Public meeting mdph activities in south weymouth and neighboring communities
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Public Meeting: MDPH Activities in South Weymouth and Neighboring Communities. Bureau of Environmental Health Assessment Massachusetts Department of Public Health February 13, 2002. Assessment of Cancer Incidence in Rockland, Weymouth, Abington, and Hingham, MA 1982-1998.

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Public Meeting: MDPH Activities in South Weymouth and Neighboring Communities

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Public Meeting:MDPH Activities in South Weymouth and Neighboring Communities

Bureau of Environmental Health Assessment

Massachusetts Department of Public Health

February 13, 2002


Assessment of Cancer Incidence in Rockland, Weymouth, Abington, and Hingham, MA 1982-1998

Bureau of Environmental Health Assessment

Massachusetts Department of Public Health

February 13, 2002


Reason for Investigation

  • Concerns about increased cancer near the NAS

  • Requests by:

    • Senator Michael Morrissey,

    • Weymouth Board of Health, and

    • Concerned residents in Rockland, Weymouth, Abington, and Hingham

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Community Cancer Concerns

  • Suspected increases in cancer in the four towns

  • Possible link to environmental contamination present at NAS

  • Suspected increases in cancer in other areas of the four towns unrelated to NAS

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Investigative Approach

  • Calculate cancer rates for each town and by smaller areas (census tracts)

  • Evaluate available cancer risk factor information

  • Evaluate geographic patterns of cancer in each town

  • Evaluate patterns of cancer in relation to environmental sources (particularly NAS)

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Massachusetts Cancer Registry

  • Population-based surveillance system established in 1982

  • Massachusetts law requires reporting of all newly diagnosed primary cancers in Mass. residents

  • Confidential database

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Bladder

Brain

Kidney

Leukemia

Liver

Lung

Non-Hodgkin’s Lymphoma (NHL)

Pancreas

Eight Cancer Types Evaluated

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Cancer Data Evaluated

  • 1982-1998

  • Three smaller time periods

    • 1982-1986

    • 1987-1994

    • 1995-1998

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Statistical Methods

  • Standardized Incidence Ratio

    Observed # of cases

    SIR = x 100

    Expected # of cases

  • 95% Confidence Interval

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Summary of Major Findings

  • The majority of cancer types evaluated occurred at or near the expected rates in the four towns and in their census tracts

  • Lung cancer was statistically significantly elevated in three of the four towns

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Summary of Major Findings

  • In Weymouth, leukemia and pancreatic cancer were statistically significantly elevated in some time periods

  • Some isolated elevations in cancer types occurred in some census tracts during certain time periods

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Statistically Significant Findings

  • Lung cancer elevated in Weymouth, Abington, and Rockland

  • Lung cancer lower than expected in Hingham

  • Pancreatic cancer elevated in Weymouth during 1982-1986

  • Leukemia elevated in Weymouth during 1987-1994

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Lung Cancer Incidence in Weymouth, MA

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Lung Cancer Incidence inRockland, MA

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Lung Cancer Incidence inAbington, MA

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Lung Cancer Incidence inHingham, MA

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Factors Considered

  • Cancer may be caused by one or many different factors

  • Review of MCR data on cancer risk factors

    • age/gender

    • smoking history

    • occupation

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Lung Cancer Risk Factors

  • Age

  • Smoking

  • Second-hand smoke

  • Occupation/environmental exposures

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Review of Risk Factors:Lung Cancer

  • Age and gender patterns did not appear unusual

  • Workplace exposures may have played a role in some diagnoses

  • Majority of those with lung cancer were current or former smokers

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Smoking History: Lung Cancer

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Smoking History: Lung Cancer

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Smoking History: Lung Cancer

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Smoking History: Lung Cancer

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Cancer Rates by Census Tract

  • SIRs were also calculated for the census tracts that subdivide each of the four towns

    • 8 CTs in Weymouth

    • 3 CTs in Abington

    • 3 CTs in Hingham

    • 2 CTs in Rockland

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


rate = or < expected

rate > expected

rate statistically significantly > expected

Lung Cancer Incidence

1982-1986


rate = or < expected

rate > expected

rate statistically significantly > expected

Lung Cancer Incidence

1987-1994


rate = or < expected

rate > expected

rate statistically significantly > expected

Lung Cancer Incidence

1995-1998


Pancreatic Cancer Incidence in Weymouth, MA

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


rate = or < expected

rate > expected

rate statistically significantly > expected

Pancreatic Cancer Incidence

1982-1986


Review of Risk Factors:Pancreatic Cancer

  • Age patterns were as expected

  • More women than men were diagnosed with pancreatic cancer

  • Workplace exposures possible

  • Smoking may have played an important role for some individuals

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Smoking History: Pancreatic Cancer

