The Geography of Cancer

New Jersey struggles with a baffling outbreak

The citizens of Rutherford, N.J., a prosperous, green and pleasant town seven miles from New York City, normally use their well-appointed high school auditorium for everything from class plays to graduations. But last week more than 500 parents were gathered there for a very grim purpose. School officials, acting on reports from parents alarmed by an apparently high incidence of cancers in the town, had compiled a list of eleven residents recently afflicted either with leukemia or Hodgkin's disease and asked state health authorities to investigate. Now the townspeople were assembled to hear the findings.

The news was not good. Dr. Ronald Altman, chief epidemiologist for the state's department of health, revealed that Rutherford residents had suffered 32 cases of leukemia and related cancers during the past five years. The eleven cases of Hodgkin's disease, he said, were more than would have been expected in a town with Rutherford's 20,000 population. The total number of leukemia cases (13) was not unusual, he went on, but the distribution of the cases by age range was. A town of Rutherford's size could normally expect .58 cases of leukemia in the 5-to-19-year-old age group during this period. Rutherford had six cases in this category, five of them among children in the same small school district. Said Dr. Arnold Rubin of the northern New Jersey chapter of the Leukemia Society of America: "It's unlikely that they have occurred purely by accident." Concerned Rutherford residents had their own ideas about the cause. Mrs. Vivian Cleffi, whose nine-year-old son James died of leukemia in 1976, held "Big Business" responsible. Some people raised questions about the quality of the local water. Others indicted the air, mentioning the smells from nearby industrial plants that one woman described as the "Sunday night sepsis." Everyone agreed that serious investigation was essential. "There are some questions that have to be answered," said Mrs. Betsy Van Winkle, who also lost a son to leukemia in 1977.

Doctors and environmental officials plan to test Rutherford's air, water and soil, check out any radiation sources in the area and interview families of cancer victims to identify any factors that might reveal causal links between the various cases. But they candidly warned it was impossible to promise hard results. Studies of similar clusters, as such groupings of cases are called, have turned up no clear clues as to their causes.

Rutherford's cancer rate is not the only one that needs investigation, though. New Jersey as a whole has the unhappy distinction of being one of the most cancer-ridden states in the nation. A study covering the years 1950 through 1969 put the state's cancer death rate for white males at 205 per 100,000, a full 17% above the national average of 174. The same study put the rate for New Jersey women at 148 per 100,000, nearly 14% above the U.S. average of 130. New Jersey's mortality rate for bladder and urinary cancers, malignancies long asociated with exposure to certain chemicals, was 9.68 per 100,000 white males, some 50% above the national average. The chemical industry is one of New Jersey's biggest employers. In Salem County, where chemical plants stand shoulder to shoulder along the Delaware River the bladder cancer mortality was 16.1 per 100,000 men, more than double the national average.

Many researchers and New Jersey residents are sure they know the reason, noting that the geography of cancer roughly follows the geography of some industries, particularly the chemical industries. With a population of some 7.3 million crammed into 7,521 sq. mi., New Jersey is both the most densely populated state in the nation and one of the most industrialized. Tests done a year ago identified at least seven potential carcinogens in the air. Sampling of 250 wells in twelve counties completed last month showed that almost all of them contained trace amounts of 50 chemicals, including such known or suspected carcinogens as vinyl chloride, carbon tetrachloride, not to mention the pesticides aldrin and dieldrin. These levels are not believed at this time to present a health hazard. Federal studies have noted that water from two major suppliers contains small amounts of chemicals called trihalomethanes known to be mutagenic, (i.e., capable of causing mutations in bacteria) and possibly carcinogenic as well.

Until a year ago, toxic chemical disposal was all but unregulated in the state. Many chemicals were dumped promiscuously into landfills and other areas that drained into wells and water sources. The automobile may also be at fault. Cars are responsible for at least half of the benzene, a potential carcinogen, in New Jersey's air. New Jersey's department of environmental protection will soon send some 12,000 New Jersey firms a questionnaire to determine if they use any of 188 known or suspected carcinogens. The department is also working with the National Institute of Health to establish a cancer registry and set up a computer network for storing and correlating information on the disease.

These plans will do little to ease the anguish of people in Rutherford and elsewhere around the state who have already lost children, husbands or wives to cancer. But it will undoubtedly help thousands of other Garden Staters who, unless something is done, are likely to face continued exposure to carcinogens. Science may never succeed in identifying all the genetic, metabolic and immunological links in the biological chain of events that leads to cancer. But it can identify the environmental links, and if it does, that deadly chain can be broken.

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