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Public Health concerns regarding unhealthy
drinking water and its possible relationship to a
cancer cluster study in Palm Beach County
Florida
Sharon Pardo
PUBH-8165-10 Environmental Health
Target Audience: Acreage Florida Residents
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Final Presentation Project for Environmental Health
Course
Walden University
Department of Public Health PhD Program
January 23, 2010
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There is currently an on-going investigation regarding the
existence of a cancer cluster in a specific area of Palm
Beach County, Florida known as the acreage.
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Specifically, the incidence of pediatric brain tumors is
under epidemiological investigation
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One possible cause being investigated for the occurrence
of cancer in the acreage is contaminated well water
Florida Department of Health (2009)
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Learn about Water quality and safety and possible
health effects (such as cancer) secondary to unsafe
or contaminate water
Discuss what prevention measures such as
regulatory controls
Discuss what a cancer cluster study involves and
how one is proven to be true
Discuss the current status of the acreage cancer
cluster study in Palm Beach County Florida
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Groundwater * upper water table or deeper
reservoirs
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Surface Water * lakes, reservoirs, rivers
(Moeller, 2005, p. 161)
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There is no such thing as naturally pure water
Some of these impurities occur naturally
Others can come from man-made sources
(U.S. Environmental Protection Agency, 2009)
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U.S. EPA – categorizes water contaminants into the
following categories:
- microorganisms * Giardia Lamblia
- disinfectants * chlorine
- disinfection by products
- inorganic chemicals * arsenic
- organic chemicals *benzene
- radionuclides * radium
U.S. Environmental Protection Agency (2010).
At the Federal Level :
Safe Drinking Water Act (SDWA P.L. 95-523)
Purpose of SDWA is to ensure public water supplies
are free from potentially harmful materials and that
supplies meet federal standards for public health
However, keep in mind the SDWA does not provide
protection for small water systems and / or private
well use
(U.S. Environmental Protection Agency ,2008).
At the state and local level:
Florida Safe Drinking Water Act
Specifically sets drinking water standards for over 100 chemical
compounds, microorganisms, and radionuclides considered
health risks (again this does not pertain to private well
consumers)
In order to provide some legislature for private well water
consumers the state legislature passed the Florida Statutes
Chapter 64E-8 Drinking Water Systems to provide standards
for well setback and well construction
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A cancer cluster is a greater than expected
number of cancer cases occurring within a
group of people in a specific geographic area
over a specific period of time
(Centers for Disease Control , 2009)
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A true cancer cluster should have the following
characteristics:
Several cases of a rare type of cancer
Lager than expected numbers of a more common
type of cancer
Type of cancer not usually seen in this type of
people (children with adult type cancer)
(American Cancer Society , 2010)
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According to the American Cancer Society more that 1,000
suspected cancer clusters are reported to State Health
Departments each year
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Cancer is the cause of death for 1 out of every 5 Americans
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Specifically for children in 2007, 10,400 children under age
15 were diagnosed with cancer, making it the leading cause
of death by disease among US children 1-14 years of age
(American Cancer Society 2010a)
Many researchers are skeptical of cancer clusters for the
following reasons:
 People tend to treat random events as though they are
not random (clustering illusion)
 Cancer is not just one disease; it is actually an umbrella
term for at least 100 different but related diseases
 Each type of cancer has certain known and/or suspected
risk factors associated with it.
 Cancer is almost always caused by a combination of
factors that interact in ways that are not yet fully
understood.
(American Cancer Society, 2010b)
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Model used by epidemiologists that states that no
one factor is the sole cause for a disease or chronic
condition, rather for a disease such as cancer several
factors predetermine the disease and these factors all
interrelate with each other
(Krieger, N. 1994)
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May 13 2009: Florida Department of Health Bureau
of Epidemiology received request from concerned
citizen to investigate possible high occurrence of
pediatric brain tumors for acreage residents
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The Florida Department of Health then launched a
Level 1 investigation
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Data gathering: review of health statistics for
acreage area for time period of 1995-2007. Existing
data from Florida Cancer Data System and 2000 US
census data was used
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Level 1 study can not link causality, it is just to
determine if an increase incidence of pediatric brain
tumors does exist
(Palm Beach County Health Department, 2009)
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Florida Department of Environmental
Protection in conjunction with Florida
Department of Health sampled 50 wells for a
variety of contaminants
Preliminary findings showed that water form
residential wells met drinking water standards
(Florida Department of Environmental Protection,
2009).
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Total Cancer rates may be elevated in the acreage,
not specifically for pediatric cases
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However, is the data a true representation of recent
population since population data used was from
2000
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Level II investigation is occurring to recalculate
rates with more recent population estimates, verify
if pediatric brain tumor rates are greater than
expected, and further examine residence histories
and additional risk factors for pediatric brain
cancers
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Florida Department of Environmental Protection has
concluded its involvement at this time
American Cancer Society (2010). Cancer Clusters. Retrieved on January 20 2010, from
http://www.cancer.org/docroot/PED/content/PED_1_3x_Cancer_Clusters.asp?sitearea=PE
D.
American Cancer Society (2010) . Childhood Cancer. Retrieved on January 23 2010, from
http://www.cancer.gov/cancertopics/factsheet/Sites-Types/childhood.
Centers for Disease Control (2010) Cancer Clusters. Retrieved on January 20 2010 from
http://www.cdc.gov/nceh/clusters/about.htm.
Florida Department of Environmental Protection (2009). Retrieved on January 20 2010, from
http://www.dep.state.fl.us/secretary/news/2009/files/2009_11_report.pdf.
Krieger, N. (1994). Epidemiology and the web of causation: has anyone seen the spider? Soc.
Sci Med Oct;39(7), 887-903. Retrieved on January 29 2010, from
http://www.ncbi.nlm.nih.gov/pubmed/7992123.
Moeller, D.W. (2005). Environmental Health Third Edition. Cambridge, MA:Harvard University
Press.
Palm Beach County Health Department (2009). Acreage Cancer Cluster Review and
Findings. Retrieved on January 20 2010, from
http://www.pbchd.com/pdfs/environmental/acreage_cancer_cluster_review.pdf.
Palm Beach Post (2009) . Palm Beach Post News. Retrieved on January 20, 2010, from
http://www.palmbeachpost.com/news/new-tests-in-acreage-cancer-study-to-focus167987.html.
U.S. Environmental Protection Agency (2009). Ground Water and Drinking Water What
Contaminants may be found in Drinking Water. Retrieved on January 23 2010, from
http://www.epa.gov/safewater/dwh/contams.html.
U.S. Environmental Protection Agency (2010). Drinking Water Contaminants. Retrieved
on January 22 2010, from
http://www.epa.gov/safewater/contaminants/index.html.
United States Environmental Protection Agency (2008). Safe Drinking Water Act (SDWA)
Basic Information. Retrieved on December 30 2009, from
http://www.epa.gov/safewater/sdwa/basicinformation.html
(2008) Chapter 64E-8 Drinking Water Systems
http://www.myfloridaeh.com/water/manual/pdfs/64E-8.pdf.