NATICK CANCER STUDY TASK FORCE
OLD MEETING MINUTES (1997, Part C)
(and some other meetings of interest)
(Last updated on December 26, 1997)
  • 1997, Part A (970313-970514, including NCSTF meetings 1-8)
  • 1997, Part B (970515-970827, including NCSTF meetings 9-16)
  • 1997, Part C (970828-971005, including NCSTF meetings 17-19)
  • 1997, Part D (971006-971116, including NCSTF meetings 20-22)
  • 1997, Part E (971117-971231, including NCSTF meetings 23-25)
  • Recent Meeting Minutes
    • Also see our members, our upcoming meetings, and our main cancer page.

    Meeting 17: Thursday, August 28th, 1997 (7:30-9:15 pm, NTH, Room 307, 13 E. Central St.):
      Moderated by Mel Albert, minutes by Mary Ellen Siudut.

      Attendees (* Steering Committee, ** Non-members):
      Jay Ball, Tom Branham*, Dick Miller*, Jill Miller, Carol Scannell*, Mel Albert**, Mary Brown, Peter Silbermann**, Mary Ellen Siudut; Natick Tab reporter, Natick Bulletin photographer.

      Agenda Items:

    1. Upcoming NCSTF Meetings have been scheduled 7:30 pm on Sept. 8 and 22, Oct. 6 and 20 in Town Hall Main Auditorium. Dick will ask Town Clerk to post these dates.
    2. Dick reported on August 15th special meeting (Dick, Jay) with David DeLuca (another Town Counsel from same law firm as John Flynn), concerning the rewording of the "Sensitive-Data Agreement." Good progess, awaiting response. Jay will expedite, Dick will report back next meeting.
    3. Dick reported on August 20th special meeting (Dick, Tom, Carol, Jay) with Mass. Dept. of Public Health (Martha Steele, Theresa Barry and Paul Jacobson). It was an amicable meeting, with general agreement. We will not need to fight for the $50K State Budget line item. We will need MDPH support of our NCSTF project choice(s) since they are responsible for expenditure, but they agree that this money is for our local needs and not for their staff. No need for premature project decisions,either; funds only need to be committed by June 30th, 1998. MDPH has mapped cancer incidence points (rather like NCSTF has mapped the deaths) but cannot discuss confidential details. We presented Peter's draft Natick mortality mapping, and discussed possibly-significant items.

      4. MDPH requested a list of some or all of the projects on which NCSTF may want to expend this $50K budget item. Dick has responded with some possibilities:
      a. Professional help plus volunteers to gather and analyze local health data. MDPH had reservations about this use (re its own confidentiality constraints, which are a different issue).
      b. Professional help plus volunteers to gather and analyze certain extra local environmental data on historical pollutionants (example: soil testing).
      c. Ground Water Modelling (possible 50% match for USGS work portion which cannot be done by SSCOM).
      Martha Steele has proposed a small follow-up meeting at MDPH/Boston (with her, Theresa, Suzanne Condon). Dick to arrange this after our next meeting.
    4. Review of New Mapping:

