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It Would Break Your HeartChristopher  Myers

"It Would Break Your Heart" (continued)

Jennifer Peppe Hahn recalls long summer days playing in a natural spring in her friend’s backyard just east of Area B. From when she was a young girl until she got sick at age 12, Hahn and her friend splashed in the water, drank lemonade and invented adventures for their Barbies. They also may have been exposed to tetrachloroethylene (PCE) and trichloroethene (TCE).

 In 1997, the Army found that levels of PCE (a chemical solvent linked to breast, lung and other cancers) spiked at 20,000 parts per billion (ppb) in the spring though the level returned to less than 1 ppb a month later. (The increase may have been caused by nearby excavation work in Area B.) The EPA’s maximum contaminant level of PCE for drinking water is 5 ppb. Hahn thinks the chemicals were in the spring long before monitoring began. Had she been warned, she says, she might not have become sick.

Hahn, now 39, was diagnosed with Hodgkin lymphoma in 1985 and suffered through a year of treatment that included radiation and the removal of her spleen. She later developed breast cancer. “I’ve spent my whole life getting very sick and in and out of the hospital,” says Hahn. “Now I have tumors in my thyroid. I have a mass on my pancreas that gets biopsied every six months, and I have no breasts. And I believe that this was all caused by environmental exposure that nobody will even do any critical thinking long enough to look into.”

For decades, people in Frederick appreciated the base’s economic engine but were wary of its secret work. Although bioweapons research ended in 1969 by order of President Richard Nixon, biomedical research by the Army, other agencies and companies continues at the base today.

Concern about the environmental exposures from Fort Detrick increased in April 2009, when the EPA added Area B to its National Priorities List (NPL), part of the Superfund cleanup program. The NPL designation initiated a raft of meetings, investigations, studies and remedies that will likely play out over more than a decade.

By June 2010, worry about a possible cancer cluster had spread through Frederick. Started by a concerned family, the Kristen Renee Foundation (KRF) began mobilizing people. It held large public meetings, placed newspaper ads and later conducted its own cancer survey.

After hearing the community’s concerns, Frederick County health officer Barbara Brookmyer, MD, MPH ’94, launched an investigation with the Maryland State Department of Health and Mental Hygiene (DHMH). In August 2010, she began a series of community meetings. At the first meeting, people vented decades’ worth of frustration for more than three hours. Brookmyer’s staff wrote down every question, solicited answers from the Army and other agencies and posted responses on the Department’s website. She also formed a Technical Advisory Committee (TAC) of concerned individuals like Hahn.

Clifford Mitchell, MD, MPH ’91, MS, director of the DHMH’s Environmental Health Bureau and a former Bloomberg School faculty member, analyzed data from the Maryland Cancer Registry, which collects cancer incidence information and patient demographics. “You’ve got specific addresses, you’ve got specific diagnoses and you’ve got really good clinical information,” he says. Without the registry, it would be almost impossible to know specific cancer rates (number of cases divided by the population at risk) in Maryland—and thus ascertain whether the rates near Fort Detrick are unusual.

However, like all cancer registries, the Maryland database has limitations. It does not, for example, track cancer cases before its 1992 inception. This concerned some residents because the registry would not include people who may have been exposed to carcinogens in the 1940s and 1950s and died from cancer by the 1980s. Hahn believes the registry misses the years when the cluster would have been most evident. “Just because there wasn’t enough efficiently available data does not mean there was not an issue,” Hahn says.

Mitchell acknowledges the issue but says there is no practical way to identify all the cancer cases from that era, track down people who have died or moved away, gather their health histories, determine population details, etc. The registry data, he says, is still the best data source given the circumstances.

While Mitchell pored over the data, KRF began to amass its own. Randy White, who founded KRF and named it after his daughter who died of cancer in 2008, says they spent more than $300,000 on a survey mailed to 30,000 people near Fort Detrick. From 15,000 responses, they said they learned of 1,200 cancer cases within 10 miles of the Fort. Although it was based on self-reported data (which is far from the scientific gold standard), the finding raised alarm among the public.

Brookmyer points out, however, that number is not remarkable given how many people were at risk. In fact, she says the cancer registry documented 1,059 cases within a 1-mile radius of Fort Detrick in just eight years. “If we’re talking about collecting cancer information spanning 40 years you’d expect in this area there would be more than just a 1,000 cases,” says Brookmyer. “So that’s one of the challenges: to make good use of the data and to be able to understand the rate.”

The long-awaited October 2011 report from DHMH and the Frederick County Health Department (FCHD) found that there were no statistically significant increases in specific types of cancer within 1 mile of Fort Detrick—except for lymphoma. Rates for lymphoma near Fort Detrick were higher than Maryland’s rates, but not higher than Frederick County’s, she says, adding that lymphoma rates will continue to be scrutinized as new data become available.

Few in the community were satisfied. “It is the saddest thing I’ve ever witnessed. You’ve got the state of Maryland trying to put together evidence that there is no cancer cluster,” says White. “I think it’s all smoke and mirrors to protect their ass. I think there’s a day of reckoning coming because the citizens of Frederick are tired of the song and dance, the pony show.”

Mitchell understands people’s frustration. They want to know if a specific exposure caused the cancer that’s afflicted them, and he can’t say for sure.  “Sometimes it might be a family that has a genetic risk. Sometimes it might be that they are people who are very long lived and so they might have died of other causes, but they didn’t. … And after a while nature takes its course—something happens, and oftentimes that’s cancer,” says Mitchell. “At the end of the day, I can’t answer the question, ‘Can you promise me that this wasn’t an environmental exposure?’ What I can say is, this is what we know, this is what we don’t know. And I have to admit the limits of my own knowledge.”

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Frederick Voices

Frederick Voices

People from Frederick, Md. and public health professionals talk about a possible cancer cluster and whether it can be linked to nearby Fort Detrick.

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