A new study by government scientists is the first to document regional differences in the incidence of childhood cancers -- and it shows that the South has the lowest reported rate of all U.S. regions.

But it's still unclear whether fewer children in the South are getting cancer, or whether fewer children there are having their cancers diagnosed.

The study, conducted by the Centers for Disease Control and Prevention in Atlanta, found that childhood cancer in the United States is relatively rare, affecting about 166 out of every one million children. While the Northeast has the highest rate with 179 cases per million children, the South has the lowest rate with 159 cases per million. The rate for the West was 165 per million, while the Midwest's rate was 166 per million.

The researchers looked at children up to age 14 and adolescents between 15 and 19 years of age who were diagnosed with cancer from 2001 to 2003. They found that the cancers occurring most frequently in children are leukemias, cancers of the central nervous system, and lymphomas, which originate in the immune system.

Besides finding differences among regions, the researchers also discovered differences in cancer rates among racial and ethnic groups. For example, the rate of leukemias for Hispanic children at 53.71 per million was significantly higher than that of non-Hispanic children at 41.37 per million. At the same time, the rate of central nervous system cancers was significantly lower for Hispanic children (25 per million) than for non-Hispanic children (30.31 per million). Overall, white, non-Hispanic, adolescent boys have the highest cancer incidence rate.

While the Northeast has the highest childhood cancer incidence rates, it also has the lowest childhood cancer death rate of all the U.S. regions.

Some childhood cancer experts are stumped by the findings, the Associated Press reports:

Dr. Rafael Ducos, a children's cancer physician at Ochsner Medical Center in New Orleans, said the South's low rates were perplexing and might simply reflect under-reporting there and over-reporting in other regions.

"I'm at a loss to explain it," he said.

Scientists say environmental factors including radiation, other pollution, and the age of housing stock might be factors behind the regional disparity in cancer rates. So might access to quality health care. Dr. Lindsay Frazier, a cancer specialist at Children's Hospital Boston and Dana Farber Cancer Institute, told the AP that there might be better access to cancer centers in the Northeast resulting in more diagnoses; that could also explain why children's cancer death rates are lowest there.

The study appears in the June issue of the journal Pediatrics.

Labels: cancer, CDC, children, health care, health disparities, public health

Earlier this year, the U.S. Centers for Disease Control and Prevention confirmed that trailers the Federal Emergency Management Agency provided to families displaced by Hurricane Katrina were contaminated with dangerously high levels of formaldehyde. Now, a new study suggests that the chemical -- which has already been linked to cancer and respiratory illnesses -- carries another risk: amyotrophic lateral sclerosis, commonly known as Lou Gehrig's disease.

ALS is a progressive disease that causes damage to nerve cells in the brain and spinal cord and leads to paralysis and death. There is no cure or effective treatment for the condition.

The study's lead author is Marc Weisskopf, an assistant professor of epidemiology and environmental health at the Harvard School of Public Health. He and his colleagues analyzed data from an American Cancer Society study of more than 1 million people who were monitored for 15 years, finding that 617 men and 539 women died of ALS during that time. Only those who reported formaldehyde exposure had a higher risk -- 34 percent -- of developing the illness.

At this time, neither the CDC nor FEMA have any programs in place to help trailer residents with medical expenses incurred as a result of living in unsafe housing.

Labels: CDC, FEMA, formaldehyde, Gulf Coast Reconstruction Watch, public health, toxic trailers

Those of us following the disaster on the Gulf Coast know the Federal Emergency Management Agency gave hurricane-displaced families temporary housing that was later found to be contaminated with hazardous formaldehyde. We also know the federal Agency for Toxic Substances and Disease Registry, a division of the Atlanta-based Centers for Disease Control and Prevention, dragged its feet before finally studying the trailer contamination and complied with FEMA's demands not to consider long-term impacts like cancer.

Well, it turns out the toxic trailer debacle is part of a bigger story about the ATSDR's failure to protect public health.