      5. Peter Silbermann presented his new Natick mortality-data mapping. He reiterated that the current data is preliminary and not verified; data on types of cancer and how to categorize cancer types needs review by medical personnel. Any judgment or conclusion as to clusters must be viewed with skepticism.
      For 21 years of cancer-death names from Roger Wade and MDPH (death certificates, not Mass. Cancer Registry or our latest database from Charlene Zion), Peter has been locating addresses for as many as possible. He has added 80 points since prior map, still is attempting to verify locations for another 150 victims. Town is using tax records as one way to verify address information with what appears on the death certificate.
      Per request at prior meeting, Peter has normalized the data for population, by computing the number of cancer deaths per 1000 population in each Census Block: [(1000 x # cancer deaths in Census Block) / (Population in Census Block)]. Mapping is not yet broken down by cancer types, although some approximation of same is indicated by color-keying the data points.
      Federal govt. divides Natick into 6 Census Tracks, 27 Census Blocks, or about 800 TIGER Blocks. Peter now has the data broken down one step finer into Census Blocks and has normalized it to their population densities. Mapping in this manner is more revealing, and will help us to suggest further steps.
      Peter Silbermann discussed grouping the data differently, perhaps mapping data by TIGER Blocks. (We would have to purchase copies of the location and population databases resolved into TIGER Blocks.) Since there are 800 TIGER Blocks into which to subdivide Natick's population of about 32,000, this would break down into only about 40 people per geographic area. We then would need to be careful about grouping TIGER Block data without adding our own biases where the census mapping is arbitrary (and therefore statistically more reliable?).
    5. Dr. Harlee Strauss visited briefly (from her Fluoridation Committee meeting downstairs) to discuss mapping analysis techniques. She was Principal Investigator for the Cape Cod Breast Cancer Study; Dr. Rosen of the Boston Univ. School of Public Health was in charge of that data analysis. They had epidemiological incidence data for this study (instead of mortality). Dr. Strauss recommended Dr. Richard Clapp of BU as a best resource for the NCSTF project, and was pleased to learn we've  already been meeting with him.
    6. We need someone with medical expertise who can help our volunteers identify (from death certificates and the new MDPH database) which ones should be identified as cancer victims.
    7. Tom and Carol presented first draft of proposed newsletter to inform and invite back all original Task Force members (also to other regular attendees). Approved, subject to review by Dick before mailing.

      8. Deferred items:

    8. Later, Tom and Carol will propose revised letter to volunteers.

      9. Action items:

    9. After Sept. 8th, Dick will arrange a Boston meeting (plus Marco Kaltofen, Peter Silbermann, Richard Clapp, Charlene Zion?) with MDPH, so we each know what the other plans to do on its Natick projects and how each can further help the other.
    10. Jill has created a Microsoft-Access computer database from MDPH/Charlotte Zion’s Natick death statistics. The reason for death and associated illnesses are in a numeric code which is difficult to use in current form; Jill will contact Charlene to resolve questions. Then we will need volunteers to decipher data and to look up some missing addresses (in Town Clerk’s Office, etc.). Although this data is gathered from public sources, once we tabulate it we will want to handle it with sensitivity. Volunteers will sign our Sensitive-Use Agreement to limit spread of these names and addresses.
    11. Jay will expedite Sensitive-Use Agreement with Town Counsel.
    12. Tom and Carol will provide Dick with next draft of Newsletter to members; Dick then will edit and arrange its mailing.
    13. All attendees will read Mary Ellen's August 28th draft statement to Selectmen and comment to her, so she can present updated draft to NCSTF on September 8th.

      14. Jill will be moderator at our September 8th meeting.
    Meeting 18: Monday, Sept. 8th, 1997 (7:30-9:45pm, NTH, 1st-Floor Auditorium, 13 E. Central St.):
      Moderated by Jill Miller, minutes by Mary Ellen Siudut.

      Attendees (* Steering Committee, ** Non-members):
      Elsa Anza-Obey (Middlesex News reporter)**, Jay Ball, Tom Branham*, Mary Brown, Kevin Doherty (Knoll Environmental)**, Bob Goldkamp, Dick Miller*, Jill Miller, Catherine Rizzo**, Carol Scannell*, Peter Silbermann**, Mary Ellen Siudut, Roger Wade (Natick Director of Public Health)**.

      Agenda items:

    1. First Newsletter by Tom & Carol; labels by Jill, mailing by Carol on Sept. 4 to all original NCSTF members plus other regular attendees.
    2. Dick reported discussions with Jane Hladick, Town Clerk. She had not been posting our meetings because we were not on her official list (although the NCSTF was officially created by Selectmen on March 13, 1997) and had not been given her official information. This now has been done.

      3. She gave Dick a copy of Mass. Open Meeting Law, with guidelines for calling Executive Session. Town Counsel will determine how guidelines apply, in order to avoid inconsiderate release of "sensitive" data (names and addresses which are not confidential in legal sense, but which we are assembling into a potentially-harmful database). Secondly, our data analysis process starts with crude data and progressively refines it; early stages may be highly unreliable. Premature or erroneous publicity could adversely impact public by reducing real estate values, reducing insurability and career advancement, and heightening anxiety -- without creating any immediate good and without yet knowing that the information is reliable. The appropriateness of going into Executive Session and withholding this information from the public was debated. At the end of the meeting, the press was asked to leave before we viewed and discussed the latest mapping (new at prior meeting).
    3. Begin use of "Sensitive-Data Agreement" for appropriate volunteers (Jay, Dick).
    4. Review of Latest Mapping (Peter). We discussed availability and verification of map data, statistical techniques, etc.

