Thursday, July 1, 2010
State health officials say they can find no evidence of a cancer cluster in Carlsbad. But some community residents are not satisfied with the results. They are pushing for tests of the soil at one local elementary school.
MAUREEN CAVANAUGH (Host): I'm Maureen Cavanaugh. You're listening to These Days on KPBS. A report issued by state health officials this week should have come as good news to the residents of Carlsbad. The California Cancer Registry found no elevated risk of cancer in the community. But the report has not satisfied activists and concerned parents in Carlsbad who say they still believe there could be a cancer cluster in the area. Despite the state findings, they are pushing for soil testing at a Carlsbad elementary school where several teachers and former students have been diagnosed with cancer. I’d like to welcome my guests. KPBS investigative reporter Amita Sharma. Good morning, Amita.
AMITA SHARMA (KPBS Investigative Reporter): Good morning, Maureen.
CAVANAUGH: And Dr. Philip Ziring is professor of Clinical Pediatrics at UC San Francisco. Dr. Ziring, good morning.
DR. PHILIP ZIRING (Professor of Clinical Pediatrics, University of California San Francisco): Good morning to you.
CAVANAUGH: Amita, you’ve been following this story for several weeks now. How did it begin?
SHARMA: Well, I believe it started at funerals. A number of people had died from cancer within the Kelly Elementary School area. People started talking to one another about what was happening and how many funerals they were attending and how many people they knew who were getting sick. And then they started questioning whether there was a pattern or some sort of environmental cause for the illnesses. At Kelly Elementary School, community members say at least 18 children, possibly 19 students, who once attended the school have developed cancer over the last decade. Four of them have died. Nine teachers, they say, have developed cancer. There have also been reports of infertility problems. Several teachers at the school have asked the district to conduct soil, air and water testing. The district had refused thus far because they said that they were waiting to hear the results from the California Department of Public Health on whether there was an unusual pattern of cancers in the Carlsbad area. And this week the agency said that there was no cluster in Carlsbad.
CAVANAUGH: Now, they seem to be concentrating, the people who are concerned about this, on the soil at Kelly Elementary. Why is that?
SHARMA: Well, Carlsbad was once a farming town and during that period, there were lots of pesticides that were used in the soil that are now banned. Arsenic was used, DDT was used. The school district, because of the laws, the change in the laws, they have to test, they have to do these environmental tests on any schools built after 1999 or any areas, any school sites, where they’re doing expanded construction. And so in two of the sites, at two of the sites where they have tested, they did find pesticides at levels high enough to warrant cleanup. They also, at a third site, found methane gas. So the belief is that poss – and these schools are near the Kelly Elementary School where they found the pesticides. So it’s the belief of the community that the soil, air and water should be tested at Kelly to see if the same situation exists there. Kelly Elementary School was built in 1979 so it was not subject to the same environmental rules.
CAVANAUGH: There – In your story this morning, Amita, you documented a very strange aspect of this story, the lengths that some people are willing to go to try to get soil samples from this elementary school.
SHARMA: That’s right. Just last week word spread that dump trucks were taking soil out of Kelly Elementary School. A group of citizens in four separate cars followed one truck with soil but they believe that the truck driver was aware he was being followed and then just turned around and went back to the school so the folks never got the soil sample that they sought to have independently tested. It should be said that Congressman Brian Bilbray as well as San Diego County Supervisor Bill Horn have called on the school district to test. A Bilbray representative told me that it’s important to do at the very least to put the community members’ concerns at ease.
CAVANAUGH: Now even though the California Cancer Registry has not found evidence of a cancer cluster in Carlsbad, will any further investigation go on? I believe that you spoke with a man named Ken August.
SHARMA: Right. Well, community members have asked the state to look at the Kelly Elementary School specifically, not just the surrounding community because when they looked at the surrounding community, they found that they could only confirm half of the 323 cases that residents have reported of cancer to the Registry. So now they’re saying, look, you need to look at the school where the actual cancer cases were reported. And, as you said, I spoke to Ken August, and here’s more of what he said.
KEN AUGUST (California Department of Public Health): You know, the process is what drives us. When we find out more about those 18 cases, if they’re all in the Registry, if we have every case, that will help dictate what the next step would be, whether it’s to launch a 9-month study or whether it’s to do something else that’s going to be more in – more of what the county – or the community wants.
CAVANAUGH: You know, we invited Ken August of the California Department of Public Health to be on our program today. He declined to be here, as did the San Diego County health officials and representatives from the CDC, so very few people actually seem to want to talk about this. I believe that you spoke, Amita, to the principal of Kelly Elementary. What does he have to say about this soil testing?
SHARMA: Actually, I spoke to the superintendent…
SHARMA: …in the Carlsbad School District. And he says that he’s going to make a recommendation to the school board later this month that they actually allow environmental testing at Kelly Elementary School. I asked him where he stood personally on the issue. He said it’s not really appropriate for him to express that opinion but he added that he would like people within the community to get a sense of peace, a sense of closure on this issue and that he wants to have – he wants the community to believe that the district is doing the best for their children.
CAVANAUGH: I want to reintroduce my second guest, Dr. Philip Ziring, a professor of Clinical Pediatris – Pediatrics, that is, at UC San Francisco. And, Dr. Ziring, I know that you’ve been critical of the way the Cancer Registry focuses primarily on the rate of incidence of cancer in the community. What do you think they should focus on to determine if there’s any kind of a cluster or a higher-than-normal incidence of cancer?
