MINUTES OF THE meeting

of the

ASSEMBLY Committee on Natural Resources, Agriculture, and Mining

 

Seventy-First Session

May 21, 2001

 

 

The Committee on Natural Resources, Agriculture, and Miningwas called to order at 1:30 p.m., on Monday, May 21, 2001.  Chairman Marcia de Braga presided in Room 3142 of the Legislative Building, Carson City, Nevada.  Exhibit A was the Agenda.  Exhibit B was the Guest List.  All exhibits are available and on file at the Research Library of the Legislative Counsel Bureau.

 

COMMITTEE MEMBERS PRESENT:

 

Mrs.  Marcia de Braga, Chairman

Mr.    Douglas Bache

Mr.    David Brown

Mr.    John Carpenter

Mr.    Jerry Claborn

Mr.    David Humke

Mr.    John Marvel

Mr.    Harry Mortenson

Mr.    Roy Neighbors

Ms.   Genie Ohrenschall

 

COMMITTEE MEMBERS ABSENT:

 

Mr.    Tom Collins, Vice Chairman

Mr.    John J. Lee

 

STAFF MEMBERS PRESENT:

 

Linda Eissmann, Committee Policy Analyst

June Rigsby, Committee Secretary

 

OTHERS PRESENT:

 

Dr. Mary Guinan, State Health Officer, Nevada State Health Division

Dr. Randall Todd, Epidemiologist, Nevada State Health Division

Allen Biaggi, Administrator, Nevada Division of Environmental Protection

 

Roll was called. Chairman de Braga opened the hearing on the Fallon leukemia cluster investigation.

 

Dr. Mary Guinan, State Health Officer, Nevada State Health Division, introduced Dr. Todd.  Dr. Randall Todd, Epidemiologist, Nevada State Health Division, read a prepared statement (no handout) outlining the progress of the leukemia cluster investigation. Dr. Todd first addressed tests on water, air and soil. The municipal water system in Fallon was routinely tested, as mandated under the Safe Drinking Water Act. Eleven residences had been identified that were currently or previously occupied by a case family, each home served by a domestic well. Using the same protocol as for a municipal system, the private well water was tested.

 

Dr. Todd reported that, of the 11 households, nine had been tested. One property owner refused, and the other well had been capped. Results on the first five wells revealed no volatile organic compounds related to jet fuel in the water. Additional water testing would be conducted in the coming months by the Centers for Disease Control (CDC) and the Agency for Toxic Substances and Disease Registry (ATSDR). Air and soil testing would be included in the upcoming analyses performed by the CDC and the ATSDR.

 

On the question of blood and tissue testing of victims and family members, Dr. Todd reported the CDC would conduct that part of the investigation in the months ahead. The study protocol was under development, and the Health Division had received a rough draft for review. By federal law, the CDC could not finalize that study until approval was received by their Institutional Review Board for the Protection of Human Subjects.  That process normally took up to nine months; however, due to the high priority of the situation, the CDC would expedite and pass judgment within 6 to 12 weeks.

 

Dr. Todd addressed several issues regarding the Nevada Cancer Registry. He described the registry as a computer-based system, utilizing the Rocky Mountain Cancer Data System software. It was capable of generating reports and performing rudimentary statistical analyses. It did not have geographic mapping capability; however, the registry data could be exported to other computer sites for more thorough geographical mapping and statistical analysis.

 

On the issue of extracting hospital records, Dr. Todd explained the process began with the issuance, by the hospitals, of a Disease Index. That listing included the names of all patients seen for treatment. Each patient had an international classification code (ICD) attached to the hospital record. That code was the flag for a record to be extracted by the state registry staff on-site. Dr. Todd described the time to extract a hospital record as 40 minutes for a trained professional. The data was then entered into the computer, followed by a quality assurance review for accuracy and completeness. Dr. Todd explained that, in addition to hospitals, laboratories were also required to report to the state of Nevada.

 

In response to the progress since the February leukemia hearings, Dr. Todd explained a panel of experts had been assembled to oversee all phases of the investigation. Knowledge of the water quality of case residences served by the municipal system was established early in the investigation. Data for residences served by private domestic wells was imminent. Since February, global positioning satellite (GPS) data was obtained on every case residence located in Churchill County. Each was plotted on a map, and that analysis did not reveal any significant geographic pattern nor proximity to the jet fuel pipeline. Most case residences were shown to be upwind from the Fallon Naval Air Station (NAS) and up-gradient from underground water sources, with respect to the NAS.

