MN Health Department to Release Water Gremlin Cancer Report

Cancer in Minnesota 1988-2014

The state health department will release a cancer study that will help identify the cancer rates of a population around Water Gremlin plant. I have been digging into the information that the MN Health Department collects about cancer in Minnesota.  Our state is very health conscious.  In 1988 our legislature passed a bill that created a cancer database and required all health providers to submit data about the diagnosis of cancer and deaths from cancer.  In 2017 the health department published a report called Cancer in Minnesota 1988-2014.  The report compares cancer rates by region, cancer type, demographics like age, and ethnicity.  All of the cancer rates are calculated based on the 2010 census.  Cancer rates are the number of cancer diagnosis per 1,000 people in a geographic area.

2017 Biennial Cancer Report

The complete 2017 report can be downloaded at: https://www.health.state.mn.us/data/mcrs/docs/2017biennial.pdf#

You can see from this graph that age makes a big difference.  If you prefer to look at the numbers instead of the graph here is the table data.


So what does this mean for the Water Gremlin contamination zone?  It can give us a baseline for what is generally normal in Minnesota.  To be able to make any comparisons we need to see this report for the contamination zone.  I reached out to the MH Health Department with that question.  I received a response that they are already working on a report that narrows the analysis to 5 census tracks that surround the Water Gremlin plant. 

Apples to Apples

In order to see if we are comparing apples to apples the study must review any differences between the make up of the state population and the make up of our community population.  If we have a larger number of young people than the state, the numbers will not compare.  Our numbers may look lower than the state.  If we have a larger number of old people than the state our numbers will look high because there is a much higher instance of cancer in older people.

We will need to look at the make up of the state demographics and look at cancer rates within an age group rather than an entire population.  This may take some work.  I am hopeful that Judy Punyko, PhD, Supervisor of the Minnesota Cancer Reporting System Data Analysis Unit will normalize the data so that we can compare apples to apples.

Even with a more targeted analysis the report will be meaningful but not completely accurate.  Take a look at the map of the census tracks surrounding Water Gremlin.

Here are the population counts for each track.

Track Population
402.00  1,742
403.01  1,742
405.02  2,601
405.03  3,249
405.04  3,943
Total  13,277

There are approximately 3,000 mailing addresses within the contamination zone.  Using two people per address the relevant population will be closer to 6,000. Will the targeted report show normal cancer rates or higher rates? Will it be accurate considering it will includes an area twice the size of the contamination zone?

When the report is released I will review it and share my thoughts.

Why Gremlin Health

Gremlin Health is a non-profit publisher.  It will conduct research including a cancer inventory of the residents of the area of contamination and will publish reports to area residents and other interested parties.  Its overall goal is to measure the impact of long term TCE exposure in the Water Gremlin contamination zone.  The first report will be the analysis of cancer rates in the contamination zone. 

When I was diagnosed with cancer in 2015, I spent a fair amount of time wondering why and how.  I have a bone cancer called multiple myeloma.  It is not genetic.  It is caused by a mutation that occurs in your bone marrow.  It puts the cancer in your blood.  Once it happens, you have it everywhere.  As I began treatment, I read a lot.  Most of the literature was focused on treatment.  Almost nothing on cause.  I was surprised that I could find no study on causation.

This past July, my wife was diagnosed with endometrial cancer.  Now our radars went up.  Were both very healthy.  We do not smoke.  We exercise 4 to 5 times a week.  We are not overweight.  What was happening?

When I learned of the Water Gremlin pollution, I had a flare of righteous anger.  Could the reason for our cancer be TCE?  How could we know?  The most obvious way is to see if the rate of cancer in the surrounding area is higher than normal.   The Minnesota Department of Health has a robust cancer tracking system to which we can compare the results of the inventory in the area of Water Gremlin contamination to normal rates of cancer.

