Millsboro study to look at origins of cancer cluster near plant

In a chemical-laden world – from the cosmetics women wear and the chemicals in dry cleaning to the more obvious pollutants, such as smoke stacks and cigarettes – it is easy to get exposed to something dangerous. What’s not as easy is knowing if and/or when that something could lead to serious and lasting side-effects, or even disease.

Elected officials and state leaders announced this week their initiative to find out a little more about the residents of the Millsboro area and the toxins they might be carrying around in their bodies.

A pilot “body burden study,” at a cost of approximately $360,000, funded by the Delaware Cancer Consortium and the Delaware Department of Natural Resources and Environmental Control, will study 32 volunteer participants who will agree to have their indoor and outdoor air monitored, as well as their blood, urine and hair, for a set of four days this fall and a set of four days next fall.

The participants can live within 5 miles of the Indian River Power Plant, including the Dagsboro, Frankford and Long Neck areas.

U.S. Rep. John Carney, who – along with representatives from the Delaware Department of Health and Social Services and the Delaware Cancer Consortium (DCC) – was instrumental in making sure further testing in the area would take place after an initial report four years ago indicated there was a cancer cluster in the area, said it had been a “long time coming,” but that he was pleased that real progress was happening.

Carney thanked Bill Bowers, chair of the DCC, and Dr. Kim Furtado, a local naturopathic doctor and member of Citizens for Clean Power, who have both worked to get further testing in the Millsboro area after it was identified as a “cancer cluster.”

The 2007 report issued by the Delaware Department of Public Health found that cancer rates around the Indian River power plant were 17 percent higher than the national average. For every 100,000 people in the country, 473.6 are diagnosed with cancer, according to the report. In Delaware, that number is 501.3.

In six ZIP codes around the Indian River power plant, however, the rate is 553.9 per 100,000 people.

The report also noted that lung cancer cases around the power plant are “significantly higher” than the Delaware average. Around the plant, lung cancer accounts for 19 percent of all cancer cases, compared to a 15 percent Delaware average.

The report came after environmental activists pressured then-Lt. Gov. Carney to study whether the plant has detrimental effects on the public’s health and cancer rates.

In 2007, officials with NRG, which owns the power plant, said they, too, welcomed the idea of further study of the issue, which they said would improve the data from which conclusions about the cluster — and the power plant — could be drawn.

“By definition, a cancer cluster occurs when a statistically higher rate of cancer exists in a defined community, as compared to the region as a whole. The higher rate of cancer — lung cancer in particular — in the Indian River area is a cancer cluster,” researchers spelled out in the report, but with caveats that have left area residents no less concerned.

“A review of 10 years of cancer data did not identify a disproportionate number of cancer cases among young people in Indian River,” the report concluded. “It also did not identify a cluster of unusual cancers or cancers with a known, rare cause. The absence of any abnormalities such as these provides no clues as to the origin of this cluster and suggests that further investigation is unlikely to be fruitful.”

Addressing what should be done about the issue now that a cancer cluster has been identified — if not definitively in its cause — the DPH praised rules from the state’s Department of Natural Resources and Environmental Control (DNREC) that were designed to reduce emissions from coal-burning power plants.

“Regardless of the unknowns regarding the causal relationship between power plant emissions and cancer, both generally and in Indian River in particular, these rules are a major step forward in providing a clean environment,” the report stated.

Since that report, under a consent decree, NRG agreed to shut down its two oldest units at the power plant and was to install air pollution controls on the newer Unit 3 and Unit 4 by the end of 2011 to reduce emissions of nitrogen oxides, sulfur dioxide and mercury.

Units 1 and 2 have since been shut down and, rather than having pollution controls installed, Unit 3 is scheduled for a complete shut-down in 2013.

Pollution controls on the largest unit, Unit 4, a $360 million project, have been lauded by state officials in recent months as significant in the fight for cleaner energy.

Carney and representatives from DHSS, DNREC and the Delaware Cancer Consortium spoke at a press event at the Millsboro Public Library last week, applauding the initiative, and all thanked the tireless community advocates for pushing their legislators and state agencies to find more answers.

Bowers said it has been a “labor of love” for about 10 years and highlighted some of the other advocacy efforts the DCC has implemented over the past decade. He mentioned the Delaware Cancer Treatment Program, which pays for cancer treatment for two years for Delawareans who are un-insured, saying Delaware is the “only state in the nation that does that.”

