Is radon the culprit in an unusually high number of cases of a rare blood illness in Schuylkill, Carbon and Luzerne counties? Or is it fly ash? Or maybe something else?
Those possibilities are being examined, along with a variety of other scenarios as part of $8.8M in research and investigations.
At Wednesday's public meeting, sponsored by the federal Agency for Toxic Substances and Disease Registry (ATSDR) and the Tri-County Polycythemia Vera (PV) Community Advisory Committee, an expert said significantly high levels of radon have been seen in studies here.
Robert K. Lewis, manager, hazardous sites cleanup, Pennsylvania Department of Health (DOH), told 50 in attendance at the Tamaqua Community Center that one environmental analysis of air quality has turned up an area of concern.
"We sampled radon in homes. Fifty percent of homes were 4 picocuries or higher," noted Lewis, who explained that 48 different locations were tested. One area tested was where a high incidence of PV cases has been identified.
"We were requested to sample along Ben Titus Road," said Lewis.
In terms of water analysis, Lewis said testing was done on "a combination of well water and commercial water supplies such as the Tamaqua Water Authority."
Lewis said results indicate that Tamaqua residential drinking water appears to have no problem with contaminants. However, "we didn't (test for) radon in water," he added. That is one area that would need to be looked at, said Lewis.
Lewis indicated that drinking water testing turned up only two lead results and two nitrate.
"The department doesn't feel that drinking water is a problem here, but we should go back and look for radon."
One expert said the entire effort is multipronged.
"You have an interdisciplinary group of scientists working on these studies," said Dr. Henry Cole of Maryland, who has been working with Tom Murphy, Hometown, a founder of the CAC group.
The meeting featured updates by the Pa. Department of Environmental Protection, the agency sampling drinking water, dust and soil at the homes of study participants.
In addition, workers are testing water and sediment at the McAdoo Superfund site and cogeneration plants in the area.
A team from Drexel University is trying to identify risk factors for the disease, while researchers at the University of Pittsburgh are studying the frequency of PV cases.
Research updates target PV incidence
The session provided a broad range of updates from a variety of sources:
Ÿ Elizabeth Irvin-Barnwell of the ATSDR said a total of 1,150 persons were screened for the JAK2 mutation, found in those who develop PV. In addition, 3,500 DNA samples were analyzed for the mutation.
"We can link each person's test with demographic factors ... it's a groundbreaking study," said Irvin-Barnwell.
Ÿ Dr. Lora Siegmann Werner of the ATSDR outlined initiatives in health education, such as developing literature to address "What does it mean if you have PV?" A comprehensive list of physicians has been completed because there is great need to get information to doctors, she said. She also lauded work by the CAC support group and Michelle Greshner.
Ÿ Dr. Jeanine Buchanich, University of Pittsburgh said, "We're working with the Department of Health to do an expansion of the original study." She said 372 cases are included in the study, all from the Pennsylvania Cancer Registry. She said as many folks as possible should take part.
"We're hoping CAC members will convey how important it is to participate in the study. The success of the study depends on getting people to participate."
Ÿ Dr. Carol Ann Gross-Davis of Drexel University reported on a case control study of 147 people.
"Of the cases, we have 24 consented who have PV. We had 10 percent who declined to participate, which is their right," she said, adding, "We're doing it through the Geisinger system, coordinating through the University of Pittsburgh."
Ÿ Dr. Jim Logue, Pennsylvania DOH principal investigator for the myeloproliferative neoplasm program, said he's been involved in cancer analyses since 2004. He announced success with a partnership.
"We secured two contracts with the University of Pittsburgh."
Ÿ David Marchetto, the department's program manager, said progress is being made.
"The pieces are coming together," he said. "We're working with state, federal and local partners." Marchetto also said, "Misclassification of the disease is a concern to us. There are cases reported to the cancer registry that aren't PV, not only here but in southwestern and central Pa. as well."
Similarly, sometimes PV cases do not get reported, he stated.
It was noted that Dr. Peter Jaran, environmental engineer from New Jersey, will look at groundwater and potential sources of contamination.
Local residents had several questions for the experts.
Irene Genther, a Nesquehoning resident and former educator with extensive background in the sciences, asked for clarification as to whether susceptibility to PV can be attributed to heredity. Irvin-Barnwell said heredity itself isn't seen as a factor. Still, family history and ethnicity are areas being examined.
Genther advised attendees that contaminants such as fly ash dust and radon aren't found only in the ground, but are airborne.
Some said a solution isn't coming fast enough.
"It's been eight years and we still don't have an answer," said PV patient Merle Wertman, Tamaqua. Wertman was on hand with wife Linda. The two have been staying on top of developments with the disease. Wertman was diagnosed in 2003. He has no family history of cancer.
Dr. Cole had words of praise for Murphy, a community volunteer who devotes himself to the role of environmental and health activist.
"Joe has put so much into this," said Cole. "He's been the guiding light. He put his whole heart and soul into this."
Those in attendance gave Murphy a round of applause for his role in coordinating activities of the CAC.