By Chris Bowman, The Sacramento Bee, Calif. Knight Ridder/Tribune Business News
Dec. 31--Three months after going public with fears of too many cancers in their neighborhood, residents on the southern outskirts of Sacramento see the first hint of expanded government help.
Sacramento County Health Officer Dr. Glennah Trochet has invited some residents in the Calvine-Florin area to meet with her and top state health officials next month.
Though the officials have made no promises, their call for the Jan. 16 discussion opens a crack in the state Department of Health Services' reluctance to use more than statistical analyses to investigate.
'There is now an activist group there that is not convinced there isn't a problem, so we need to engage in dialogues,' Trochet said.
Volunteers organized as the Concerned Residents Initiative believe their neighborhood just north of Elk Grove has an abnormally high rate of leukemia and lymphoma, which stem from cancerous cells in the bone marrow.
The cancers have struck at least 60 residents -- 17 of them children -- in the past 12 years, The Bee has verified. The diseases have killed 16, including two girls and a 3-year-old boy.
The victims were diagnosed while they lived in a 3-square-mile area between Florin and Calvine roads, or shortly after they moved away. Twelve lived on or within a few blocks of Auberry Drive, a milelong street with 127 homes.
Some residents suspect something toxic in their air, soil or drinking water is partly responsible for the cancers and fear more people will fall ill before the culprits are identified.
They hope to get the kind of leave-no-stone-unturned investigations that were undertaken with suspected cancer clusters -- an unusual grouping not likely due to chance -- in areas such as Long Island, N.Y.; Woburn, Mass.; and McFarland in the San Joaquin Valley.
But veterans of those investigations warn that results have been confounding and disappointing.
Scientists descended on the tiny Kern County farm town of McFarland in the 1980s believing pesticides most likely were to blame for the various cancers that struck 13 children.
More than 20 years of multiple environmental and health surveys totaling millions of dollars failed to unravel the mystery, said Richard Kreutzer, the principal investigator.
'We could not demonstrate anything we could assign as a factor causing the cluster,' said Kreutzer, now director of the state's environmental health investigation branch.
In the Calvine-Florin area, health officials maintain there is no evidence of a cancer cluster based on their statistical analyses of cases reported to the state.
But they have encouraged residents to come forward with cases and possible environmental causes.
'We want to find out what the questions are and hear what the issues are,' Trochet said of the upcoming meeting. 'It's an opportunity for us to do some education and find out how best to communicate with residents.'
The meeting would be the first between health officials and the community since The Bee broke the news of the residents' cancer concerns on Sept. 22.
Dee Lewis, a resident near Auberry Drive who is leading the neighborhood's search for answers, called Trochet's invitation 'a good start.'
Earlier this month, the state health department invited Lewis to join a group of nationally recognized scientists and public health advocates working to establish an environmental heath tracking system for California.
Such a system would help scientists spot disease clusters in individual communities and neighborhoods, such as Calvine-Florin, and act swiftly to resolve them.
For now, Lewis and her growing band of volunteers are pressing state officials with troubling questions:
What gave us cancer? How can we protect our children? Is there something different about the Calvine-Florin area? Are there clusters of cancer cases in neighborhoods here?
The odds are stacked against them getting definitive answers soon, if at all.
Even if the state looked deeper, and even if it found an unusually high cancer rate, chances are it would be the result of a random occurrence, most scientists say.
Even if it were an environmentally spawned cluster, health investigators would not likely find it in their computer analyses. Populations such as Calvine-Florin's 40,000 are too small for scientists to distinguish true clusters from statistical flukes.
And even if residents uncovered evidence of cancer-causing contamination, it likely would take huge political support to launch an investigation.
'These studies require a huge investment of human capital. They're not just academic exercises. They're political campaigns. And unless there's the political will, studies don't get done,' said Jan Schlichtmann, an attorney who represented families in the working-class Boston suburb of Woburn.
