NATICK CANCER STUDY TASK FORCE
OLD MEETING MINUTES (1997, Part D)
(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 20: Monday, Oct. 6th, 1997 (7:30-9:45pm, Natick Town Hall, 1st-Fl. Aud., 13 E. Central St.):
      Moderated by Jay Ball, minutes by Dick and Jill Miller.

      Attendees (*=Steering Committee, **=Non-members):
      Adrianne Appel (Natick TAB reporter)**, Elsa Anza-Obey (Middlesex News reporter)**, Jay Ball, Tom Branham*, Mary Brown, Beth Donnelly, Bonnie McCormick**, Dick Miller*, Jill Miller, Catherine Rizzo**, Carol Scannell*, Peter Silbermann**.

      Agenda Items:

    1. Confirmed meeting schedule for November and December.
    2. Members signed Sensitive-Data form, more signings due.
    3. Inactive members list: Jill brought list for Selectmen to contact. Instead, Jay proposed NCSTF handle this internally, with letter explaining no longer member but encouraging future activity; approved. Dick, Jill and Catherine volunteer (see Action).
    4. Dr. Krikorian's level of participation: Beth confirmed that he does not wish to attend meetings routinely, but will do so occasionally when we have specific agenda topics justifying his presence.
    5. Volunteers projects: Carol phoned all volunteers on current list (most from Election Day, etc.), found various ready to volunteer and some ready to volunteer for current Town Clerk address lookups. Jill is now working with five new volunteers on this project, four of them already trained and working. Jill showed her data forms: typically 20 names per assignment for finding address and other missing not-yet-noted information, often including length of time in that location (and, if brief, in prior location as well). We expect that this project will add many data points for our mapping.
    6. %-cancer-deaths graph (non-sensitive). Jill has a draft plot at the quarterly level, as desired. We debated various ways to get better statistical insight, agree that Tom and Jill will experiment with some readily-available data-analysis methods. Dick and Jill have located -- but not yet received or plotted -- Massachusetts and Total U.S. sources for annual total deaths and annual cancer deaths, at least since 1979, to compare with our current data for Natick.
    7. Dick announced an important new book: Living Downstream -- An Ecologist Looks at Cancer and the Environment, by Sandra Steingraber. Dick thinks earlier books were useful to our task, while this readable book describes our task. You can read Rachel Envir. & Health Weekly's online review of it now, on our main cancer page's links.
    8. Dick has already replied (on behalf of NCSTF) to erroneous editorial in Natick TAB of Sept. 30, in time for his Letter to Editor to appear in tomorrow's TAB. It did, on p.26.
    9. Draft Status Report for Natick Selectmen: Tom presents his new draft, already with brief review by Dick and Jay. General agreement that it addresses prior topics without prior problems, but Mary Ellen will also be consulted re this. Dick will add some brief info about dates and number of meetings. Dick's motion to add two sentences about our Sensitive-Data Agreement failed to win enough votes. Present to Selectmen in late October or early November?
    10. (In executive session) Cancer-mapping project: Peter presented two new maps, one recent one. Much discussion, some suggestions for follow-up work -- which should benefit from additional data points now expected from new volunteers.

      11. Deferred items:

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

      13. Action items:

    13. Dick to head visit to MDPH/Boston.
    14. Dick will write letter to inactive members, Jill will print address labels, Catherine will mail.
    15. Dick to bring old mappings to future meetings.
    16. Dick to bring "Sensitive-Data Agreement" forms for remaining member signatures.
    17. Dick to report re Natick Historical Society, etc.
    18. Jill to report re volunteers status.
    19. Jill to present improved total-deaths graph (linear regression analysis, etc.).
    20. Tom to circulate (including Mary Ellen), then present (final?) draft Status Report for Selectmen.
    21. Carol will moderate the next meeting.
    Meeting 21: Monday, Oct. 20th, 1997 (7:30-10:15 pm, NTH, 1st-Floor Auditorium, 13 E. Central St.):
      Moderated by Carol Scannell, minutes by Mary Ellen Siudut.