The Washington Independent just published a two-part investigation examining what it calls the agency's "questionable approaches" to communities with environmental health concerns. The first installment posted last week examined evidence of cover-ups in ATSDR's health studies of the Great Lakes region (initially uncovered by the Center for Public Integrity) and an eastern Pennsylvania community with unusually high rates of a rare blood cancer. (I've also been covering the Pennsylvania study on my Hometown Hazards blog.)

This week's installment looks at the agency's actions in two Southern communities -- Midlothian, Tx., and Athens, Ga. In Midlothian, the ATSDR considered health effects of air pollution from several industrial facilities at the request of local residents concerned about the rate of birth defects. The agency came up with "indeterminate" findings, but critics of the study -- among them a former CDC epidemiologist -- say the agency used faulty monitoring data from the state and failed to consider key pollutants.

The Athens case involves a health study requested by resident Jill McElheney, who was living across the street from a petroleum tank farm when her 4-year-old son was diagnosed with leukemia; subsequent lab tests found their well was contaminated with toxic chemicals linked to the cancer. The ATSDR also came up with inconclusive findings in that study -- but failed to consider a facility less than 200 yards from the sick child's home, ignored air emissions, and declined to talk with the families of five other local children with leukemia who McElheney knew.

The series' conclusion?

The ATSDR's approach to public health studies of environmental sources has proven negligent in all the cases investigated by The Washington Independent. Some members of the local communities say the agency expends energy to make sure no health problem is found.

Labels: ATSDR, birth defects, CDC, FEMA, Georgia, leukemia, polycythemia vera, texas, toxic trailers

"Kristen" and "Client #9?" Whatever. This week it's been Spitzer's High Class Hooker Channel, All the Time (probably because so much of our nation's media is headquartered in New York).

But the real sex story, of course, was the bombshell report from the Centers for Disease Control and Prevention that one out of four teens -- some 3 million -- have sexually transmitted infections.

The numbers are even more shocking when you drill down into the report and find out who's getting hit the hardest. Kai Wright at The Root notes that, even though the CDC finds that African-American youth aren't necessarily engaging in riskier sexual behavior, the numbers for black youth are off the charts:

[S]adly, researchers found blacks once again hardest hit by a health problem: A whopping half of African American teens in the study had an STI.

The study is just the latest on a growing list of Centers for Disease Control and Prevention investigations that have found the sexual health of black youth to be in critical condition. You name it, and we're more likely to get it. HIV/AIDS? Yup, we're 69 percent of newly diagnosed cases among teens. Syphilis? While it's holding steady or declining in other racial groups, it's shooting up among black teens, particularly boys. Teen pregnancies? Rates went up for the first time in 14 years in 2006, and black girls saw the highest spike.

Even scarier: the fact that the CDC report didn't even look at several STD's -- including HIV:

[R]esearchers expect the teen STI and STD rate to be even higher than they actually found, because their study didn't include a number of serious infections, such as syphilis, gonorrhea and, the big one, HIV. Which raises a giant, troubling question. There's much we don't know about HIV, but one thing is clear: If you've got an untreated STI or STD and you have unprotected sex with someone who's HIV positive, the chances of you contracting the virus go up as much as five-fold. If half of black teen girls had an STI in 2004, the potential growth of the black AIDS epidemic is off the charts.

The upshot: Whatever certain campaign operatives might think, race still plays a major factor in determining the health and life chances of millions of people.

Labels: CDC, public health, race and racism, the root

Move comes amid ongoing coverup of key federal health report

The Federal Emergency Management Agency has announced it will make some of the mobile homes sitting empty in an Arkansas field available to victims of the tornadoes that recently devastated the South. Touring the damaged areas last week, FEMA Administrator R. David Paulison said he'd prefer to place victims in rental properties but that this could be difficult in rural areas. The freak winter storms destroyed more than 800 homes in the hardest-hit states of Arkansas and Tennessee.

While there have been widespread reports about dangerously high formaldehyde levels in FEMA travel trailers provided to people displaced by Hurricane Katrina, the agency draws a distinction between those trailers and the larger mobile homes. The agency emphasizes that the mobile homes were manufactured in accordance with federal regulations governing allowable formaldehyde emissions; for more on that distinction, see the FEMA factsheet on the provision of Katrina mobile homes to Indian tribal governments.

