Eastern Shore Community Health Partners has worked with environmental activists, public health agencies and university scientists for research. In 2005, three years before the nonprofit’s formation, Louisiana environmental activist Wilma Subra kicked off our efforts by heading up a town meeting in Fairhope, AL. that attracted media attention and helped lead to two rare cancer studies in Baldwin County conducted by the Alabama Department of Public Health. In 2008, professors Mark Witten and Paul Sheppard with University of Arizona conducted tree core sampling on the Eastern Shore. A study with the University of South Alabama began in 2010, looking at childhood leukemia rates in Baldwin County. In 2012, studies with the University of Alabama at Birmingham’s School of Public Health and Oxford University in England began. The UAB and Oxford University studies were to initially focus on ALS. Currently, the UAB study is on hold as the School of Public Health investigates the feasibility of the study. Currently, the UAB study is on hold as the School of Public Health investigates the feasibility of an ALS study started by the school’s director Dr. John Waterbor and one of his students, Courtney Williams, who graduated in May 2013.
Environmental Activist, Wilma Subra
When Lesley Pacey first set out in 2005 to understand why the Eastern Shore of Mobile Bay was experiencing so many rare cancer
cases, she garnered the interest of internationally lauded environmental activist Wilma Subra.
Committed to protecting the environment as well as the health and safety of citizens, Subra in 1981 started Subra Company, a chemistry lab and environmental consulting firm in New Iberia, LA.
A 1999 recipient of the Mac Arthur Fellowship “Genius” Award, Subra provides technical assistance to citizens, across the United States and abroad, concerned with their environment by combining technical research and evaluation. She then presents the information she gathers to community members so strategies may be developed to address local struggles.
Pacey shared her public health concerns with Subra in 2005, pointing to her own database of adults and children with rare cancers as well as the Alabama Department of Public Health’s (ADPH) website, which showed a drastic jump in new leukemia, lymphoma and brain cancer cases in Baldwin County from 2001 to 2002.
According to the ADPH website, new leukemia cases rose from 7 in 2001 to 17 in 2002. Non-Hodgkin’s lymphoma jumped from 13 new cases in 2001 to 31 new cases in 2002. Baldwin County saw brain and other nervous system cancer cases increase from 8 in 2001 to 13 in 2002.
Based on these findings, Subra was convinced the Eastern Shore was experiencing too many incidences of rare cancer. In February 2005, she traveled to Fairhope to provide packets of environmental information to concerned citizens.
Flanked by ADPH’s toxicologist Dr. Neil Sass – who expressed concern over the rare cancer cases and vowed to launch a public health assessment in Baldwin County – Subra delved into her environmental findings.
She provided participants with a report highlighting environmental issues facing the Eastern Shore of Mobile Bay, painting a picture of the chemicals affecting our air and water quality as well as our public health.
Her handout detailed millions of pounds of toxic emissions from Mobile and Baldwin county industries, pointing to releases of benzene, dioxin, mercury and other chemicals mostly stemming from Mobile County industries.
She shared a 2004 American Lung Association State of the Air Report that showed Mobile and Baldwin counties received an F grade for ozone pollution.
Subra listed Alabama Fish Consumption Advisories showing that largemouth bass in Mobile and Baldwin county waterways were contaminated with mercury and unsafe to consume. She also provided data about oil and gas production and distribution activities in the area and recommended residents dig deeper for data concerning pesticides, herbicides and fungicides in the area, as well as mosquito control programs, which frequently use diesel (a source of benzene emissions) as a carrier. Subra recommended residents test for chemicals in the drinking water, look into chemicals used by commercial and industrial facilities in the area, identify ambient air concentrations of toxic chemicals and determine potential sources of contaminated soils.
Throughout the years, Subra has helped many communities identify environmental issues facing their families, translating those concerns into policy changes at the state and federal levels through service on multi-stake holder committees. She has completed a seven-year term as vice-chair of the Environmental Protection Agency National Advisory Council for Environmental Policy and Technology (NACEPT), a five-year term on the National Advisory Committee of the U. S. Representative to the Commission for Environmental Cooperation and a six-year term on the EPA National Environmental Justice Advisory Council (NEJAC), where she served as a member of the Cumulative Risk and Impacts Working Group of the NEJAC Council, and chaired the NEJAC Gulf Coast Hurricanes Work Group. Subra holds degrees in microbiology/chemistry from the University of Southwestern Louisiana. She received the Mac Arthur Fellowship Genius Award from the Mac Arthur Foundation in 1999 for helping ordinary citizens understand, cope with and combat environmental issues in their communities. She also was one of three finalists in the Environmental Category of the 2004 Volvo for Life Award.
University of Arizona
Compelled by chronic disease incidence data provided by ESCHP, two researchers from the University of Arizona journeyed to the Eastern Shore in June 2008 in search of answers. Drs. Mark Witten and Paul Sheppard collected tree core samples from more than 20 trees as part of a study into rare cancers and neurological diseases among Eastern Shore residents.