      Attendees (*=Steering Committee, **=Non-members):
      Jay Ball, Tom Branham*, Mary Brown, Beth Donnelly, Dick Miller*, Jill Miller, Catherine Rizzo, Carol Scannell*, Peter Silbermann**, Mary Ellen Siudut.
      Agenda Items:

    1. Inactive members: Dick gave Catherine Rizzo labels and thank-you letters to be sent to ex-members.
    2. Dick noted changes to NCSTF's Web site: a new Publications List on the main cancer webpage, and rearranged Members, Volunteers et al at top of NCSTF webpage.
    3. Beth noted issues for Dr. Krikorian at next meeting (question period will be open-ended):

      4. Which other cancers are related to pancreatic?
      Other factors for graphing?
    4. Carol Scannell called the entire volunteer list, seeking volunteers to help locate missing addresses using death certificates. Jill now coordinates five volunteers working at Town Clerk's Office on death certificates from 1969-1975. They work one to multiple-hour visits, have finished 160 out of about 500. Other volunteers would be helpful.

      5. Jill has found several extra deaths in the Massachusetts records for Natick, which are not in the Town Clerk's records.
      For now Jill only looks at primary cause of death, but can go back & get further information later.  She also wondered if we should be charting deaths grouped by age ranges, since childhood cancers are more likely to be environmentally caused.
    5. Percent-Cancer Death graphing: Jill presented her new, multi-colored graphing of total annual cancer deaths as % of total annual deaths, 1969-1995. Multiple graphs were presented. One graphed Natick against Massachusetts and USA. All cancer ratios have been increasing. Jill observed that there is an approximate 2% increase from USA to Massachusetts, and another 2% increase from Massachusetts to Natick; this might be due to Natick being less rural than the Massachusetts average, and Massachusetts being less rural than the USA average. Because the National data starts in 1979, its best-fit straight line starts then. It was noted that graphs are consistent with the MDPH report: as a whole, Natick’s cancer deaths are in line with other towns. This averaging of data, however, does not address possible "hot spots" within a town.

      6. Jill obtained death counts from MDPH for towns near us, and has produced a similar graph that plots Natick against adjacent Ashland, Dover, Framingham, Sherborn, Wayland, Wellesley and Weston, plus Boston and Newton. All members reacted to the sharp peaks that Natick and the three "W" towns to our north and east all shared in the 1974 and early-1975 time period. This peak does not appear for the other towns or the state. Jill will add data for more neighboring towns, plus Norwood and Peabody which may be similar to Natick, and will graph these to see which may share the same peaks. It was noted that the Dow Chemical activity spanned the 1962-1989 period. Dick & Jill will bring several color copies of these graphs to the next meeting, to facilitate discussion.
    6. Public Information Request from Natick Tab (outgrowth of editorial in Sept. 30th Tab commenting on our viewing of maps in executive session): At issue is whether everything we discuss must be accessible to the public. Are we unable to protect the Sensitive-Data portion? Does our coming to a meeting with a map make it public? The request is in the hands of Town Council.
    7. We reconsidered whether task force members must sign the Sensitive Data Agreement in order to view maps. Purpose of document is to declare our intention not to disseminate sensitive data inappropriately. We agreed that signing agreement was less important that our moral obligation. We voted that volunteers will be required to sign but that Task Force members will not.
    8. Dick reported on October 7th meeting at MDPH/Boston (Dick, Jill, Roger, Tom attended, met with Suzanne Condon, Martha Steele, Theresa Barry, Chad Lewis; also Susanne Simon of US ATSDR, and Dick Clapp of B.U. School of Public Health). Chad demonstrated MDPH's computer analysis methodology (using MapInfo on PC-compatible; CAMEO, free from EPA, also may help, as would map databases). We described current NCSTF data analysis work, we discussed MDPH administration of NCSTF's $50K State-budget item (which will require a PAC this year if budget continuance is desired into next year), etc. Meeting was deemed cooperative and productive.
    9. Discussed U.S. Army Natick Labs' action re our request that its Phase-2 groundwater mapping be done by US Geological Survey. The Labs lacked confidence in the up-to-50% cost matching available from USGS and found the USGS total cost too high, so the USGS will only be serving in a support role for the survey; another group will do the work. We had hoped to use that 50% match to extend the scope to a regional, independent survey including all of Natick, not just the area covered by NLabs. EPA has, however, included a minor support role for USGS on that project.

      10. Clean-up work at Natick Labs has begun.  The most-contaminated near-surface soil was dug up and temporarily stored under a seamless tarp, surrounded with haybales.  NLabs waited about one and half weeks for the test results on the soil to come back; apparently no further digging is required, and the test results also determine how and where the soil can be moved. Removal is underway.

