Fluoride Action Network

Medical Mystery

Source: The Tampa Tribune | April 18th, 2004 | By Mike Salinero & Jan Hollingsworth
Location: United States, Florida
Industry type: Phosphate Industry

PLANT CITY – The old gray buildings on the edge of town are a grim specter, heavy and forbidding like the fear that has enveloped this rural community.

Something seems wrong here. People say they can feel it in their aching joints, their cracking bones and teeth.

To some, the fear is as tangible as the neighbors and relatives who have been diagnosed with cancer or the pets that have died in peculiar circumstances.

Sharon Douglas, 55, wonders if pollution is to blame for her ongoing battle with ovarian cancer and recurrent melanoma in her 10-year-old horse, Forrest.

Alicia Barker, 33, is sure the smokestacks she can see out her back window are to blame for her toddler’s breathing troubles. Cheyenne, 16 months, is so used to inhaling medicine that she reaches on her own for her nebulizer.

Yes, many residents believe there’s something wrong here, and they suspect the culprit is down the road at Coronet Industries, the rusting century- old plant that, until last month, turned phosphate into an animal feed supplement.

There are other, less visible suspects than the phosphate processor, which owners say market forces prompted them to close.

State health and environmental officials point to abandoned, unlined landfills and agricultural chemicals as potential sources of pollution that need to be investigated in the area they call Coronet Junction.

Or it could be that people here are no sicker than anywhere else; that the malignancies, miscarriages and other maladies just seem more pronounced here in the shadow of the plant.

No one may ever know for sure. And that troubles Doug Holt, director of the Hillsborough County Health Department.

“You’ve got to be careful not to dismiss the people’s illnesses. They have real illnesses,” Holt said.

“What we don’t know is if there’s something in the environment that’s causing it.”

Snapshot Of The Community

Former Chicago residents David and Cindy Johnson didn’t know about any of these things in 1987 when they decided to move to the country.

An oak-shaded, one-story home with neighbors that included strawberry fields and citrus groves caught their fancy.

The tasty well water was the clincher.

The Johnsons suspected something was wrong, however, when their 19-month-old grandson, Jacob Johnson, lost an eye to cancer. A daughter developed asthma, and Cindy Johnson suffers from back and bowel problems.

Bertha Kelly, 70, wonders if her two daughters, now adults, are having fertility problems because she raised them there.

Her son has breathing and stomach trouble.

Her sister, who worked as a security guard at the Coronet plant, died of brain cancer.

She worries there’s something in the air or in her well that’s harmful.

“You can’t tell where it’s coming from,” said Kelly, who also worked in security at the plant.

Kelly and the Johnsons are among hundreds of people living near Coronet who participated in a community health survey conducted by The Tampa Tribune and WFLA, News Channel 8.

The intention was to do what no state or federal agency involved in the yearlong Coronet Junction investigation has done: Ask people basic questions about their health and lifestyle.

Epidemiologists contacted by the Tribune say that while the informal survey of 250 households neighboring the Coronet plant is by no means scientific, it does offer some insight into the community.

“What you’ve done is a good baseline, a snapshot of the community,” said Lynn Goldman, an environmental epidemiologist, pediatrician and professor at Johns Hopkins Bloomberg School of Public Health in Baltimore.

Epidemiology is concerned with the causes and occurrence of disease in a population.

The rates of illness found in the survey don’t seem far out of line with the general population, she said, but that so many people are complaining would be a concern.

Still, linking illness to environmental conditions is tricky.

“It’s difficult even with a door-to-door survey to prove cause and effect,” said Goldman, who in the 1990s directed the U.S. Environmental Protection Agency’s pesticide and toxic chemicals regulatory programs.

When asked to comment on the health survey, Coronet released the following statement:

“Informal and unscientific surveys like this fail to provide real answers to real concerns. Coronet continues to work with all government agencies in their reviews so that the public receives answers to their questions based on scientific facts.

“More importantly, there is a lot we already know based on a number of scientific studies, including that there is no evidence linking the plant to residents’ health concerns.”

No Medical Inquiry

State and federal investigators have focused on examining the environment around Coronet rather than the people living and working there.

They have found various contaminants in air, water and soil – and in the urine of some residents screened for exposure to arsenic, lead and other chemicals.

The environmental testing established the presence of potentially harmful substances, many at levels that far exceeded state and federal health standards.

The urine tests established that some of the chemicals had found their way into peoples’ bodies.

None of the contaminants appeared to be at high enough levels to pose “an imminent threat” to the community, health officials concluded.

Given the “extremely high” concentrations of toxic chemicals in Coronet’s process ponds and in monitoring wells on the plant site, Holt, the county health department director, found the results of the off-site environmental tests “reassuring” – a sentiment he and other health officials shared with the community last month.

“What I can’t do is answer the question about `what is making me sick’ ” he said.

Health officials say it would take years and hundreds of thousands of dollars to establish a link – if there is one – between pollution and the illnesses in the community. And even if that effort is made, they say, the science of environmental epidemiology is not always conclusive, especially on a neighborhood level.

“When you analyze small groups, you lack the opportunity to draw meaningful conclusions,” said Randy Merchant, environmental administrator for the state Department of Health.

To achieve a statistically valid sample population, health officials used census tracts in a 48-square-mile area around Coronet.

They concluded that rates for eight kinds of cancer in the area were no higher than in the rest of the state or the county. In fact, they were a little lower.

However, in casting a wide- enough net for a valid sample in the sparsely populated area, investigators had to include people far from the Coronet Junction area.