      5. Jay asked if we could normalize the data for age, suggested that we compute the ratio of people who died of cancer to those who died of all causes. Jill can plot this by the year for the entire town, but doing so for smaller sections would greatly increase the work load; to do so, addresses must be located for nearly half of all names, not just nearly half of those with a sensitive cancer. (Note that MDPH only analyzed some environmentally-likely cancers, not all cancers!)
      Roger Wade reported that the Public Health Dept. just finished reconciling septic system lot/plot numbers to addresses. This information would be a great help to Peter. Address data is available from a FoxPro database.
      We currently have available 2 separate data resources:
      a. Peter currently has 786 data points of cancer mortality originating from MDPH and Natick Public Health. Peter is mapping this data as addresses become available. Data is divided into 20 groups of cancer, currently as assigned by Peter without detailed medical knowledge but hopefully tracking the categories used in May 1997 MDPH report.
      b. Jill has all 6,540 death records (all causes for Natick, 1969-1995). Of these, 1,611 were directly caused by cancer (some with other cancers as mentioned conditions), and an additional 154 listed cancer as a mentioned condition. This is based upon the computer database received from Charlene Zion, in another division of MDPH, in July 1997. Prior to 1987, this database lacks the address information.
      Jill has transferred this data to Microsoft Access, where it now is easy to manipulate. It uses ISDA (International standard) codes for cause of death and contributing diseases, including hundreds of codes for types of cancer, which Jill now is able to decipher. Charlene Zion says ISDA codes include about 70 cancer groups, which in turn include hundreds of cancer types (for example, Code 140 for lip cancer is subdivided into upper lip external, et al). She did not recognize the 20 groups in other branch of MDPH.
    5. Mary Brown, Dick to seek medical volunteers to interprete and categorize the cancer types into one or several sets of groupings that may correlate with environmental issues, and describe these groupings so lay volunteers can tabulate the data. Catherine Rizzo will seek reports regarding the same, from American Cancer Society office in Framingham.
    6. Mary Ellen presented second draft for a status report to Selectmen. It was rejected as too lengthly, with selected quotes and conclusions that we had not all agreed upon. Discussion of type and timing of report to Selectman. Group feels we should prepare a one-page statement of "What do we know?", "What do we suspect", "Where are we going from here?". Tom proposed that we could report that we concluded that a general town-wide survery was not, at least, an early priority; we concentrated on mapping data which is more readily available. Three rounds of ever-improving mapping have been completed, and more will be required before we are ready to draw conclusions.
    7. The MDPH cancer-incidence data used in its May 1997 report may be less reliable in the later half of the reporting period, due to staff reduction, heavy workloads, and time delays and inconsistency in reporting to the Mass. Cancer Registry by doctors and hospitals.
    8. Guest reporter asked when we might expect to have a report or feel we could discuss findings/map with public. Dick estimated two to twelve months until data gains high confidence level. Then we consult with Selectmen re actions, including how much sensitive data to make public. We will react sooner if we discover any significant problem area.

      9. Deferred items:

    9. Later, Dick will submit past bills for reimbursements to volunteers.
    10. Later, Tom and Carol will propose revised letter to volunteers.

      11. Action items:

    11. Dick will schedule meeting with MDPH.
    12. Jay will moderate the next meeting.
    Meeting 19: Monday, Sept. 22th, 1997 (7:30-9:30pm, NTH, 1st-Floor Auditorium, 13 E. Central St.):
      Moderated by Jay Ball, minutes by Mary Ellen Siudut.

      Attendees (*=Steering Committee, **=Non-members):
      Elsa Anza-Obey (Middlesex News reporter)**, Jay Ball, Tom Branham*, Mary Brown, Beth Donnelly, Dick Miller*, Jill Miller, Catherine Rizzo**, Carol Scannell*, Peter Silbermann**, Mary Ellen Siudut, Roger Wade (Natick Director of Public Health)**.