      Deferred items:

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

      12. Action items:

    12. Dick to bring old mappings to future meetings.
    13. Dick to report re Natick Historical Society, etc.
    14. Jill to report re volunteers status.
    15. Jill to present additional %-cancer graphs (multiple copies).
    16. Tom to circulate (including Mary Ellen), then present (final?) draft Status Report for Selectmen.
    17. Mary Brown will moderate the next meeting.

      18.  
    SSCOM RAB: Wednesday, Oct. 29th, 1997 (7:00-9:00pm, NLabs Officers Club, so. of Kansas St.).
    1. The U.S. Agency for Toxic Substances and Disease Registry presented its long-awaited follow-on Natick Health Study results, building upon its May 1997 report and the May 1997 report from the Mass. Dept. of Public Health. It is unfortunate that this presentation was announced after our prior NCSTF meeting. It appears to have received little if any preceding public announcement, and it was poorly attended by the public and the press. (Dick, Jill and Mary Ellen attended from NCSTF, and voiced their comments. Also in attendance: Nick Lowe, a new environmental staffer in the local office of U.S. Congressman Ed Markey.) Printed copies of ATSDR's report were not distributed as expected; however, some copies (Draft Health Consultation, Natick Laboratory Army Research, CERCLIS No. MA 1210020631, October 1997) were supplied to the NCSTF in advance, and one will be archived in the Natick Library.

      2. ATSDR presented no new Natick data, but did search the literature to analyze whether the temporary delivery of contaminated Evergreen Well water in Natick's drinking water during years about 1990 might have caused significant health problems for Natick residents. Its conclusion: Worst-case scenarios would not have resulted in serious exposures. While these projections are heavily based on short-term, heavy, single-contaminant dosages to rodents et al, which may not correlate well with longer, lower, multiple-contaminant dosages to humans, ATSDR states that these questions should be more than balanced by its "conservative" assumptions. Of course, this conclusion does not explain what did cause Natick's past rises in cancer incidence.
    2. NLabs reported on its contaminated-soil-removal operation: The originally-planned volume was removed with care, and the samples were analyzed. Because one side of the removal area shows remaining contamination, an additional amount of soil will be removed.
    3. NLabs members received the first four chapters of a new Draft Phase II Remedial Investigation Report, Vol. 1, Secs. 1-4, T-25 Area at the U.S. Army Soldier Systems Command (SSCOM), Natick, Massachusetts (Oct. 1997), plus a tour through its many and complex pages. It contains much valuable data with new presentation formats, it's very thick, and there's more to come. A copy will be archived at the Natick Library.
    Meeting 22: Monday, Nov. 3rd, 1997 (7:30-10:00pm, NTH, Room 301, 13 E. Central St.):
      Moderated by Mary Brown, minutes by Mary Ellen Siudut.

      Attendees (*=Steering Committee, **=Non-members):
      Mel Albert**, Tom Branhan*, Mary Brown, Beth Donnelly, Dr. Krikorian**, Dick Miller*, Jill Miller, Catherine Rizzo, Carol Scannell*, Mary Ellen Siudut.

      Agenda Items:

    1. Catherine mailed letter to inactive members over a week ago, inviting them to renew interest and attend meetings. Jill heard from one, who has been volunteering with database project.
    2. Review of US ATSDR presentation at Natick Labs RAB meeting of Wed., Oct. 29th. Dick distributed copies of ATSDR Draft Report and discussed highlights (see above). Presenter Dr. Brenda Edmonds (Weis) reported in this literature review that there was no evidence that Natick residents should be concerned with contamination from volatile organics (PCE and TCE) in the public water supply. The literature showed that, assuming the worse case scenario of exposure levels, residents would not have suffered adverse health effects.
    3. Dr. John Krikorian, of Columbia Metrowest Medical Center, Framingham, paid a special visit. He discussed cancer causes, groupings and reporting, and answered questions from the task force.