 

Since February, Dr. Todd stated the CDC and the ATSDR had accepted the invitation from the Nevada Health Division to augment the existing investigation. The role of the CDC would be to focus on the collection of biological and environmental specimens from case families and a group of comparison families. The role of the ATSDR was described as to assess the community for completed environmental pathways from known or suspected sources of contamination to human populations.  That included industrial, agricultural, military, and other sources in Churchill County.

 

Dr. Todd reviewed conclusions, to date, of the expert panel. A report had previously been provided, and a copy could be found on the Health Division Web site.  In terms of what would facilitate the investigation, Dr. Todd stated the Health Division was confident that the CDC and the ATSDR would provide sufficient guidance and scientific resources. He voiced concern over the diversion of Health Division professionals to deal with issues of fear and rumors in the news media. Dr. Todd acknowledged that additional resources would be helpful to deal with those aspects of the investigation.  A request had been forwarded to the CDC asking for assistance in the development of a comprehensive communication plan for dealing with public concerns.

 

Dr. Todd concluded his prepared testimony by stating that additional community education and public information resources would free the scientists to focus on the investigation.

Chairman de Braga requested clarification on the ability of his agency to deal with the media. Dr. Todd explained some of his staff were devoted to public information; however, frequently the calls were beyond the scope of knowledge for the staff, and the calls were transferred to his desk for a more detailed answer. Dr. Todd summarized his dealings with the media as mostly “reactive,” and he voiced concern that his agency should be more “proactive.”

 

Assemblyman Neighbors asked how often the drinking water was tested in the Churchill area. Dr Todd explained the protocol mandated by the Safe Drinking Water Act was closely followed.

 

Assemblyman Mortenson voiced frustration over the use of acronyms and asked if any blood or tissue analyses of the victims had been conducted. Dr. Todd responded to the first statement and explained ATSDR referred to the Agency for Toxic Substances and Disease Registry. Regarding testing of the children, Dr. Todd speculated there was routine diagnostic blood testing performed on the children; however, additional biological analyses would be conducted later using the testing protocol set forth by the CDC.

 

Assemblyman Mortenson expressed his frustration over the amount of time it was taking to get answers for the families. Dr. Todd explained it was essential for the CDC to establish a scientific-based methodology from which reliable conclusions and interpretations could be made.

 

Chairman de Braga asked if the expert review panel would remain in place as the involvement of the CDC increased. Dr. Todd replied in the affirmative. In response to Chairman de Braga’s question regarding the value of geographic mapping, Dr. Todd explained the development of mapping software was impeded by the low number of central disease registries (i.e., one per state). The Nevada Cancer Registry data could be exported to another computer site for mapping.

 

Regarding the requirements to report to the State Health Division Registry, Dr. Todd explained it was covered by NRS 457 and NAC 457. Under those statutes, hospitals, medical laboratories, and physicians must report. If a dermatologist received a report of malignant melanoma on a client, Dr. Todd stated it would be reported if it was on the list of reportable skin cancers. The medical specialty most impacted by the requirement for physician reporting was dermatology, according to Dr. Todd. The group of cancers that were not reportable were the “non-invasive” skin cancers and some forms of cervical cancer.

Chairman de Braga posed the question about a diagnosis in Nevada that was followed by treatment in California. Dr. Todd stated there were scenarios, such as that, which challenged the ability of his agency to track cancer. The most invisible cases were those in which the patient gave up his Nevada address and moved to another state in order to be closer to his place of medical treatment. In that situation, the cooperative exchange of registry data between states would fail to alert the original state of residence.

 

Chairman de Braga requested clarification of how the registry was used to identify a possible cluster and to investigate a suspected cluster. Dr. Todd described the data elements of the registry as including the patient’s name, address, diagnosis, and date of diagnosis. The analysis of the registry data began with a calculation of the rate of incidence based upon area population, age-adjustment of the rates, followed by comparison of the statistics with those of other states and other areas within the state.