      Agenda Items:

    1. Jay reported Town Counsel discussion re "Sensitive Data" treatment.
    2. Regretfully accepted the resignation of Helen Johnson due to sensitive-data conflict with her real estate business.
    3. Discussed the updating of list of active members. Dick to provide active list at next meeting. We will ask Selectman to send a letter to others on their original list of members, asking whether they prefer to attend meetings or to be removed from list.
    4. Now that we have a "Sensitive-Data Agreement", volunteers handling data should sign it. We questioned whether NCSTF members need to sign, since being a member of committee implied responsible handling of information. We decided that NCSTF members would sign at next meeting.
    5. Jill presented a graph she prepared (1969-1995) of Cancer deaths vs. Deaths from all causes in Natick. Jill was asked to graph the data more finely, breaking down the years into quarters. Also asked to produce a graph of all Massachusetts or national cancer deaths, for comparison.
    6. Discussed the categorizing of cancers. MDPH only analyzed 20 types of cancer which they felt were likely to have environmental causes, not all cancers. Peter Silbermann's data included all cancers, so we need to correlate the data.
    7. Jill's ongoing database work reveals many records which want matching with addresses at the Town Clerk's Office. She asked for volunteers for this task. Jay will help; Carol will coordinate and phone other volunteers.
    8. Beth Donnelly and Jill and Dick spoke to Dr. Krikorian this week. He was helpful, knowledgeable regarding statistical issues as well as cancers, and has volunteered to help occasionally when we have specific medical questions or issues that need his expertise. American Cancer Society office on Speen St. also has been helpful.
    9. Catherine explained that death certificates usually list the primary cause of death and then a secondary cause. For example, in one cancer-caused death the primary cause was listed as congestive heart failure and the secondary as lymphoma. This might be why some people, known to have died of cancer in Natick, are not showing up on reports. Jill's data includes secondary causes after 1970 but not for the previous 10 years.

      10. Suggested: If we find a flaw in a data collection technique employed by one of the agencies, we should make recommendations to improve it.
    10. Draft Status Report for the Selectman: Tom will provide a new version for next meeting. We brainstormed on what the report should contain.
    11. Cancer-incidence data is reported directly to the MDPH and never reaches the Natick Health Dept.
    12. Discussed seeking volunteers for a research project to learn more about former land uses and activities that have potential environmental impact. One question, from Marco Kaltofen, is: Which Natick factories might have produced which colors of leather, and where might such be (burned and) dumped? These old wastes can become modern carcinogens -- and at end of 19th Century, Natick was the largest shoe manufacturer in the country! Catherine Rizzo and Charlie Thrasher already have agreed to help, as has Reference Desk of Natick Library. Dick will ask the Natick Historical Society how it can assist in this project.
    13. We went into executive session, so Peter Silbermann could present the latest cancer-deaths mapping.

      14. Deferred items:

    14. Later, Dick will submit past bills for reimbursements to volunteers.
    15. Later, Tom and Carol will propose revised letter to volunteers.

      16. Action items:

    16. Dick will head visit to MDPH.
    17. Dick to bring old mappings to future meetings.
    18. Dick to bring "Sensitive-Data Agreement" forms.
    19. Dick to report re Natick Historical Society, etc.
    20. Carol to report re volunteers status.
    21. Jill to present list of inactive members, prior to request for notification by Selectmen.
    22. Jill to present improved total-deaths graph.
    23. Tom to present draft Status Report for Selectmen.
    24. Jay will moderate the next meeting.

    SSCOM RAB: Tuesday, Sept. 23rd, 1997 (7:00-8:30pm, NLabs Conference Center, so. of Kansas St.).
    1. 6 high-grade oil-water separators to be installed in NLabs storm drainage system over next 1-2 years; T25 outfall pipe to receive top priority, probably Spring 1998, but not until requested outfall testing has been done during a storm event.
    2. Groundwater study compromise: USGS not lead agency, but has expanded role and will provide independent overview as requested.
    3. Contaminated soil removal expected mid-October.