to PV or another blood disease.

Since the rates of PV are higher in this area of Pennsylvania than other parts of the state, ATSDR will offer free blood tests to the community for the purpose of screening for the JAK2 gene marker. By volunteering for this testing, residents can learn if they carry this marker, even though they are currently without symptoms of PV. Early diagnosis and treatment of PV can prevent or delay complications.

Individuals aged 40 or older are deemed most likely to test positive for the JAK2 marker; however, anyone living in Carbon, Luzerne or Schuylkill County is eligible for the screening. Blood draw clinics will be set up in Hazelton, Tamaqua and Pottsville from August 3-6 and August 10-13, 2009. Individuals are encouraged to make an appointment ahead of time by signing up at the public meeting or by calling 1-877-525-4860.

MEDIA NOTICE: A media availability session with the presenters and ATSDR officials will be held on site prior to the start of the public session from 6:00 to 6:45 p.m.

ATSDR, a federal public health agency of the U.S. Department of Health and Human Services, evaluates the human health effects of exposure to hazardous substances.

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