He also said the State’s encouragement of preventive screening has allowed for disparities in colo-rectal cancer rates between white and African-Americans to become almost non-existent compared to other states. But even with the successes, he said, there is more to be done.

“We need more information on why people get cancer. We need to know a lot more on the environmental factors. This study is very innovative and cutting-edge. The Congressman has been very modest about his role in this,” he added of Carney. “He and Meg [Maley, chair of the DCC’s Environmental Committee] have been involved since Day 1.”

Maley explained that the pilot study is actually part of a broader, statewide initiative, the Multi-Media Exposure Study or MMES. “Lovingly, we call it a body burden study,” she said. The pilot study is a “walk before you run,” way to get data from the Millsboro area, she said, because of funding issues.

The original initiative was designed to be about five years’ worth of data and would allow for the archiving of samples for study at a later date. That initiative would have provided for more than 400 people statewide to be studied in depth, but they could not get it completely funded, so this pilot study is a beginning.

“It’s doing something in lieu of doing nothing,” Maley said, adding that is has taken years of meetings and talks to get as far as they have.

She also said the Millsboro portion is happening because of the “advocacy and activism” of the citizens downstate who have pushed for more intense testing of the area. She said she hopes that the federal government will appreciate the fact that the State has supported the initiative through funding, and might possibly see that it is “worth more study.”

David Small, deputy director of DNREC, added, “This study will take our efforts to the next level by modernizing the way we collect and analyze information about the impact of environmental pollution on public health.”

Rita Landgraf, Secretary of the state Department of Health and Social Services, said the study will “provide crucial information as we move forward in our continuing fight against cancer in this state and in the Millsboro area in particular.”

She also mentioned Gov. Jack Markell’s recent announcement at Trap Pond about efforts to create more walkable and bikeable trails throughout the county and said the Markell administration is “creating an environment that supports health and healthy choices.”

“Millsboro is doing the same thing today,” she continued. “It is an important step for them,” she said of the community environmental advocates, “to approach us and for us to listen to them.”

Furtado – who, with Citizens for Clean Power, has been pushing for more testing for the past four years – said she appreciates the will to get the study done, but that she was nonetheless “frustrated” after the announcement.

“This would not be happening if not for Rep. Carney,” she said. “Years ago, we were ignored, and while we appreciate the political will to make this happen, it would be a shame to do the wrong testing, not find anything, and think there is not an issue. They will be checking for acute high-dose exposure,” she emphasized, instead of chronic low-dose exposure, “and we all know the community doesn’t have that.”

Furtado said she will be continuing to talk with representatives about including recommendations she made for the study, including provoked heavy metals urine testing.

She also said she questioned the small number of participants in the study – 32, while using no inclusion criteria. “For example, half of them could be smokers, and it would be unscientific to have that small a number. With 32 people, there is a lot of confounding data to make your data meaningless.”

She offered an analogy, saying, “We want to find out if you have any wine glasses (toxins) in your kitchen. We know that you store them in your cabinets (body tissues). However, when we come to your kitchen, we refuse to look in your cabinets. We only agree to look on your countertops (blood stream and urine).

“Now, unless you have just had a party (acute high-dose exposures), we won’t likely find any wine glasses on your counters. So, having made our assessment, we conclude you do not have any wine glasses. Bravo! We missed the correct assessment due to looking in the wrong location. Better luck next time.”

Dr. John Thornberg of RTI international, an independent, nonprofit institute that provides research, development and technical services to government and commercial clients worldwide, said the number 32 was a “statistical power calculation based on a hypothesis.”

He said issues of demographics and ZIP code and variables, such as non-smokers or smokers, were all considered but, with the “timing of the NRG [project], we could not be that selective.”

Carney said it was imperative to get “pre-shutdown” and “post-shutdown” data for the power plant and its environs. The study will take place this fall and next, with a full report expected in the spring of 2012, before the shutdown of NRG’s Unit 3 in 2013.

Maley also reiterated that funding was also an issue.

“We will learn a whole lot,” she said, when asked if 32 was a viable number in extracting any real valuable data. “Would I love it if it was 400?—yes. Can we afford it?—no. I don’t think anyone of us sees this as an end goal, but is it better than nothing?—absolutely. I am so excited that we are doing something, especially in this budget climate."”

Those interested in volunteering for the study can contact Michael Phelps at RTI Inc. at (800) 845-6708.