However, there have been credible reports that FEMA's mobile homes are also sickening people. The Minneapolis Star-Tribune reported earlier this month about the plight of a Minnesota couple and their infant daughter who were displaced by last year's historic floods in that state and who moved into a FEMA mobile home originally purchased for Katrina victims. Within three days, they developed serious breathing problems and were ordered by a doctor to remove the baby from the home. People who visited them for brief periods also reported adverse reactions including breathing difficulties and nosebleeds.

Becky Gillette, a Sierra Club activist who has focused on the formaldehyde contamination issue, told the paper that her office has received health complaints from people living in FEMA's mobile homes as well as its travel trailers. "The experience of people we've heard from show that it's just as bad in mobile homes," she said.

We recently reported that FEMA has been accused of meddling into the federal health study of formaldehyde contamination in the trailers and mobile homes it provided to Katrina's displaced. In a more detailed story, Salon reported that in May 2006 FEMA asked the Agency for Toxic Substances and Disease Registry, a division of the Atlanta-based Centers for Disease Control and Prevention, to do a health consultation on the FEMA trailers:

Dr. Christopher De Rosa, chief of toxicology for ATSDR, told FEMA that any report on health risks of exposure to formaldehyde would have to include information on the risk of cancer and other potential long-term problems. At that point, De Rosa was cut out of the loop. Internal ATSDR documents show that FEMA contacted two of De Rosa's staffers, who then prepared the misleading consultation. When, nine months later, De Rosa learned ATSDR had omitted the key health information in its advisory, he drafted a letter to FEMA trial attorney Patrick Edward Preston.

"I am concerned that this health consultation is incomplete and perhaps misleading," De Rosa wrote. "Formaldehyde is classified as 'reasonably anticipated to be a human carcinogen.' As such, there is no recognized 'safe level' of exposure. Thus, any level of exposure to formaldehyde may pose a cancer risk, regardless of duration. Failure to communicate this issue is possibly misleading, and a threat to public health."

De Rosa also wrote to [ATSDR chief Dr. Howard] Frumkin, noting "FEMA's initial contact came directly to me nine months ago on this issue." "I reviewed the proposed statement and specified that they had neglected to address longer term risk including cancer." After eight months of tense negotiations, a revised report included references to the potentially harmful effects of formaldehyde. But other health information, including the likelihood of other toxic gases, such as toluene, being present, was omitted, as was De Rosa's insistence that ATSDR call for the government to take immediate action to end formaldehyde exposure to trailer residents and monitor them for long-term harmful effects. Records show that following his protests, De Rosa in October 2007 was "reassigned" out of his long-term post as director of ATSDR's divison of toxicology and environmental medicine.

Interestingly, De Rosa and Frumkin are key figures in another alleged coverup of a federal health report. Just last week, the Center for Public Integrity published an investigation describing how the CDC blocked publication of an ATSDR study into environmental hazards in the Great Lakes states reportedly because of alarming findings about pollution-related health problems. Last July, several days before the study was to be released, ATSDR suddenly withdrew it, saying further review was needed.

In a letter to De Rosa, Frumkin said the peer-reviewed study's quality was "well below expectations." After complaining to his bosses that its withholding smacked of scientific censorship, De Rosa was demoted; he's currently trying to get his former position back, claiming the demotion represented illegal retaliation by Frumkin. And there are other examples of ATSDR attempting to squelch inconvenient findings: I've reported elsewhere about the agency's efforts to cover up the conclusions of its own study that linked a rare blood cancer cluster in one Pennsylvania community to environmental factors.

U.S. House Science and Technology Committee members Brad Miller of North Carolina, Nick Lampson of Texas, and Bart Gordon of Tennessee have expressed their concern about improper interference in ATSDR's study of the FEMA trailers and have vowed to investigate further. Gordon has also indicated that the probe will extend beyond FEMA trailers:

"Our Committee has been looking closely at ATSDR for some time and we believe the report on formaldehyde in FEMA trailers may be just the tip of the iceberg. As Chairman, I assure you this will continue garnering the Committee's attention for some time to come."

Labels: ATSDR, CDC, environmental health, FEMA, scientific integrity