So on the day of the second public meeting about the Water Gremlin situation, I started Gremlin Health.  I want to know if we are different.  If our rates are similar, I will be satisfied.  I have come to peace with my cancer walk.  If our rates are off the charts, well, that will be our story.

Gremlin Health was created to answer a simple question.  Is the cancer rate unusually high in the contamination zone? 

Gremlin Health Values

Over my career, I have started 10 companies.  Most of them ended up being non-profit in the sense that they never made any money.  The ones that have been successful have been solidly grounded with values.   As I thought about what value system should govern Gremlin Health I quickly chose the Rotary Four Way Test.

I joined the White Bear Rotary in April 2015.  My businesses were doing well, and I wanted to turn some of my attention to community service.  It is a coincidence that I was diagnosed with cancer just a few weeks later.  Over my career, I have started 10 companies.  Most of them ended up being non-profit in the sense that they never made any money.  The ones that have been successful have been solidly grounded with values.   As I thought about what value system should govern Gremlin Health I quickly chose the Rotary Four Way Test.

The Rotary motto is “Service Before Self”.  Rotary uses the Four Way Test to direct service projects.  As Gremlin Health progress through learning about the impact of TCE on our community, all of our ideas and efforts will adhere to Rotary’s Four Way Test.

  1. Is it the truth?  I love this.  When I apply it to Water Gremlin, they come up wanting.  Our health inventory will present the truth.
  2. Is it fair to all concerned?  Does the $7 million settlement seem fair to all concerned?  There has been no effort yet to measure the health or economic impact of the damage.
  3. Does it build goodwill and better friendships?  We are certainly getting to know one another.  I am seeing a number of civic groups come together in unity to approach the problem.
  4. Is it beneficial to all concerned?

Check out the White Bear Rotary Website

Community cancer assessment in response to long-time exposure to perchlorate and trichloroethylene in drinking water

Abstract

In response to concerns about cancer stemming from drinking water contaminated with ammonium perchlorate and trichloroethylene, we assessed observed and expected numbers of new cancer cases for all sites combined and 16 cancer types in a California community (1988 to 1998). The numbers of observed cancer cases divided by expected numbers defined standardized incidence ratios (SIRs) and 99% confidence intervals (CI). No significant differences between observed and expected numbers were found for all cancers (SIR, 0.97; 99% CI, 0.93 to 1.02), thyroid cancer (SIR, 1.00; 99% CI, 0.63 to 1.47), or 11 other cancer types. Significantly fewer cases were observed than expected for cancer of the lung and bronchus (SIR, 0.71; 99% CI, 0.61 to 0.81) and the colon and rectum (SIR, 0.86; 0.74 to 0.99), whereas more cases were observed for uterine cancer (SIR, 1.35; 99% CI, 1.06 to 1.70) and skin melanoma (SIR, 1.42; 99% CI, 1.13 to 1.77). These findings did not identify a generalized cancer excess or thyroid cancer excess in this community.

Complete Article

TCE and Multiple Myeloma

The Relationship between Multiple Myeloma and Occupational Exposure to Six Chlorinated Solvents

Objectives

Few studies have examined whether exposure to chlorinated solvents is associated with increased risk of multiple myeloma (MM). Using occupational exposure information, we evaluated associations between the risk of MM and exposure to six chlorinated solvents: 1,1,1-trichloroethane (TCA), trichloroethylene (TCE), methylene chloride (DCM), perchloroethylene (PCE), carbon tetrachloride, and chloroform.

Methods

MM cases were identified through cancer registries and controls were identified in the general population. In-person interviews obtained lifetime occupational histories and additional information on jobs with likely solvent exposure. We reviewed each job and assigned exposure metrics of probability, frequency, intensity, and confidence using job-exposure matrices modified by job-specific questionnaire information. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between MM and having ever been exposed to each, and any, chlorinated solvent and also analyzed whether associations varied by duration and cumulative exposure. We also considered all occupations that were given the lowest confidence scores as unexposed and repeated all analyses.