Residents' willingness to help solve the puzzle is key, said Schlichtmann, whose court battle over industrial pollution and childhood leukemia was the subject of the popular book and movie 'A Civil Action.'
'What I learned from Woburn is that nobody is going to care more about that community than the community itself,' he said.
Calvine-Florin is a relatively young, middle-class and transient community without much clout. Most of the community didn't exist until the mid-1980s when tracts of starter homes replaced farm fields.
It has nowhere near the influence of Marin County, one of the nation's wealthiest enclaves, nor the influence of New York's Nassau and Suffolk counties, home to some of the most well-connected people in the country.
Federal officials recently confirmed plans for a joint investigation of Marin's high rate of breast cancers -- 223 per 100,000 people compared with the national rate of 140 per 100,000.
The investigation will pull researchers from the National Cancer Institute, the National Institute of the Environmental Health Sciences, the Centers for Disease Control and Prevention, and the U.S. Department of Health and Human Services.
On Long Island, a group of women drew on their political connections and public relations savvy to engineer an astonishing achievement: Congress' 1993 passage of a law forcing the National Cancer Institute to spend about $30 million for an unprecedented series of studies on pollution and breast cancer in their communities.
'People with more resources and better connected to policymakers can make the wheel squeak louder,' said Joseph Lyou, executive director of the California League of Conservation Voters Education Fund, which is pushing for environmental health tracking.
On the flip side, Calvine-Florin is not poor enough nor disenfranchised enough to attract interests that come to the aid of the defenseless.
McFarland, a town of mostly farm workers, became a cause celèbre in the 1980s for politicians, pesticide-reform groups and civil rights advocates. The United Farm Workers union organized a well-funded campaign around the town's tragedy, complete with a video, 'The Wrath of Grapes.' '
In Calvine-Florin, Lewis and her volunteers have been building political and media attention from scratch.
'We're middle class and we get placated, kind of like parents do to the middle child,' said Lewis, 37, a stay-at-home mom with two children.
Her battle is hardly unique, said Shelley Hearne, a visiting scholar at the Johns Hopkins University School of Public Health in Baltimore.
'Far too often, neighborhoods are forced to do the detective work that should be the job of public health experts,' Hearne said.
So far, Lewis and her helpers have not found any environmental smoking guns.
But in the past three months, she has formed a grass-roots group, held community and family meetings and recruited more than 200 volunteers who passed out health surveys at 17,000 area homes.
Lewis' group is verifying information from the 400 cancer questionnaires returned so far and plans to canvass another 8,000 homes in the area.
Meanwhile, individual scientists, engineers and doctors have volunteered to help residents evaluate disease patterns and test for pollutants. A pair of University of Arizona scientists recently extracted core samples from several area trees to check for toxic metals absorbed from soil and groundwater.
Also, Lewis and other residents have engaged two law firms that recently began sampling soil and water at the homes of cancer patients.
Some scientists and residents experienced in cancer cluster investigations said Calvine-Florin residents should not pin their hopes on environmental testing.
The best insights into the causes of the cancers won't come from reconstructing past exposure, they said. Rather, the causes will be revealed by following a group of healthy individuals who have different levels of pollution exposure and monitoring their health over time.
When scientists suggested such a 'cohort' study to the Long Island breast cancer activists a decade ago, 'most of them screamed, 'No, you should study me,' ' recalled Barbara Balaban, 73, a social worker who helped organize the women.
Scientists ended up doing a 'case-control' investigation of the prior exposures of 1,000 local women, half of them with breast cancer.
The study, released in August, found no evidence that pollution caused breast cancer. In retrospect, Balaban wishes the activists had put egos and individual concerns aside.
'Studying 'me' is not as fruitful as studying people who are unborn, newborn and adolescents,' Balaban said. 'That's the population where we really have to look and see what toxic exposures there really are.'
To see more of The Sacramento Bee, or to subscribe to the newspaper, go to http://www.sacbee.com
(c) 2002, The Sacramento Bee, Calif. Distributed by Knight Ridder/Tribune Business News.