      4. Cancer has become very common, is the cause of 1/4 to 1/3 of all deaths. Therefore, only cause for local-issues alarm when there are an extraordinary number in same area or cases of same very rare type in same area.
      He discussed problem of looking at an association and drawing conclusions about causation.  In reviewing world-wide studies, the minority of associations have an implied causation. (That is, a known causation.)
      He discussed categorizion of cancers by similar causation or epidemiology.
      Acute leukemia is the easiest to access environmental causation because it is very rare, unmistakable, and has a short period from exposure to onset of disease (approx. 7 years).  This is compared to lung cancer and other solid tumor cancers where the antecedent factor can be 15-20 years earlier.
      Problems in looking for an association in an epidemiological study include:
      Data may be contaminated; looking at mortality instead of incidence is difficult, because many malignancies now are highly curable (examples: prostate , breast).
      Mortality data is derived from death certificates which are misleading and vary by author; often need to look at secondary causes.  Death certificates are more useful for cancers with high incidence-to- death ratio (example: pancreatic).
      People change towns. The longer the latency period, the harder to get reliable data.  Also need data to compare against.
      "Pancreatic Cancer" also was used as a "catch all" diagnosis for various other possible cancers before the arrival of CAT scans and other improved detection technologies. CAT scans first used at MGH in Boston in 1973.  Probably not used in Metrowest until mid-1980’s.
      Categories of Cancers:
      · abdominal malignancies: bowel, colon, pancreas, stomach
      · brain, spinal cord
      · leukemia
      · lymphomas
      · sarcomas (ionized radiation)
      · endocrine-sensitive: prostate, breast, uterus
      · upper digestive tract: lungs, esophagus, head, throat
      · cervix
      · pediatric
      Multiple cancers in one residence is not necessarily a cause for special concern, since cancer is so common. But most families won't realize that.
      Question: What type of cancers may have been incorrectly diagnosed as pancreatic, so that when CAT scans came into use, we would see a decrease in pancreatic and an increase in these types? Answer: All lower abdominal cancers.
      Dr. Krikorian discussed some approaches for our study. For example, if we suspected that old tanneries cause excess cancers, we could look at another town that had tanneries, like Hudson, and see if it experienced a similar excess cancer rate.
      It is difficult to determine what number of cancers should be considered excessive. For example: Dr. Krikorian usually gets 1 case of testicular cancer a year in Framingham. Last year he had 12 cases. Is this cause for alarm?
      Discussed the local, unrelated "Blip of 1974" in NCSTF charts (see item 4, below). Dr. Krikorian is skeptical re this data. The insult that caused this would have happened many years before. A cancer "spike" should be impossible. It goes against the biology of the disease, because latency periods are so long and vary so much. Malignancies are not that well behaved or predictable.
      The same event (environmental exposure) could present itself in different histologic types of malignancies.
      A simple margin of error for statistical analysis can be computed as the square root of the number of events.
    4. Jill reported on volunteer data search. She is starting new volunteers on Wednesday. Going well!

      5. Jill reviewed her graphs of cancer death rates (as a percent of all deaths). She has added many new towns and presented many variations of data. We discussed the 1974 "blip" which remains in Natick (early 1975) plus adjacent towns on northeast and east: Wayland, Weston and Wellesley. It does not appear in any other towns adjacent to these. It is not an artifact like the famous, national 1974 blip in cancer incidence, which resulted from publicity about breast cancer and a sudden upsurge in testing (see, Living Downstream, p.252); our use of mortality data avoids that distortion.
      Jill has a new plot showing Natick vis-a-vis similar-sized, industrial towns. We will review these at our next meeting.
    5. Dick, re NCSTF Sensitive-Data Agreement: Roger Wade has provided a paper to Massachusetts health departments, regarding 950 CMR 32. A section of this Massachusetts law appears to be appropriate to our issue of data confidentiality.

      6. Following Town Counsel's advice, on October 31st Dick responded to the Natick Tab's request for full disclosure of mapping et al, citing this and related reasons. He attached a partial data listing which did not identify individuals, instead.
    6. Reviewed some of our draft mapping with Dr. Krikorian.
    7. The Draft Status Report to Selectmen has benefitted from much recent e-mail editing by its subcommittee. Now we read, discussed, edited and approved paragraphs one by one, and approved for release. Dick will schedule its presentation to the Selectmen at their next meeting: Monday, November 10th.

      8. Deferred items:

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

      10. Action items:

    10. Dick to bring old mappings to future meetings.
    11. Dick to report re Natick Historical Society, etc.
    12. Jill to report re volunteers status.
    13. Jill to present additional %-cancer graphs (multiple copies).
    14. Dick to schedule, then present Status Report to Selectmen (Nov. 10th).
    15. Jill will moderate the next meeting.
    Selectmen's Meeting: Monday, Nov. 10th, 1997 (about 8pm, NTH, 1st-Floor Aud., 13 E. Central St.):