Results

Risk of MM was significantly elevated for subjects ever exposed to TCA (OR (95% CI): 1.8 (1.1–2.9)). Ever-exposure to TCE or DCM also entailed elevated, but not statistically significant, risks of MM; these became statistically significant when occupations that had low confidence scores were considered unexposed (TCE: 1.7 (1.0–2.7); DCM: 2.0 (1.2–3.2)). Increasing duration and cumulative exposure to TCE were associated with significantly increasing risk of MM when jobs given low confidence were considered unexposed. Increasing cumulative exposure to PCE was also associated with increasing MM risk. We observed non-significantly increased MM risks with exposure to chloroform; however, few subjects were exposed.

Conclusions

Evidence from this relatively large case-control study suggests that exposures to certain chlorinated solvents may be associated with increased incidence of MM; however, the study is limited by relatively low participation (52%) among controls.

Click here for the complete article.

Cancer Survey

Help us create an inventory of the instance of cancer within the Water Gremlin exposure area. This information will help us determine if the cancer rates are higher than normal rates for similar populations.

This information will be kept private and will be used only to support Gremlin Health initiatives. We will not accept surveys from outside the MPCA defined exposure zone.

Pleas complete the follow form.

TCE an Pancreatic Cancer

Due to concerns about its toxicity, the use of trichloroethylene in the food and pharmaceutical industries has been banned in much of the world since the 1970. In Europe, legislation has forced the substitution of trichloroethylene in many processes due to the fact it has been classified as a carcinogen carrying an R45 risk phase, May cause cancer. The manufacture of trichloroethylene largely ceased after it was banned
by the Montreal Protocol in 1996. Environmental Health: A Global Access Science Source, published an article in October of 2006 entitled, “Mortality among US employees of a large computer manufacturing company: 1969-2201,” by Richard W. Clapp, the following statement is
made, “In comparison to the PMRs (Proportional Mortality Ratios), only the PCMRs for pancreatic cancer (PCMR = 126; 95%CI = 101, 157), kidney cancer (PCMR = 162; 95%CI = 124, 212), malignant melanoma of the skin (PCMR = 179; 95%CI = 131, 244), and brain and central nervous system cancer (PCMR = 166; 95%CI =129, 213) remained statistically significant.”

The Environmental Protection Agency released a final human health assessment for trichloroethylene Sept. 28, 2011, that for the first time classifies the widely used solvent as “carcinogenic to humans” by all routes of exposure; EPAʼs final assessment concluded that TCE is a mutagenic carcinogen. That means risk assessors will have to take into account that early life exposures to the solvent could increase the risk of
eventual cancer; EPAʼs classification of TCE is consistent with the World Health Organizationʼs classification of TCE as a probable human carcinogen and the U.S. National Toxicology Programʼs listing of it as “reasonable anticipated” to cause human cancer. The EPA reaffirmed their position on June 10, 2016, when they again stated, “TCE is carcinogenic to humans by all routes of exposure.”

The IARC Working Group on the Evaluation of Carcinogenic Risk to Humans. Trichloroethylene, Tetrachloroethylene, and Some Other Chlorinated Agents, Lyon (FR): International Agency for Research on Cancer; 2014 made the following statements: Trichloroethylene was considered by previous IARC Working Groups in 1979, 1987, and New data have since become available, and these have been taken into
consideration in the present evaluation. Under Other Sites it states: “A significantly increased risk of death from cancer of the pancreas was found in black females with a low or medium level of exposure to trichloroethylene, and in white females with a low or high level of exposure, and in white males with a medium level of exposure.”
The molecular alterations in pancreatic carcinogenesis can occur either spontaneously or as the result of a mutagenic carcinogen. TCE has been classified by the EPA as a mutagenic carcinogen. As discussed above in an article entitled “Risk of Pancreatic Cancer in Workers Exposed to Chlorinated Hydrocarbon Solvents and Related
Compounds: A Metal Analysis,” Journal of Epidemiology, vol 153, issue 9 2001:841-850 it was stated, “One case-control study found an association between organochlorine levels and K-ras mutations in pancreatic cancer.”

