Water Resources Research Act Program

Details for Project ID 2018AL190B

ASSESSING SOCIO-ENVIRONMENTAL FACTORS IN THE CLEBURNE COUNTY, ALABAMA, CHILDHOOD LEUKEMIA CLUSTER

Institute: Alabama
Year Established: 2018 Start Date: 2018-03-01 End Date: 2019-02-28
Total Federal Funds: $24,890 Total Non-Federal Funds: $63,767

Principal Investigators: LOCHA ASHWOOD, Ming-Kuo Lee

Abstract: J. Identification and Statement of Major Regional Water Problem: Leukemia accounts for more childhood cancer diagnoses than any other malignant disease (Filippini et al., 2015; National Cancer Institute 2017a). Rates of childhood acute myeloid leukemia rose by 1.1% per year in the US between 1975 and 2010, while overall leukemia rates for adults have risen by .3% each year (Linet et al. 2016; National Cancer Institute 2017). Leukemia’s overall rarity, combined with its childhood proliferation, calls for detailed cancer cluster research. Rural Fruithurst, Alabama, and its unincorporated neighbor, Muscadine, offer a unique opportunity to study the role of environmental exposure in contracting childhood leukemia. Cleburne County, which houses these rural communities, typically averages about one childhood leukemia diagnosis in a 5-year period (Alabama Department of Public Health, 2015). The Muscadine-Fruithurst census block (1,544 people) houses only 10% of Cleburne County’s total population, yet our preliminary research identified that in five years – from 2013 to 2017 – five children have been diagnosed with leukemia in this area, about 49 times the prevalence expected. In addition, between 2016 and 2017, four adults have been diagnosed with leukemia, and two adults with lymphoma, which etiologically is closely related to leukemia. The alarming spike in leukemia in this rural Alabama community warrants urgent attention, and simultaneously offers a unique opportunity to explore the role of environmental risk factors in childhood leukemia (Wiemels, 2012). Only 5% of childhood cancers are known to be caused by an inherited genetic mutation, making the kind of work we propose all the more necessary (National Cancer Institute 2017b). Our preliminary research suggests that children may have been 2 exposed to radon, heavy metals, and volatile organic compounds in ground water sediments. The leukemia cluster rests upon Heflin Phyllite, a metamorphic rock that can potentially produce high levels of radon (222Rn). Radiation produced by radon in the water or air may elevate the frequency of childhood leukemia (Hsu et al., 2013; Tong et al., 2012; Rassaschou-Nielsen et al., 2008). Further, we have found elevated levels of carcinogenic heavy metals (arsenic, chromium, lead, nickel) and semi-volatile organic compounds (Bis(2-ethylhexyl) phthalate) in soils near the Fruithurst Problend Rubber plant, only 1/8 mile from the town’s elementary school. Volatile organic compounds are associated with childhood leukemia, especially organic solvents like trichloroethylene and benzene (Belson et al., 2007). Much of the community has transitioned to municipal water sourced from a cold spring near the city Anniston in neighboring Calhoun County, where metals, agrochemicals, and organic solvents have been found at two EPA superfund sites on the National Priorities List. In addition, our preliminary data shows that those diagnosed or mothers of children regularly consumed well-water in the last ten years. The incubation periods between past environmental exposures and the onset of leukemia vary between one and 15 years, depending on exposure (Amenian, 1987; Nadler and Zurbenko, 2016; Howard, 2013). Some households still use well water drawn from deep wells (>150 ft) that may be hydrologically connected to the Knox carbonate aquifer that receive groundwater recharge near the Superfund sites, as well as Problend. The main objective of this study is to use Community Based Research Methods to gather health and environmental data across leukemia-impacted watersheds. We will use interviews, surveys, sampling, and laboratory analysis to explore potential human exposure to environmental pollutants. Although environmental pollution has been a source of great public concern of human health for decades, more research is needed to investigate environmental exposures at the community level. Our results will help create a template for community-based cancer research that serves science and the public.