That’s one of the many lessons from the childhood cancer cluster that haunted the New Jersey town of Toms River, the subject of a new book by journalist Dan Fagin.
Despite enormous costs and efforts, health investigators have never determined the cause in any of the hundreds of residential cancer clusters examined in the United States since 1960. They haven’t even identified likely culprits, but for two highly publicized exceptions. The Toms River cluster is one of them.
At least 69 children in the seaside community developed leukemia or brain tumors in the late 1970s through 1990s. Some died. Health investigators, egged on by parent activists, eventually determined that most of the victims lived in the parts of town that were most exposed to the toxic wastes – via drinking water and polluted air – of two large chemical plants.
In the other exceptional case, investigators linked a 1970s outbreak of childhood leukemia in Woburn, Mass., to industrial contaminants in the city water supply. The liability lawsuit brought by victims’ families against Beatrice Foods and W.R. Grace inspired the acclaimed book-turned-movie thriller, A Civil Action.
Toms River is not written in a made-for-the-movies way. Rather, it’s a blend of equal parts narrative and context. Rich primers on the history and science of environmental health investigations are woven throughout the story at all the right places, like well-placed streetlamps.
Fagin’s exploration is as enlightening as it gets in the murky world of cancer clusters. It’s also courageous. Few journalists dare to drill deep into suspect clusters for much the same reasons health authorities are loath to investigate them. They are fraught with ambiguity, highly nuanced, extremely time-consuming and always inconclusive.
Fagin explains why, in the cold eyes of science, the perceived "cluster" almost always dissolves into statistical insignificance. But, impressively, he also shows the limits of that science.
To analyze disease patterns, health scientists rely on tumor registries that track cancer diagnoses and deaths statewide. But the method is not scientifically valid at the community level. The population of Toms River – roughly 90,000 in 2000 – is too small for scientists to tell whether a higher-than-expected incidence of like cancers is a fluke or a real “cluster” – one unlikely due to chance – meriting on-site investigation. But that didn’t stop New Jersey officials from telling Toms River residents their cancer rates were not unusual – no worries.
“A clever political solution – and a scientifically illegitimate one,” says Fagin, a veteran investigative reporter who teaches science and environmental reporting at New York University.
Though science-oriented, Fagin’s account sharply illustrates the power of grassroots activism and the importance of the bedrock federal pollution-controls laws enacted in the 1970s.
Activist parents working their social connections drove the cluster investigation more than science and evidence. The drama culminated in 2001 when some of the families of cancer victims won a multimillion-dollar settlement against Ciba-Geigy (formerly Toms River Chemical Co.) and Union Carbide and the local water utility.
For 25 years, the fast-growing chemical manufacturers profited by using the town’s namesake river as a sewer and secretly burying their toxic wastes in the sandy soil – eventually contaminating municipal wells. State pollution enforcers knew, but said and did nothing. The local water utility knew, but took no action and left its customers in the dark.
Ciba-Geigy didn’t build a modern lined landfill or treatment plants until the new U.S. Environmental Protection Agency came to town. The EPA also blew the lid off of the drinking water contaminants.
Toms River is scholarly, but it is not an academic tome. For all the science and government agencies the author navigates, the writing is blessedly fluid, unassuming and unblemished by acronyms. And Fagin’s investigative what-did-they-know-and-when-did-they-know-it approach gives the industrial poisoning of Toms River its due in public outrage and corporate disgrace.
Next month Chris Bowman reviews The Mountains and the Fathers: Growing up in the Big Dry by Joe Wilkins, a memoir that explores the myth of manhood in the American West.