“In a population this size, it is extremely difficult – if not impossible – to get strong evidence” from an epidemiological study, said Michael Thun, vice president of epidemiology and surveillance research for the American Cancer Society.

Nor does such an approach include illnesses diagnosed after people leave the area or patients not captured in the state’s cancer database, which only in 1997 began tracking people treated outside of hospitals.

Most of the environmental testing offers only a fleeting glimpse of what was in the air, soil and water at the time the samples were taken. The urine screenings would reflect chemicals ingested in previous days or weeks, not months or years.

Holt said those results also were limited because many people with private wells near Coronet stopped drinking the water when they became concerned about possible pollution.

“It is a snapshot in time,” said Shaun Crawford, a state health assessor. “We know the current and the future; unfortunately, we can’t tell the past.”

In dealing with environmental health issues, the past can be critical, Holt said.

“Things that may have happened 10, 20 or 30 years ago – some of the concerns relate to things that go well back in time,” he said.

A 3-Step Process

The Coronet Junction investigation began last spring with a list of more than 60 cases of cancer compiled by resident Elaine Edenfield and a few of her friends.

“It was just a group of us from Wiggins Road,” Edenfield said. “It was just people that we knew of who had cancer from Wiggins to Sparkman [roads]. We didn’t go door to door.”

Edenfield, a nurse, contacted the Hillsborough health department when she learned of plans to build Lakeside Station, a development to consist of thousands of homes and a school, on property Coronet once mined for phosphate.

The mined-out pits became a dumping ground for refuse from Plant City and Hillsborough County.

“The main thing I was worried about was the landfill,” she said. “I brought up, `Why do so many people have cancer out here? IBS? Diarrhea?’ ”

Edenfield said she suffered from irritable bowel syndrome until 10 years ago, when she stopped drinking water from her 25-foot well. “But I still bathe in it, brush my teeth in it,” she said.

She and other residents wonder why those investigating the health complaints haven’t asked them about their medical histories.

The state used a survey similar to the Tribune’s in the early 1990s when it was investigating health complaints linked to the fungicide Benlate DF, which was blamed for crop damage in 40 states.

The survey results prompted health officials to conclude the complaints warranted further investigation.

Years of investigation failed to establish a link between Benlate, which DuPont eventually pulled off the market, and the reported health effects, which included central nervous system, respiratory and chronic fatiguelike symptoms.

Holt said state and federal agencies now follow a three- step process when investigating a potential public health threat from pollution.

A survey of individual residents is the final step.

Investigators first must establish whether people are being exposed to harmful pollution. If they are, the next step is to stop the exposure, Holt said.

“We have certainly identified some areas of ongoing exposure – the water,” he said. “We’ve taken action to stop any additional exposures.”

Holt referred to some 40 drinking water wells within a quarter-mile of Coronet that contain one or more contaminants which exceed state and federal standards – including arsenic, boron, radium, lead and cadmium. The state is supplying those residents with bottled water.

“While we have seen exceedances, they are not at the point we would have any reason to believe they would be associated with illness,” Holt said.

However, that assessment is based on a statistical analysis of each contaminant by itself, not the possible combined effect of wells contaminated with multiple compounds that exceed health-based standards.

“Unfortunately, the science has not caught up to evaluate synergistic effects,” Crawford said.

Eternal Questions, Lingering Fears

The Florida Department of Environmental Protection has linked pollution from Coronet to at least seven of the contaminated wells.

The well tests were conducted within a quarter-mile radius of the plant’s southern border in an area where state environmental regulators had suspected groundwater contamination was moving off the Coronet site.

Investigators suspect a plume of pollution is migrating underground, posing a threat to other wells in the vicinity.

“We’ll be monitoring these for some time,” Holt said.

Many people who are worried about their health, however, live more than a quarter- mile from Coronet.

Holt said there’s no reason at this time to expand the testing because there’s no evidence of pollutants traveling that far from Coronet.

“There isn’t a certainty about a lot of this stuff and how to go forward,” Merchant said.

Any further action likely will hinge on the results of tests on fish caught in local ponds not far from Coronet and the landfills. Those are expected next month or earlier.

“Fish are a good marker to tell us the presence of long- term chemicals,” said state health department biologist Susan Bland. Coronet’s neighbors have complained for years about pollution flowing from the plant’s stacks. Thirty-nine percent of those who completed the Tribune’s health survey mentioned respiratory problems.

“As long as there were smokestacks there, people were going to be scared,” Holt said.

Although the plant is closed, the Coronet story is far from over:

* Company officials are working with state regulators to develop a plan to close and rehabilitate the Coronet site. DEP has estimated the cost at tens of millions of dollars.

* More than 700 residents and former employees are suing the company, alleging pollution from the plant has damaged their health and property values.

* Preliminary environmental tests at the suspect landfills also show high levels of some contaminants, but not at levels likely to cause illness, officials said. That investigation, which involves Lincoln Park, a second community with many health complaints, continues.

* Developers still are seeking permission from Plant City commissioners to build Lakeside Station on and near those landfills.

“These situations are almost uniformly frustrating and unsatisfying to everyone involved,” said Thun, who worked for the national Centers for Disease Control and Prevention before joining the American Cancer Society. They’re often complicated by litigation and the natural desire to have an explanation for an illness, he said.

“I think the thing for the community to keep in mind is concern about cancer clusters and toxic exposure is fraught with uncertainty,” he said. “But one certainty is this: Divisiveness can devastate a community.”