Realty Times February 10, 1999

Neighborhoods Across The U.S. Wrestle With Disease Clusters
by Stuart Lieberman

New Jersey is well known for the nice things it offers, such as Atlantic City entertainment, horse farms, agriculture, and the famous New Jersey shore. Now, it might also become known for being the state with the first alleged autism cluster, something that you are unlikely to see referenced in Garden State travel brochures.

Earlier this year, state and federal officials reported on a possible autism cluster in a New Jersey shore community. According to published reports, about 40 children between ages three and ten have been diagnosed with autism. Some suggest that this is twelve times the expected prevalence rate.

According to the Autism Society of America, over 380,000 Americans are believed to have this disease. While there are no medical tests for autism, it is diagnosed by the presence or absence of certain behaviors, generally relating to learning abilities and interactions with people and objects.

New Jersey officials are questioning whether the water, the air, or a nearby landfill are to blame. But the bigger question remain unanswered: whether these cases represent a truly high rate of this disease caused by a single factor, or whether they are nothing more than a statistical aberration. In other words, there is a real possibility that this is nothing more than a most unfortunate coincidence.

What is a disease cluster? According to the National Cancer Institute, a cluster is the occurrence of a greater than expected number of cases of a certain disease within a group of people, a specified area, or a time period. Disease clusters have included certain birth defects in the 1960s, Legionaries Disease in the 1970s , and a certain AIDS related illness in the 1980s.

New Jersey's alleged autism cluster appears to be the first of its kind. The more commonly reported type of cluster is the cancer cluster. In recent years, the federal government has investigated many reported cancer clusters throughout the United States. Some, but certainly not all, have allegedly been linked to high tension wires. What is important to understand, however, is that few reports, if any, have resulted in strong proof that one particular common cause was to blame.

Though cancer clusters are often unresolved, they are expensive to investigate. Government studies of groundwater, soils, factory emissions, can cost millions of dollars. And often, the studies are inconclusive. But emotions tend to run high and government officials often feel compelled to do something, if only so that they can report that something has been done.

As one scientist explained, if you toss a quarter ten times, on average five should come up heads and the other five should come up tails. However, sometimes, you might get eight heads and two tails. According to statisticians, on very rare occasions statistics indicate that you will hit heads ten out of ten times. Obviously, there is nothing magical about a coin that hits heads ten out of ten times. But try explaining this to an understandably nervous community with ten very sick children.

According to the New Jersey Department of Health, many cancer clusters occur by chance, and are not caused by common environmental or toxic factors. Many cancers are caused by a lifetime of exposure to cancer causing substances or by certain repeated habits. That agency maintains that cancer is usually not caused by environmentally based contaminants.

In the mid 1970s, residents of a small central California farm town believed that they suffered from an abnormal incidence of cancer. On one block, 14 cancer cases were reported. But, they were different kinds of cancer, such as liver cancer, eye cancer, and bone cancer.

This leads to another important point to remember. Cancer is not one disease; there are about 100 diseases that are called cancer. After all kinds of expensive sampling was performed, no source was found in the California case. Neighbors have petitioned the Environmental Protection Agency to perform another study, which is underway.

In the early 1990s, another New Jersey community reported that 61 children had various forms of cancer. Investigations to determine whether a single cause exists are underway. So far, once, again, it is still unclear whether the New Jersey cases have a common source, or are just another statistical abnormality.

According to the New Jersey Department of Health, cancer cluster concerns are raised when someone's friend or family member is diagnosed with cancer. This creates a heightened awareness of cancer, and when the person meets someone else with a form of cancer, which may or may not be the same kind of cancer, he or she may believe that a cluster exists.

Many people do not realize that cancer is actually a common disease. According to the American Cancer Society, one out of three Americans will eventually develop cancer. Considering these statistics, it really is not that surprising that several neighbors and others in close proximity might be stricken with a form of cancer.

At this time, there are many, many questions, and very few good answers. Nobody wants to minimize the pain, frustration and anxiety associated with a serious illness. And emotions run high when several persons in close proximity appear to become stricken by the same disease. As of now, however, it appears that many reported disease clusters may be nothing more than statistical abnormalities, and not indicators of a common toxic threat.



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