In Churchill
County, which
includes Fallon
(opposite page),
an unusual
number of
children were
diagnosed
with acute
lymphocytic
leukemia and
acute myelocytic
leukemia.
CR | Page No. 40 | Winter 2009
In sparsely populated Churchill
County, which includes Fallon,
you’d expect to see one case of
childhood leukemia every five
years, says Guinan. But there had
been five diagnoses within a few
months of one another. And while
her team was investigating, there
were even more.
There was no question if
this was a cluster. “This was an
ongoing situation, and we knew
there was a problem,” says
Guinan. The search was on for the
responsible environmental agent
or agents.
By the end of 2001, 15 children
who were current or former
residents of Churchill County
had been diagnosed with acute
lymphocytic leukemia (ALL) or
acute myelocytic leukemia (AML).
over the next three years, there
were two more diagnoses, with
the last child diagnosed in 2004.
Three have died. The investigators
looked at where the parents
had been during pregnancy,
and asked about exposures to
solvents, chemicals, radiation and
other toxins. There were plenty
of suspects. Arsenic naturally
occurred in Fallon’s water. Some
residents thought a jet fuel
pipeline that ran through town
could be leaking. others believed
an underground explosion in 1963
had put radioactive substances
into the water supply. But there
were no answers, just new cases.
By this point, the investigations
were ostensibly over. But the
community was not satisfied,
and they lobbied for additional
research funding. U.S. Senator
Harry Reid, of Nevada, obtained
$750,000 from the federal
government to pursue avenues
that had not been explored by
the Centers for Disease Control
IF YOU SUSPECT A CANCER CLUSTER
If you’re concerned that you may be living in a cancer cluster,
first make sure you have facts and documentation about the cancers
in your area, says Linda Gillick, a resident of Toms River, N.J., the
location of an infamous childhood cancer cluster.
Next, contact your local county health office to get in touch with your
regional cancer registry. The registry staff can tell you if the rates of
cancers in your area are unusual, explains Raymond Richard Neutra,
the chief emeritus of the Division of Environmental and Occupational
Disease Control at the California Department of Public Health.
Report any worrisome findings to your local, county and state health
agencies. “If that doesn’t work,” suggests Gillick, “go to the media.”
Visit www.communityhealthstudies.com for more information about
the study of environmental health issues such as cancer clusters, says
Wendel Brunner, the director of public health for the health services
department of Contra Costa County, in California.
and Prevention. one of the new
investigators, Joe Wiemels, a
molecular epidemiologist who is
involved in the Northern California
Childhood Leukemia Study, noted
that the Fallon cluster looked
like an infection, since it was so
defined in space and time. His
group is investigating whether
there might be a rare or unknown
virus—or an overreaction to a
common virus—that might be
responsible. A second investigator,
Chris Pritsos, the chair of the
department of nutrition at
the University of Nevada, in
Reno, is looking more closely at
groundwater contaminants. And
Mark Witten, a research professor
in pediatrics at the University of
Arizona, in Tucson, is investigating
environmental tungsten, a
naturally occurring hard metal.
He is studying the chemicals that
can be identified in tree core rings
to develop a history of chemical
exposures in the area. How long
these researchers will have
access to the funding they need
to continue their research is not
known; their budgets have already
been cut. And no matter how long
they work, they may still never
find an answer.
IMPROVING CANCER
CLUSTER INVESTIGATIONS
Will researchers ever get better
at determining which clusters are
not statistical flukes and what
causes them? Many researchers
