Fear of exposure

Cancer used to be a quiet curse. Those who contracted the disease kept their concerns private, and the news of their diagnoses spread to family and friends in whispers. But that’s no longer the case. In an age when invasive cancer will strike one in every three American men between the ages of 60 and 79, and one in four women of the same age group, according to estimates by the American Cancer Society, the disease has become a constant topic of conversation. Cancer victims share their diagnoses with their co-workers and neighbors; cancer registries track the number of local cancer cases; and Hollywood churns out blockbuster films like Erin Brockovich, about environmentally caused cancers and the advocates who bring big polluters to justice.

But the causes of any one case of cancer are notoriously difficult to pinpoint, leaving many people with a constant, low-level foreboding that can explode into full-blown panic under the right conditions. Though scientists insist that lifestyle choices (smoking, alcohol and obesity) cause more cancers than environmental contaminants (polluted drinking water or air), communities hit with a seemingly excessive number of cases are likely to look outside for causes. When big polluters are known to have dumped carcinogens onto the ground and into the water nearby, as rocket manufacturers did in years past at Rancho Cordova’s Aerojet facility, the public’s concerns might deserve extra attention.

That was apparently the conclusion reached by administrators at Delta Dental, the state’s largest dental-health carrier. Delta Dental’s information-technology affiliate, Deltanet Inc., is housed in a business complex on International Avenue in Rancho Cordova. Over the last few years, employees noticed a seemingly higher-than-average number of cancer cases on the second floor of their building. According to two Deltanet employees, what started as mild concern began to grow when a co-worker and his assistant from the same office were diagnosed with esophageal cancer within two weeks of one another, bringing the total number of cancer cases to eight out of approximately 150 people. (Employees known to have cancer chose not to discuss their health with SN&R.)

The two employees who did speak to SN&R—on the condition that they remain anonymous to protect their jobs—say that various people in the building are going to their doctors for cancer screening, X-rays and blood work to ensure that they aren’t stricken with the same cancers affecting their co-workers. One Deltanet employee estimated that at least 20 of his co-workers had been tested for cancer. Some are still awaiting results.

Jeff Album, public-relations officer for Delta Dental, said the company recently ordered air and water tests as part of a team effort to analyze the environmental factors in the building and investigate the cases on-site. An epidemiologist and an expert in occupational medicine also are part of the team. It was the first time, said Album, that any such tests had been done on the premises. The campus is fairly new, with the oldest building only about five years old. There have been no statistical anomalies in cancer rates in the adjacent buildings, according to Album.

“We’re taking some extra efforts to rule out any kind of contamination,” Album said by phone from his office in San Francisco. “We’re just going to rule it out because we know how fearful people get.”

Album could not confirm a close working relationship between the two employees diagnosed with esophageal cancer, but he did say that three of the eight cancer cases were of types traditionally caused by something other than environmental factors. The other five were similar in that they all showed up in the digestive system, either in the throat, stomach or esophagus, which transfers food and drink into the stomach. These five cases concerned employees because they could be related to carcinogens absorbed into the body through water or some other medium available in the workplace. Employees also were concerned because esophageal cancer is considered very rare.

The Cancer Surveillance Program for the entire Sacramento region counted only 591 new cases of esophageal cancer between 1996 and 2000. Those cases peaked among men between the ages of 65 and 69. A similar five-year study for 1995 through 1999 found 1,044 stomach-cancer diagnoses and 1,607 for the oral cavity and pharynx (throat) in the Sacramento area.

Though environmental factors like air and water contamination concern the two employees who spoke to SN&R, regulators in the area seemed skeptical.

“People usually have to be exposed a long time,” said Alex MacDonald of the California Regional Water Quality Control Board. Neither MacDonald nor neighborhood groups involved in environmental cleanup in the area had heard of a clustered group of cases at the Deltanet site.

Epidemiologist Monica Brown, who works for the Cancer Surveillance Program’s Region 3, which encompasses the Sacramento area, understands why people are concerned when they see what appear to be increasing numbers of cases.