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Leukemia Incidence in Weymouth, MA

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


rate = or < expected

rate > expected

rate statistically significantly > expected

Leukemia Incidence

1987-1994


Review of Risk Factors: Leukemia

  • Age and gender patterns did not appear unusual

  • A variety of different leukemia subtypes were reported

  • Workplace exposures may have played a role in some diagnoses

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Evaluation of Geographic Distribution

  • Place of residence at time of diagnosis was mapped for each individual

  • Patterns of individuals diagnosed with cancer were evaluated spatially

  • Other factors that may indicate a cluster were considered

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Community Environmental Concerns

  • Naval Air Station

  • Potentially hazardous waste sites (21E sites)

  • Weymouth Neck Landfill

  • Specific community environmental concerns in Weymouth and Hingham

  • Suburban Auto and two landfills in Rockland

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Sources of Environmental Information

  • ATSDR Public Health Assessment

  • Environmental Baseline Study

  • ATSDR Private Well Survey

  • Modeled Flight Track Patterns

  • Recent Investigations in NW corner of NAS

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Summary of Geographic Distribution Analysis

  • With the exception of lung cancer, no consistent spatial patterns were observed in any one area of the four towns

  • The geographic pattern of cancer did not show a clear pattern suggesting a common environmental exposure related to the NAS

  • Patterns of cancer near other areas of community environmental concern were not atypical

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


rate = or < expected

rate > expected

rate statistically significantly > expected

Lung Cancer Incidence

1995-1998


Conclusions

  • Majority of cancer types occurred at or near the expected rates in the four towns between 1982-1998

  • Lung cancer is increasing in Weymouth and Rockland, particularly in CTs near the NAS

  • Evaluation of risk factors showed smoking likely played a role in increased lung cancer rates

  • Occupation also played a role in lung cancer for some individuals

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Conclusions (cont.)

  • With the exception of lung cancer, patterns by census tract showed no consistent elevations of cancer over time

  • The geographic pattern of cancer did not show a clear pattern suggesting a common environmental exposure related to the NAS

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


MDPH Recommendations

  • The MDPH should further investigate the pattern of lung cancer with respect to length of residence, particularly among non-smokers, to determine if a clearer pattern of this cancer emerges

  • Results should be considered by town Boards of Health when planning future prevention or intervention strategies in the four towns

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


MDPH Recommendations (cont.)

  • Tobacco control efforts should be focused accordingly in the towns of Weymouth, Abington, and Rockland

  • Cancer incidence will continue to be monitored in these four towns through the use of the MCR

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Weymouth Health Needs Assessment

February 2002


Weymouth Health Needs Assessment

  • Weymouth Board of Health Sponsored

  • Purpose to identify health needs of Weymouth residents

  • Purpose to design programs to improve the health of residents

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Weymouth Health Needs Assessment

  • Confidential mailed survey to 5000 Weymouth residents

  • Survey conducted by JSI Research and Training Institute of Boston

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


WeymouthHealth Needs Assessment

  • Identify respiratory problems in the household

  • Identify risk factors for heart disease in the household

  • Identify health care services needs

  • Identify possible environmental health outcomes

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Weymouth Health Needs Assessment

  • Questions designed to address specific arsenic and SWNAS concerns

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Weymouth Health Needs Assessment

  • Identify the occurrence of Multiple Sclerosis and other types of neurodegenerative diseases

  • Identify the occurrence of Lupus Erythematosus and other types of autoimmune diseases

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Weymouth Health Needs Assessment

  • Identify the occurrence of aplastic anemia and myelodysplastic syndrome

  • Identify the occurrence of diseases of the kidney

  • Identify the occurrence of birth defects

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


Weymouth Health Needs Assessment

  • The environmental health outcome component of the survey will tell us if these outcomes occur at rates greater than would be expected or if they occur more often in certain areas of the community.

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


How to Contact BEHA

Massachusetts Department of Public Health

Bureau of Environmental Health Assessment

250 Washington Street, 7th floor

Boston, MA 02108

Telephone: (617) 624-5757

Fax: (617) 624-5777

www.state.ma.us/dph/beha

Massachusetts Department of Public Health, Bureau of Environmental Health Assessment


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