Andy Miller is CEO and editor of Georgia Health News.This story was done in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.
Cristy Rice wants to know what caused her daughter’s cancer.
She’s reeling as any parent would with a child’s life-or-death struggle. But she’s also astounded that a rare form of the disease struck not only her teenager in June, but also other children in the same southeast Georgia region during the same summer.
It’s “mind-blowing,’’ said Rice, who lives in Waycross. “It’s outrageous.”
But is it environmental? The four childhood cancer diagnoses in Waycross and in neighboring Brantley County have reignited fears among residents that pollutants might be harming their health.
The affected children range in age from 2 to 14. Rice’s daughter Lexi is one of three diagnosed with rhabdomyosarcoma, a cancer that forms in the body’s soft tissues. It produces just 350 new cases each year in the United States.
The fourth child has Ewing sarcoma, a type of cancer that occurs most often in and around the bones. It affects roughly one in 1 million Americans each year, although the rate is somewhat higher for children, according to the National Cancer Institute.
Health experts have said the two types of sarcomas have no known environmental causes. Still, folks in Waycross can’t help but wonder. The 14,000 or so residents of the only incorporated community in Ware County, which sits on the Florida line, know their city has a history of problems with industrial contamination.
Having three rhabdomyosarcoma diagnoses in such a relatively small area is unusual, said Dr. Patrick O’Neal, director of health protection for the state Department of Public Health. The agency is investigating the cases “with great intensity,” he said.
But it remains to be seen whether the Waycross cases amount to a “cancer cluster,” defined by the Atlanta-based Centers for Disease Control and Prevention as a greater-than-expected number of cancer cases that occur within a group of people in a geographic area over a period of time. Proving a cancer cluster is difficult, because researchers must confirm that the individual cases are of the same type or derived from the same cause.
POLLUTION A FACTOR?
Public health officials, searching for a possible cancer link, have been looking into an industrial site that’s a sore spot for some in the community — namely, the CSX rail yard in Waycross, where contaminants include “chlorinated solvents, paint waste,’’ said Jim Brown, a state Environmental Protection Division official.
The “volatile organic compounds,” or VOCs, can cause eye, nose and throat irritation, loss of coordination, and damage to the liver, kidneys and central nervous system, according to the U.S. Environmental Protection Agency. They can also cause cancer in animals, and some are suspected or known to cause cancer in humans, the federal agency says.
But Brown, manager of the hazardous waste corrective action program at Georgia’s Environmental Protection Division, said the agency doesn’t think chemical releases at the rail yard are to blame for health problems in Waycross.
After a public meeting in November 2013, the EPD collected and analyzed soil and groundwater samples from residences around the CSX facility, Brown said. No contamination was detected in those samples above a health-based standard, and the results of that investigation were presented to the community at a public meeting in May 2014, he said.
Meanwhile, according to Brown, the railroad company, in tandem with the EPD and the Georgia Department of Public Health, has been investigating and cleaning up its solid waste management units.
“CSX is committed to being a good steward of the environment,” CSX spokeswoman Kristin Seay said in a statement. “CSX complies with all environmental regulations and is in compliance with current permits. … We have been a proud neighbor to Waycross for more than a century and look forward to continuing to work with our community partners.”
WHAT ABOUT WASTEWATER?
The rail yard is not the only potential source of industrial contamination in Waycross. Nearby is the former Seven Out facility, which treated industrial wastewater until its owners abandoned it in 2004.
In January 2005, the EPA took emergency action to remove about 350,000 gallons of wastewater and other liquids that flowed into a nearby drainage ditch. And two years ago, residents pointed to Seven Out as the possible origin of elevated chemical levels found in a drainage canal that runs through a Waycross park — although the Department of Public Health concluded that adverse effects were unlikely.
A third site of concern was Atlanta Gas Light’s manufactured-gas plant in Waycross, which closed in 1964. The investigation and cleanup of the site were conducted in the mid-1990s, concluding in 2001. Brown, with the EPD, said 125,000 tons of contaminated sediment were removed from nearby canals and their banks. The sediment contained volatile organic compounds.
LOOKING AT A ‘RED FLAG’
State Rep. Jason Spencer, a Woodbine Republican whose district includes Ware County, has heard the community’s concerns and believes the childhood cancers are a red flag.
“I want (the Department of Public Health) to really dive into this issue,’’ said Spencer, a physician assistant.
One challenge to establishing a direct cause is that cancer is all too common. As the CDC points out, cancer is the second-leading cause of death in the United States, responsible for one out of four deaths nationwide.
“There are no established environmental risk factors for either rhabdomyosarcoma or Ewing’s sarcoma,” said Dr. Sharon Savage, chief of the Clinical Genetics Branch of the Division of Cancer Epidemiology and Genetics at the National Cancer Institute. “It is difficult to identify the specific causes of most cancers, but particularly challenging for rare malignancies.”
O’Neal, of the Department of Public Health, said the investigation “will take much longer than anyone would like.” He urged community residents and area health care officials to contact the agency with any new information.
Georgia has a strong registry of cancer cases, but it often takes six to 12 months for clinicians to send information. “It’s not immediate reporting,’’ O’Neal said.
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