Jordan Green of Yes!Weekly has an interesting post that highlights elevated rates of certain types of cancer in the vicinity around the White Street Landfill. He cites a study that apparently demonstrated higher rates than expected of multiple myeloma, pancreatic cancer, brain cancer, leukemia and "non-Hodgkins disease" (which I presume to be non-Hodgkins lymphoma).
I find this type of research interesting because my own medical training and specialty deal with these types of issues.
What must be understood is that the findings Jordan Green reports are extremely preliminary from the standpoint of demonstrating causation. If we were to use a baseball analogy, it would be the equivalent of the batter making contact with the ball, but barely breaking out of the batter's box on the way to first base.
Here are the reasons.
First, in order to demonstrate that an environmentally-caused illness has taken place, one needs to also demonstrate that a true exposure has taken place. And I am speaking of not merely the perception of an exposure, but a genuine, quantifiable, measurable exposure.
There are typically several potential routes of exposure-- including inhalation, ingestion, and dermatologic (absorbing the offending material through the skin). It is not being alleged that anyone in the landfill area has ingested anything from the landfill; and the City of Greensboro pipes in the area's drinking water from afar. No one is credibly alleging that they are absorbing offending material from the landfill through their skin. So that leaves perhaps the route of inhalation as the theoretical means by which area residents could be exposed.
But I am not aware of one single measurement of any kind of toxin or offending agent in the neighborhood's ambient air that came from the landfill. That kind of measurement is necessary to demonstrate that some kind of exposure is likely to have taken place.
Second, the amount of specific exposure has to be high enough to cause a cancer.
Third, the type of exposure attributable to the landfill has to be a known cancer-causing agent.
Fourth, the type of exposure has to be known to cause the specific kind of cancer that has been found in the vicinity.
And so, the type of study Green quoted has not even begun to demonstrate causation. Its only value is to generate a hypothesis-- to raise a question.
Now let's talk about cancer.
The causation of "cancer" can be a tricky subject. But each type of cancer is different; and each will have different potential causes.
It has been thought for many years, for instance, that some cancers are caused by viruses, or that heredity plays a role. Health behaviors, including smoking and alcohol, can also play a role. The food and drink we consume, or the contaminants or substances they contain, can theoretically be a source. The radon in our homes is a possible cause of cancer. Exposure to medical radiation can play a role.
But there is little doubt that it is possible that "environmental" exposures can cause certain types of cancers. In fact, it has been demonstrated that some cancers can be occupational in origin, due to exposures at work.
Non-Hodgkins lymphoma is a disease that consists of several subtypes; and these subtypes in reality are all distinct disease entities that act differently. The same is true of leukemia.
Lymphoma can be caused by certain types of pesticides, organic solvents, viruses, and even medication. Industries affected include farming, construction, and manufacturing-- especially rubber manufacturing. Genetic causes have been suspected also. And it has been felt that other disease entities can cause lymphoma.
Pancreatic cancer has been felt to be much more common among smokers and diabetics. The aluminum and coke/coal industries have been implicated.
Brain cancer has been seen in farmers. I am not immediately aware of any exposures known to lead to multiple myeloma, but I suppose there may be some out there in the literature.
Leukemia has been studied extensively. Benzene, medical radiation, ethylene oxide, certain pesticides, carbon disulfide and carbon tetrachloride have been described as culprits. Certain kinds of cancer chemotherapy can also lead to leukemia. Viruses and heredity have been blamed. Industries affected include farming, the rubber industry, the boat industry, the shoe industry, and the health care industry.
Obviously, the cancers experienced by residents in the White Street Landfill region could have been caused by a number of different factors. Sorting out this picture would take enormous amounts of funds for research, and could literally require decades. And it would require reopening the landfill in order to re-create the possible exposures that were alleged to have taken place, so that the exposures could be measured. It takes years for cancer to develop after an exposure takes place, and the community would have to be observed over a prolonged period of time. The numbers would then have to be tested statistically to determine if the measured exposures correlate with cancer incidence. And it would be helpful to determine if the medical literature supports the premise that the specific cancer being studied could be caused by the specific exposure that had taken place near the landfill.
Every cancer case would have to be identified; and researchers would likely have to consider the cancer patient's personal history, and any other potential exposures the person may have had over an entire lifetime.
The reality is that, for many cancer cases that are diagnosed and treated, we do not know the cause. Each of us have family and friends who have contracted some type of cancer, and we do not know why or how.
In summary, Jordan Green generates a hypothesis; and testing to a definitive conclusion is going to be an enormous task that could take many years, and lots of money. It would require that the landfill be reopened and operated under the same conditions it was operated previously.
But the implications of the finding Green relates are serious. Who would want to live or invest in an area that is suspected of being the site of a cancer cluster? If this type of information gets out to a greater extent, it could theoretically diminish development and investment in east Greensboro.
The east Greensboro political community tends to say often that they want more investment and development there. It has oft been true, however, that they take political positions that make such investment considerably less likely. Demagoguing health effects alleged to be due to the White Street Landfill is just one example.
Remain mindful we do not even have a discrete, demonstrable exposure that we can point to; and yet the landfill has been the subject of political crusades and allegations of health impacts.
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