The International Agency for Research on Cancer, 1995, stated the following: trichloroethylene is a probable carcinogen to humans based on limited human evidence and sufficient animal evidence.” In this monograph, under mutations in protooncogenes in tumors from trichloroethylene-treated animals it was stated, “H-ras
and K-ras mutations each contributed to 4% to the total in treated mice.
The molecular alterations induced by mutagenic carcinogens like TCE regarding the genesis of pancreatic carcinoma are as follows: Kras, Kras (chromosome 12p) is the most frequently altered oncogene in pancreatic cancer, with activating point mutations being present in 90%-95% of cases. CDKN2A. The CDKN2A gene (chromosome 9p) is
inactivated in 95% of pancreatic cancers, making it the most frequently inactivated tumor suppressor gene in these tumors. SMAD4. The SMAD4 tumor suppressor gene (chromosome 18q) is inactivated in 55% of pancreatic cancers. TP53. Inactivation of the TP53 tumor suppressor gene (chromosome 17p) occurs in 70%-75% of pancreatic
cancers. DNA Methylation Abnormalities. Several DNA methylation abnormalities also occur in pancreatic cancer.

Dangers of TCE

“The exposures to TCE that these communities suffered should never have happened,” said Minnesota Pollution Control  Agency (MPCA) Commissioner Laura Bishop. “We know this penalty will be small consolation to those who may face increased health risks because they lived near the facility. Still, it is one of the largest environmental penalties in the state’s history, and sends a strong signal of the agency’s expectations.”

TCE is an industrial solvent that is used in some industries and is found in some household products such as adhesives, paint and stain removers, and parts cleaners. Usually it’s in a liquid form, but it is highly volatile, meaning it easily becomes airborne. When it does, the emissions must be properly controlled or they can be harmful to breathe. Water Gremlin used TCE to coat metal parts. The facility’s air permit required pollution control equipment to keep emissions to allowable levels.

In January 2019 an ongoing MPCA investigation discovered the company had not reported that the pollution control equipment had not been operating at its required levels. As a result, TCE was emitted from the facility at levels that may pose a risk to human health over an area extending up to 1.5 miles from the facility. According to MDH, elevated TCE exposures may increase the risk of birth defects and certain types of cancers.

When the MPCA discovered the full extent of the violations in January, the agency demanded that Water Gremlin voluntarily shut down the TCE portion of their operation; the company complied. Bishop said the quick resolution of the investigation and large penalty show the seriousness of the violations.

“The great majority of Minnesota businesses live up to the terms of their emissions permits,” said Bishop. “The lapses in management and pollution control at Water Gremlin are the exception, not the rule in Minnesota.”

The penalty agreement allows Water Gremlin to restart the production line that was the source of the problem — but they must use an alternative, less toxic product than TCE. The company also agreed to place air monitors on all four sides of the property, at their expense, so the community and MPCA can be assured that all emissions are within health limits.

Click here to view the complete article.

Water Gremlin: trichloroethylene (TCE) area of concern

The Minnesota Pollution Control Agency (MPCA) and the Minnesota Department of Health (MDH) are investigating possible community exposures to an industrial solvent used by a manufacturer in White Bear Township.

Water Gremlin, Inc. at 4400 Otter Lake Road in White Bear Township, makes fishing sinkers and battery terminal posts. In January 2019, the MPCA learned that the facility was releasing trichloroethylene from its manufacturing process into the air at levels above health guidelines. The MPCA requested the company to shut down the TCE production line on January 14, 2019, which they did the same day. This action stopped the TCE emissions, and that part of the facility will remain shut down as long as necessary to protect public health.

The following map contains the area of exposure.

Click here for the complete article.