 

In response to Chairman de Braga’s question about a possible cluster in the 1970s, Dr. Todd responded the Nevada Cancer Registry was not developed until the 1980s. Dr. Mary Guinan, State Health Officer, offered clarification on the real purpose of a cancer registry. It was not designed to identify a cluster, but rather it was used as a reference to confirm a cluster using statistical analyses. Physicians and communities were the typical means by which attention was drawn to an alleged cluster. The registry was used to evaluate the claim.

 

Chairman de Braga asked if the Nevada State Health Division had sufficient resources to perform the leukemia investigation. Dr. Todd stated the Health Division had taken the lead on the study and, to date, the resources were good. Funds for water-testing were supplemented by the Division of Emergency Management. Federal funds, as supplied by the CDC and the ATSDR, would be very helpful. 

 

Dr. Guinan interjected her support of Dr. Todd’s tireless efforts on behalf of the residents of Fallon. Dr. Guinan stated the hiring of a Chronic Disease Epidemiologist to assist Dr. Todd with analytical work would be most helpful. Testing of theories was very time-consuming for a multitude of tasks assigned to the Health Division.

 

Chairman de Braga asked if the Centers for Disease Control (CDC) would fill that gap. Dr. Todd clarified the upcoming assistance from the CDC would focus exclusively on the Fallon cluster, whereas the need for a second epidemiologist was a long-term solution for the Health Division. The Department of Energy had

 

funded a proposal for that position, and a decision on funding was pending. Dr. Todd stated there was always an attempt to maximize federal resources.

 

Chairman de Braga addressed the issue of disease clusters in the animal population as reported by a local veterinarian. Dr. Todd replied he had ongoing dialogue with a veterinarian, and, to date, there was no evidence to suggest any relationship between human leukemia and animal leukemia. Dr. Guinan added the Health Division had met with the Department of Agriculture in order to pose the question of that relationship. Although feline and bovine leukemia viruses were known to exist, there was no apparent connection with family pets based on the findings of the in-depth interviews with the victim families in Fallon. Reported animal defects at the Indian reservations adjoining the Sierra Army Depot were under study.

 

On the possible link to summer events, Chairman de Braga asked if there was significance attached to the fact that two of the leukemia victims had only spent spring and summer vacations in Fallon. That situation suggested the possible involvement of pesticides or herbicides or a relationship to seasonal temperatures. Dr. Todd stated he asked the ATSDR to look at all contaminant pathways, including those associated with agricultural, industrial and military practices. He emphasized the military would not be the sole focus of attention.

 

Dr. Guinan interjected that a large-scale national study of leukemia failed to pinpoint an association between pesticides and childhood leukemia.

 

Chairman de Braga reacted with surprise and stated she had read recent articles that drew the opposite conclusion about that association. She added it was essential to accelerate the dissemination of usable information to the residents of Fallon. There was a need for public reassurance that progress was being made in the investigation. Chairman de Braga voiced concern over the number of harmful pollutants that might disappear from the environment before they could be detected. She cited the example of a small industrial operation near Kennametal that had recently ceased operations. Transient events would be the most difficult to pinpoint, for example fuel dumping over Fallon.

 

In defense of the current cluster study, Dr. Guinan was encouraged by the advent of new technology that would significantly benefit the Fallon investigation. She stated Fallon would be the first cancer cluster study to utilize newly acquired information on the body burden of environmental agents. Blood and urine were exhaustively studied for environmental substances that were suspected to cause disease. It established baseline levels for a nationwide sample, and all of the victim families in Fallon would be compared to that new standard.

 

In response to Chairman de Braga’s question on the effect of chemotherapy, Dr. Guinan stated chemotherapy would not affect the measurement of environmental toxins; however, there would be impact to the leukemic cells.

 

Assemblyman Mortenson asked if children had been included in that benchmark study. Dr. Guinan responded they had been included in a study of the effects of second-hand smoke.

 

Assemblyman Carpenter requested information on the effectiveness of leukemia treatments for the children. Dr. Guinan explained there were regional treatment centers established across the United States that guaranteed a uniform protocol for treating Acute Lymphocytic Leukemia. An estimated 85 percent of childhood victims would survive. State of the art technology and treatment included chemotherapy, bone marrow transplants, and stem cell planting.

