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told the story of the attorneys who
fought two large corporations that
were found to have leaked toxic
chemicals into the water supply
in Woburn, Mass., where health
officials had identified a childhood
cancer cluster. And two years later,
Julia Roberts won an Academy
Award for best actress as Erin
Brockovich, the file clerk who gets
Pacific Gas and Electric to make
a big payout to the residents of
Hinkley, Calif., where cancer was
linked to water the company had
contaminated with chromium.
Both movies, as is Hollywood
tradition, played fast and loose with
some of the facts. Even so, they
captured real truths often seen
in cancer cluster investigations:
a skeptical public that fears a
corporate or government cover-up, and the impact community
organizations, politicians and the
media have on these investigations.
Yet, they also undoubtedly
promoted the notion that a person
with enough grit and determination
can find the true cause of a cluster,
and who is responsible will be made
to pay. And as any epidemiologist
would be quick to point out, it is
the rare cancer cluster that has a
Hollywood ending.
Central Valley. Agricultural fields
surrounded the town, which had
a population of about 10,000
at the time. McFarland was also
the site of an Army pilot training
field during World War II. The
community had become convinced
that there was something in the
air, land or water that was making
the kids there sick.
The initial investigation conducted
by Neutra’s office indicated an
unusually high rate of childhood
cancer, he says, “and because of
where the area was located, and
the potential for pesticide exposure,
we took a look at it.” He and others
conducted a series of environmental
sampling studies over a seven-year
period. But no potential cause was
identified. The findings, which were
far from satisfactory for the people
of McFarland, became even more
disconcerting after seven more
children were diagnosed with cancer.
one of the key difficulties
the investigators faced, says
Neutra, was reconstructing which
pesticides were used around
McFarland and when. As a result,
the McFarland investigation led to
passage of a law requiring farmers
to register their pesticide use,
and this data is now often used in
cancer cluster investigations. But
for the families in McFarland, there
wasn’t—and still isn’t—an answer
to their cluster’s cause.
Mary Guinan knows what it
feels like to be unable to give a
community the answers it craves.
She’s the dean of the University
of Nevada, Las Vegas, School
of Public Health and the acting
Nevada state health officer. An
epidemiologist, Guinan held the
position of Nevada state health
officer from 1998 to 2002. And it
was during this time that a state
legislator from Fallon, a small city
in western Nevada, called to ask
if she was aware that doctors at
the Fallon hospital were growing
concerned about the number of
children being diagnosed with
leukemia.
CR | Page No. 39 | www.CRmagazine.org
NO ANSWERS
Neutra, for one, readily recalls
a childhood cancer cluster he
investigated during the late 1980s
in McFarland, a town in California’s