The pair has done similar studies in Nevada, Connecticut, Kansas, California and New York, particularly in places believed to have abnormally high leukemia rates.
At his lab at the University of Arizona, Sheppard uses acid dissolution to test the wood for metals and other contaminants. Witten then uses the pollution data from the trees to set up exposure experiments for mice in his laboratory. If the mice develop cancers after exposure to similar levels of pollutants found in the trees, there’s a chance humans who live in the area where tree samples were collected would also, Witten said.
Sheppard and Witten were among the scientists who conducted a study released in 2007 that showed a relationship between rising numbers of rare cancers in Fallon, Nev., with increasing levels of tungsten found in local trees. The study showed that tungsten levels quadrupled between 1990 and 2002, whereas the amount in tree rings from nearby towns remained the same. Since 1997, 17 cases of childhood leukemia were diagnosed in children who lived in the Fallon area for some time prior to diagnosis.
In Fairhope, an initial investigation found elevated levels of chromium, zinc and mercury in the leaves of some trees in town, Witten said.
In past decades, Fairhope has been home to various industries and lots of farming. The region’s abundant rain, sandy soil and permeable shallow aquifers raise questions about the groundwater most people in Baldwin County drink, the scientists said.
They were also curious about neighboring Mobile County’s long run as one of the most polluting counties in the nation. Mobile in 2000 ranked the eighth most polluted county in the nation but many polluting industries have shut down since the mid 1990s.
The Sybil H. Smith Charitable Trust in November 2008 provided a $10,000 grant for the research.
Studies performed in 2008 revealed three trees with considerable heavy metal spikes. Two of those trees were in Fairhope and one was in Daphne. Repeated sampling would have had to occur around the trees of interest to definitively link the contaminants to local environmental factors, Sheppard explained. Future studies would cost about $10,000 for each repeated visit. While the ESCHP board found the results compelling, its members voted to focus on other environmental studies instead of raising the money to bring the Arizona researchers back to conduct repeated sampling.
Since November 2012, Eastern Shore Community Health Partners, Inc. has been working with Anne Silk, an epidemiologist at Oxford University in England, to study our rare disease clusters. Ms. Silk, who has 15 years experience studying the causes of ALS is studying our rare cancer and ALS cases and is developing theories about the environmental exposures of interest in our community. She recently completed a report that points to multiple contributing factors of concern. She said future studies should take into account neurotoxic chemicals in water as well as radio frequency and microwave signals from media towers; low frequency, long range radar beams from river vessels; trace element analysis of low levels of zinc and magnesium and high levels of iron, copper in water. Also studies should focus on analysis of airports, air bases and flyover patterns in the area and their potential adverse effects on human health. “Factors include radar, wave form, frequency, pulse rate, travel of beams (e.g. TACAN signal can cover 100 miles), communication signals to and from the ground, aerosol particulates from fuel – can be highly neurotoxic,” Silk stated in her report.
University of Alabama at Birmingham
Eastern Shore Community Health Partners Inc. reached out to Dr. John Waterbor, director of the University of Alabama’s School of Public Health in 2012 concerning our suspected disease clusters. A few months later in 2013, UAB doctoral student Courtney Williams contacted our organization to begin a multi-tiered study that would focus firstly on ALS and eventually on rare cancer in Baldwin County, Ala. The study was also to consider environmental causality. Using our rare disease database, Williams inputted rare cancer and neurological disease data into spreadsheets, met with our board members and mapped out a plan of action that included surveys for ALS patients as well as environmental issues that could be linked to elevated ALS rates in BaldwinCounty. The study came to a standstill, however, in May 2013 after Williams graduated from UAB. Currently, Dr. Waterbor is meeting with UAB staff specializing in ALS and epidemiology to determine the feasibility of studying the ALS cases in BaldwinCounty and possible environmental factors. Waterbor is hopeful staff, students and funding can be secured to continue the ALS study. Citing confidence in the findings of the Alabama Department of Public Health’s 2008 cancer assessment of BaldwinCounty, UAB no longer intends to look at rare cancer in our community
University of South Alabama
Eastern Shore Community Health Partners, Inc. began a partnership with University of South Alabama in 2010. Under the direction of Dr. Jim Connors, several USA students began a four-part study that focused on assessing childhood leukemia rates in Baldwin County and studying potential environmental contaminants in the area.
One USA student studied acute lymphocytic leukemia (ALL) rates in children in Mobile and Baldwin counties, comparing those rates to state and federal ALL rates. The study, which was to be fully released in December 2013, found that ALL rates in Baldwin County were comparable to the incidence rate for ALL statewide and nationally. However, Dr. Connors added that the possibility of ALL hot spots within smaller geographical areas (such as streets, cities and towns) within Baldwin County may be studied in an expanded analysis that could begin after a committee finished its review of the initial leukemia study.
The remaining phases of the study will look at the potential for specific cancer causing contaminants in the Baldwin County environment.