Brown believes that cancer rates appear to be going up because people talk about cancer much more freely than they used to, especially people who survive the disease and live to tell the tale. Plus, we’re living longer, she said, and cancer shows up at greater percentages the older we get. “Now,” she said, “we have the opportunity to die of cancer.”

After interviewing Brown, SN&R learned that Delta Dental hired her as part of its research team.

Album explained by e-mail that the independent company performing the tests at the Deltanet site had “been engaged to provide a complete assessment based on their expertise as to whether or not the environment is now or has ever been a possible source of any chemical compounds that might be of concern.” He also suggested that employees needed to wait for the scientific facts before jumping to conclusions.

Most occupational exposures occur in manufacturing, where the effects of various chemicals and waste products are easy to track in a community of employees. Album said that when the contractor was hired to test air and water, the first thing it wanted to know was what Deltanet manufactured.

Album said there is no manufacturing occurring on the site, which makes it unlikely that carcinogens will be found on the property. But even if tests come back negative, the site on which the building sits has a history.

East of Deltanet, rolling hills and stands of oak are cordoned off with barbed wire, cutting off access to the Aerojet General Corp. facility—5,900 acres once dedicated to manufacturing rocket engines [see this week’s cover story]. Though new science and environmental regulation have led to cleaner manufacturing, past practices included disposing of waste in landfills, in deep injection wells and through burning.

In 1997, a contaminated plume of groundwater was found to be moving under Rancho Cordova, west of the Aerojet site. Twelve wells south of the American River were closed in the late 1990s, according to MacDonald. Some of those wells are very near the Deltanet building. The main contaminants of concern were perchlorate, which prohibits thyroid function (though the links between perchlorate exposure and cancer are still being argued), nitrosodimethylamine (a.k.a. NDMA, a probable carcinogen that also can be found in smoked meats and cleansers) and trichloroethylene (a solvent thought to be a likely carcinogen).

A new Aerojet plume recently was found to have seeped under the American River into Carmichael, which since has shut down wells that could be affected.

Rancho Cordova now draws water from the river, rather than from wells, and remediation of toxins on the Aerojet site is ongoing. Aerojet representative Tim Murphy said by phone that the company has been pursuing contaminants diligently on its property for 20 years.

This is not the first time that

community members have become concerned about possible cancer clusters in the area. Larry Ladd, a Rancho Cordova resident, said by e-mail that in 1997, he learned from the local Cancer Registry that seven women had developed thyroid cancer in his census tract. Since then, he’s been investigating the link between perchlorate and thyroid function, as well as other water-quality issues in the Rancho Cordova and Carmichael areas.

Though community activists like Ladd may spend years trying to draw links between cancer and local contaminants, Brown said that incidents of cancer are a poor indicator of an environmental problem because cancers can take seven to 10 years to show up. When looking at a single population, risk factors could include how long each of those people have been in the area, what they were exposed to before they moved there and what lifestyle choices they made in the past.

Ken August of the California Department of Health Services concurred. Cancer occurs in random patterns rather than spreading evenly throughout any area, he said. It’s statistically normal for there to be sites with more cases than expected.

“Most people are unaware of how much cancer there is,” said August. If one out of three people eventually will contract the disease, all of us will know people with cancer. But people need to remember also, he said, that if they want to reduce their risk by reducing their exposure to contaminants, they have the right to work toward that goal.

The employees of Deltanet understand intellectually that what looks like a cancer cluster may be a random occurrence. But they also know that there’s a history of contamination in the area. Someone has begun handing out informational pages quoting media stories about Aerojet’s past contamination.

As one employee asked, “Is it fair that they increase your risk, even a small percentage?” The same Deltanet employee currently is waiting on his own X-ray results. He mentioned that he knows of a couple of co-workers who are considering whether the fear of cancer might be the straw that breaks the camel’s back and moves them to leave their jobs with Deltanet.

Though Album’s team is investigating the site, this employee, who mentioned a general mistrust of big business, doesn’t necessarily trust the science. “I’m not going to believe [the results] no matter what they say,” he said.