|
Cancer Clusters Cancer clusters are one of the most frightening, frustrating situations a community can encounter. The families simply want to know what is killing their children and how to stop it from happening anymore, but these two questions are often answered last, if answered at all. I have yet to see any health agency define a "cause" for any of the clusters they have officially acknowledged. The lack of answers or assistance to the families of stricken children is a story filled with fear, helplessness, anger, self-blame, and disillusionment with the very people to whom they turn for help: their government officials. One Small Town and Sixteen Children with Cancer The McFarland story is a prime illustration of the dynamics involved when a "cancer cluster" is identified or suspected. It reads like a complicated murder mystery. The crime: at least 16 children stricken with cancer. The scene: a small rural community in Kern County, California. The suspects: everything from pesticides to electromagnetic radiation from radio transmission lines. You have a multitude of witnesses, from frightened families to campaigning politicians, each with different accounts of what has happened and what needs to be down. You have the experts and investigators, all with their own pet theories but none with enough evidence to arrest the culprit and put a stop to the mindless killing. And, in the midst of all this confusion and panic, you have the families of the victims trying to make sense out of this senseless "crime" while the list of young victims continues to grow. The scene of the crimes is the small rural town of McFarland located 20 miles north of Bakersfield. Like most towns in the San Joaquin Valley, McFarland has strong ties to farming, with a large proportion of the population of 6,500 made up of Hispanic families that earn their livelihood in the surrounding fields of cotton and citrus and almond orchards. The crime is that at least 16 McFarland children have contracted cancer. The victims range in age from under two years to 15. The types of cancer include leukemias, retinoblastomas, Wilms (kidney) tumors, osteogenic (bone) sarcoma, a neroblastoma involving nerve tissue, and two different kinds of tumors of the muscle tissue. The latest tumor, detected in 1989, is a craniopharyngeononma, a brain tumor some argue is different and shouldn't be linked with the other cancers. Since 1983 six of the 16 children have died. The first clues emerged in 1983 when Tresa Buentello, age 3, and Randy Rosales, 14, were diagnosed with cancer. Living on the same street, their parents began to wonder if the cancer cases, although different types, were connected. When a third child a block away was diagnosed with cancer, Randy's mother, Connie Rosales, realized something was terribly wrong and began to ask the Kern County officials to evaluate whether high nitrates in the water or pesticide spraying in nearby fields could be the culprit. In July of 1984, Tresa Buentell died at the age of 4. The panic and realization of what was happening united the parents who began demanding that something be done.
As is true of most instances of environmental poisoning, it wasn't the public agencies that identified the "cluster," but the local people who had to convince officials that this wasn't simply "random chance." By 1985, a total of eleven children had contracted nine different kinds of cancer between 1981 and 1984, a number four times the expected cancer rate. In addition, unusually high numbers of miscarriages, fetal deaths, and low-birth weight babies have been reported by doctors. This combination of circumstances is so unusual that public officials finally declared McFarland to be the site of a childhood cancer cluster and ordered an extensive investigation in order to try to find what is causing such health problems. Two-Phase Study As difficult as it was to get the attention and acknowledgement of the agencies that a cluster existed, the struggle to find what is killing the children of McFarland has been overwhelming, confusing, and disappointing. According to Dr. Rick Kreutzer, California Department of Health Services, Epidemiology Section and lead on the McFarland Task Force, the investigation has been divided into two phases. The first phase began in 1984 with a case control study conducted by Kern County. In this study families of the stricken children were interviewed about their life styles and a control group of parents interviewed. A comparison was made to see if there are any specific factors that could account for the health differences. In this study a specific factor was identified: the parents of the stricken children were farm workers. Dr. Kreutzer indicates this distinction between stricken and non-stricken children was a mistake in data analysis and has since been refuted. The second phase of the investigation is entailing environmental testing of air, soil, and water with prime suspects being metals in the soil, pesticide spraying, and solvents. Results so far have shown no soil levels of anything out of the ordinary and no air contaminants. Water testing has documented nitrates in water (a long standing problem in the area) and elevated levels of dibromochloropropane (DBCP) in one well. The well with DBCP was opened after the cancer cases appeared and has since been shut down; nitrate removal equipment has been installed. Nitrates are known to cause methemoglobinemia, a blood disorder commonly called the "blue baby syndrome." There is also some evidence that nitrates can form carcinogenic nitrosamines when ingested in "very high levels," resulting in stomach cancers in laboratory animals. While the reports say no pesticides were detected in McFarland’s water, health experts point out that routine tests are capable of detecting only a handful of the 15,000 pesticides registered for use on state crops. Not finding any levels may simply mean that testing was not conducted for a particular pesticide, which in fact may be there. Moreover, most pesticide ingredients are lacking critical health data and full pesticide formulations are virtually untested. Pesticides The Most Likely Killer In a preliminary report released in February 1988, the Task Force concluded that the most promising lead in explaining the health problem in McFarland is the use of pesticides. The theory is that some environmental aberration occurred in McFarland during that three year period and the cancers are the result. The fact that McFarland children have nine different kinds of cancers had left investigators baffled. Dr, Beverly Paigen, a geneticist and biochemist at Children’s Hospital in Oakland, offered a possible explanation through a process called somatic recombination, a change in genetic arrangement that can be triggered by a toxic agent. Genetic research has shown that when a single gene has been altered, it is possible that different kinds of cancers may be caused by that mutation. The task Force’s search for possible contaminants is now focused on a dozen pesticides heavily used during a three year "window of exposure" period of 1980 to 1983. Since it is estimated that only 20 percent of pesticide use is reported, some wonder whether it is even possible to find "the" pesticide. Joyce Johnston of the Kern County Action Network notes, "The twelve pesticides identified by the task force as those most heavily used during that period are the ones reported. We have no idea what was heavily used and not reported." What Do You Do When There Are No Answers? From the very beginning, McFarland parents were cautioned that coming up with answers would be difficult, if not impossible. The officials have lived up to that self-fulfilling prophecy. So with the uncertainty, unanswered questions, and continuing cancer cases appearing, the families are left to wonder, "Where do we go from here?" The Community has been successful in forcing the Department of Health Services to conduct a screening program of the children of McFarland. The screening consists of a medical history, neuropsychological tests, physical measurements, and blood testing with samples "banked" for analysis in the future. Doctors are reviewing the findings and will be referring the children to specialists if any abnormalities are identified. Lessons From Many McFarlands McFarland illustrates the lessons learned at other communities like Love Canal, Times Beach, and Stringfellow Acid Pits (Southern California): you can’t count on the agencies to "prove" there’s anything wrong or whether it is linked to particular cause. Moreover, even if they "prove" a connection, that doesn’t guarantee anything will be done to correct the situation. We’ve learned over and over again that the studies produce statistics to be analyzed away; that the tests produce numbers to be classified into safe levels or standards; and that experts can find ways to explain away anything. It is only when communities stop trying to "prove" they deserve help, and begin demanding such help that they get results. By uniting with their neighbors and organizing specific actions, they may hope to meet some of their families’ needs. Such demands may be bottled water or a new water system, assistance with meeting the financial burden of medical costs, full disclosure of pesticides used in the area, continued health monitoring, or relocation to a less hazardous area. McFarland is only one of many "clusters" in the San Joaquin Valley and across the nation. There are other communities facing the same nightmare: California towns like Fowler and Rosamond; Maryvale, Arizona; and Margan City, Louisiana. There are undoubtedly hundreds more that have yet to be identified. McFarland may be an early warning of nightmares to come.
|