DR. ZIRING: Well, it’s been the view of a number of concerned citizens, not just myself, that the focus needs to be on the Kelly School. That’s where the community’s concerns are. And each time, you know, we’ve had two of these large community forum meetings, the most recent one just a couple of days ago, each time we have attended the forum, we thought that the state and the county health departments were going to talk to us about how they would proceed to investigate the conditions at Kelly so that the community could be reassured. Each time, the reports we got were more of a blanket review of the incidents of various kinds of cancer in several census tracts within the City of Carlsbad and so they spent a lot of time at the meetings talking about the incidence of prostate cancer, various cancers of other individuals, specific cancers, but when it came to a review of the specific numbers of children at the Kelly School who appear to have become victims of cancer over the last 10 years, that was not addressed at all. And so the community’s feeling increasingly frustrated that they’re either – some of their elected officials in the terms of the school board, their appointed officials in terms of the administration at the Carlsbad Unified School District, are just not listening adequately to what their concerns are and proceeding to do a more thorough investigation. The facts seem to be that there are 18 and possibly, as of yesterday we heard of one more child, who has acquired cancer in association with participation in activities at the Kelly School. 19 children affiliated with that school, which is a relatively small elementary school. Over the past decade, there probably has been fewer than 1000 children who’ve graduated from that school.
CAVANAUGH: Now, Dr. Ziring, epidemiologists who investigate suspected cancer clusters often say people just don’t realize how many people and children actually develop cancer and that most, if not the overwhelming majority, of suspected cancer clusters are coincidence.
DR. ZIRING: That’s correct. And I think the discussion about whether there is a so-called cluster or not at the Carlsbad elementary school, at Kelly, is really a diversion of our attention to what the true issues need to be looked at. We are very concerned that if the true incidence—and this is published data by the National Cancer Institute—the true incidence of all cancers, pediatric cancers in children up to approximately age 17 or 18, is only one or two cases for every 10,000 children. We have fewer than 1,000 kids who’ve graduated from Kelly and we’re already up to 19 children with cancer. By any standard, that should at least surprise some people and say that there seems to be something going on there that requires further investigation.
CAVANAUGH: Another hallmark of a cancer cluster or a higher incidence of cancer developing is, I believe, the people who contract and develop the cancer, it’s the same type of cancer. Is that the situation that you – that we have at Kelly Elementary?
DR. ZIRING: There are a number of unusual kinds of cancers that have developed there. The most recent child has been identified has thyroid cancer. That’s not a common disease among children. We have at least 3 individuals, young women, who have been diagnosed with leiomyosarcoma in the Kelly neighborhood. The incidence of leiomyosarcoma is 3 or 4 per million. When you have unusual circumstances like that, people need to take notice of it and do the right thing for the community and use the tools they have to test the soil, for instance, or the water or the air or whatever the Environmental Protection Agency feels is warranted so that the community can be satisfied that everything that should’ve been done was actually carried out. And the whole discussion about whether there’s a cluster or not, and an argument of what clusters consist of, is really a diversion of our attention to what we really need to do.
CAVANAUGH: I wonder, Amita, as you’ve been speaking with the concerned citizens in Carlsbad, what do they suspect could possibly be in the soil that might be causing cancer at this elementary school?
SHARMA: They don’t know but they think because Carlsbad was once a farming town and pesticides, very powerful pesticides, were used, that possibly there’s a link there. You know, there’s also been discussion that perhaps emissions from the Encina Power Plant might be playing a role or that power lines, electromagnetic radiation from power lines, might be emitting something. It’s just not clear. And that’s why they want the testing done. You know, money is a factor in this. When I spoke to Carlsbad Superintendent John Roach, he said, look, if you test one school site, it costs $60,000. If you find something, if indeed there is a problem, cleanup can cost anywhere from $1 to $2 million. So you have 8 schools within the school district that have not yet been tested. $60,000 plus possibly $1 to $2 million more to clean up, John Roach says as unfortunate as it sounds, this is going to be a factor that the school board will have to consider in making its decision on whether or not to test.
CAVANAUGH: Dr. Ziring, the things that we’re talking about here, things that may possibly be in the soil or some emission from a power plant or something that may be in the air, I would imagine to a scientist this all sounds very amorphous and it sounds as if it’s very difficult to test for. What kinds of tests should be going on in Carlsbad, do you think? And do these sorts – this kind of epidemiological testing, does it even exist?
DR. ZIRING: It certainly does exist. We know that there are many environmental contaminants that can lead to cancer. Arsenic is one of them. In the right dose, for the right duration of exposure, in the right kind of host who may be genetically susceptible – and, remember, we’re talking about very young school children. And, in particular, at the Kelly Elementary School, remember that we have a very wonderful program of school gardens. And so the children at Kelly, young, 6-, 7-year old children, are in there digging in the soil, planting vegetables, and then eating the vegetables that come out of that soil. You know, how young kids put their hands in their mouths and they’re often contaminated with some of the dirt they’ve been in, I think that might consist of an exposure that’s unusual that you wouldn’t see in older people. So we have to factor in the behavior of young children and other aspects than just simply looking at census tracts and incidences of prostate cancer in Carlsbad.
CAVANAUGH: I want to thank you. We are out of time right now. What comes next, though, Amita, in this story?
SHARMA: Well, there’s a school board meeting scheduled for July 28th, I believe, but they might actually move it up a little bit, and that’s when the school board will decide whether or not to initiate testing.
CAVANAUGH: I want to thank you so much, KPBS investigative reporter Amita Sharma. Dr. Philip Ziring, who is professor of Clinical Pediatrics at UC San Francisco, thank you so much for coming in and speaking with us.
SHARMA: Thank you, Maureen.
DR. ZIRING: Thank you.
CAVANAUGH: If you’d like to comment, please go online, KPBS.org/thesedays. The second hour of These Days is coming up. Stay with us here on KPBS.