 

Allen Biaggi, Administrator of the Nevada Division of Environmental Protection (NDEP), resumed testimony on the environmental investigative efforts. He read from a prepared statement (no handout) and reviewed the overall functions of his agency. He assured the committee his staff was cooperating fully with the Nevada Health Division. Many telephone calls were forwarded to the NDEP from the Health Division telephone hotline. Staff from the NDEP had accompanied the ATSDR on a visit to the Fallon Naval Air Station. He was confident that, when the testing protocol for soil and ground water was released by the CDC, the NDEP would be even more involved in the investigation.

 

Chairman de Braga asked for clarification on a newspaper article regarding the emissions from the Kennametal plant in Fallon. Mr. Biaggi stated he was unaware of that article; however, he assured the committee the Kennametal plant was permitted. He called the Chairman’s attention to a recent memo from his office in which he addressed those concerns.

 

In response to Chairman de Braga’s question on “petroleum skimming,” Mr. Biaggi replied it was apparently a means for cleaning a fuel spill off the surface of water. He stated emphatically that petroleum would be revealed in water testing. A component of fuel floated to the surface; however, certain constituents, for example benzene and toluene, dissolved in water and were, therefore, detectable. The presence in any amount would be significant.

 

Mr. Biaggi elaborated on the efforts to perform underground fuel storage tank cleanup, an ongoing effort throughout the state. Chairman de Braga asked if there was evidence of dissolved fuel products in municipal wells, to which Mr. Biaggi responded “Not to my knowledge.” Testing of municipal water included volatile and semi-volatile substance detection, and none had been found in Fallon’s municipal water.

 

Chairman de Braga called Mr. Biaggi’s attention to a picture of fuel skimming on Fallon’s city well #2 (Exhibit C), submitted by Dr. Vera Byers and Dr. Al Levin. Mr. Biaggi was unfamiliar with such a process at that location. Chairman de Braga added she was unsure of what the photograph actually depicted.

 

Assemblyman Mortenson asked if city well #2 was in use for public consumption. Mr. Biaggi referred the question to the Health Division that administered the Safe Drinking Water Act. 

 

Chairman de Braga next directed attention to the issue of the 1994 report issued by the United States Geological Services (USGS). When the study was concluded, a copy of the findings was reportedly sent to the Nevada State Health Division. Despite some alarming statistics on the high levels of radionuclides in private well water, the report went unnoticed.  Mr. Biaggi replied he was unfamiliar with that report, and the question would be better directed to the Health Division.  Chairman de Braga stated the report should be revisited by someone with the ability to understand the significance of the findings.

 

Dr. Todd offered to clarify and added that the USGS would be involved with the water testing effort. The draft protocol for testing issued by the CDC indicated a linkage between the USGS and the investigation. Chairman de Braga acknowledged the need for that working relationship. In response to Chairman de Braga’s question on the 1994 findings, Dr. Todd responded the municipal water supplies did not show high uranium levels. If consistently high uranium levels were evidenced in the water sources of the 11 case families, it would definitely be cause for alarm. He was unable to state conclusively that none of the water sources were contaminated; however, it did not appear to be connected to leukemia.  Kidney disease would be expected.

 

Using that example, Chairman de Braga asked if the residents would have been notified of higher than expected levels of radioactivity in the water. Dr. Todd could find no copy of the 1994 report that was supposedly sent to his agency seven years ago. The USGS study concentrated on the aquifers in the area, not drinking water. Chairman de Braga reiterated, if there was evidence of a public health problem in 1994, “somebody dropped the ball.”

 

Dr. Todd explained that uranium levels often varied greatly from well to well. As with arsenic, it was incumbent upon the property owner to have private well water tested. All water sources for the victim families were tested. He acknowledged there were families in the Fallon area with extremely high levels of arsenic who were still unaware of that problem. Chairman de Braga emphasized the need for public education efforts to help the residents make more informed decisions about drinking the water. Ideally, the information would be disclosed with each real estate transaction.

 

Assemblyman Mortenson expressed his amazement that there were residents who were still unaware of very high levels of arsenic in their well water. Dr. Todd described anecdotal information in which residents experiencing health problems had stumbled upon that fact. Others were aware of the high levels and chose not to drink the water.

 

Assemblyman Mortenson asked if there were any cases where the water was found to be high in arsenic, and the residents were not notified. Dr. Todd explained, in most cases, the well owner was the person who usually ordered the test and received the results. Whether or not the report was understandable to the well owner was unknown. No governmental agency had the authority to go out, test a private well, and educate the owner about the findings.

 

Chairman de Braga added it was more likely that a person would get the report and fail to fully understand the significance of the numbers. She asked about the advisability of cooking with water containing arsenic. Dr. Todd stated his agency advised the public that boiling of water did not help. That served to concentrate the arsenic and not remove it. Bathing in water containing naturally-occurring uranium did not appear to pose a problem. Uranium could do harm in two ways. It could emit radiation, and it could react as a chemical inside the human body. The latter was of greater concern.

 

Chairman de Braga requested clarification on who was responsible when consumers remained uninformed of a known health hazard. Apparently, there were cases of a failure to post warning notices as well as a failure of the notices to get read even when displayed. Dr. Todd was unsure if there was a good single vehicle for educating the public. He explained that maximum contaminant levels (MCL) were established with the assumption that a person would continue to consume the water for many years. The issue of water consumption in schools, a relatively short-term consumption, was possibly more alarming on paper than it was in practice.

Assemblyman Carpenter asked Mr. Biaggi there were any red flags found in his investigative work.  Mr. Biaggi replied the caseloads for air, water and waste programs in Churchill County represented a small percentage of the entire statewide caseload. To date, Churchill County and Fallon did not present any red flags in his fieldwork.

 

Following a 15-minute recess in the meeting, Chairman de Braga reconvened.

 

Mr. Biaggi resumed testimony and offered to give his impression of the fuel skimming photographs. He concluded the caption on the picture of the large truck at well #2 (Exhibit C) was in error. It was, in fact, a pilot arsenic treatment system. The guests who had submitted the photos, Dr. Byers and Dr. Levin, had departed the meeting and were not available to defend that alleged misrepresentation. The other two photos were taken at a private gas station where treatment of the soil was in progress. To his knowledge, Mr. Biaggi knew of no fuel-skimming of municipal wells in Fallon.

 

Chairman de Braga asked for clarification defining the cluster based on time of diagnosis for a group of cases. As such, would the four cases of Acute Lymphocytic Leukemia diagnosed in the early 1990s be considered a distinct cluster? Dr. Todd explained his focus was “resident cases” at the time of diagnosis. Associated cases were interviewed. Those included victim families that had previously lived in the area of interest. In a review of the records for the early 1990s, Dr. Todd found only one resident case diagnosed in 1992. There were several associated cases. In his judgment, there did not appear to be a cluster at that time. The line was drawn at 1999 based on the records available to him for analysis.

 

Chairman de Braga commented the earlier cases could have been either a statistical anomaly or even a separate cluster, if all cases were indeed reported. It was her impression the four victim families from the early 1990s had lived at the Naval Air Station, and that could be significant. Dr. Todd replied he did not have access to that information. The Naval Base would have to define the resident population in order to make a judgment regarding the rate of illness. At least two of those victims were diagnosed after leaving Fallon, and it would be difficult to conclude points of environmental exposure.

 

Chairman de Braga reminded the witness that one case from the identified cluster had been diagnosed just after his arrival in Fallon. The same logic could apply and perhaps that victim had been exposed to the causal agent(s) elsewhere. Dr. Todd acknowledged the possibility; however, even if that case was excluded, statistically it was still a significant cluster.

Assemblyman Neighbors requested information on the issues of high power lines and cancer. Dr. Todd stated he had looked at research for electromagnetic radiation (EMF). Extensive research by a multitude of scientists nationwide did not support a causal link between EMF and cancer. Exposure to household appliances had been explored in the lengthy questionnaire compiled by the Health Division. It was known that household exposure levels were much higher, in general, than exposure from high power lines. Dr. Todd found no evidence of household appliance overuse in the victim families.

 

Assemblyman Carpenter asked what the chances were of discovering a cause for the leukemia cluster in Fallon. Dr. Todd replied “not good.” Most cluster investigations did not result in establishing a link, and he had been forthright with the residents of Fallon in that regard. It was important not to give the community any false hope; however, that belief did not alter his passion to continue to search for the cause.

 

Chairman de Braga voiced her frustration and concern over the dilemma facing families with children. Should they stay in Fallon or leave? That question was asked of her with increasing frequency. Dr. Todd acknowledged he fielded the same question every day. In his judgment, the problem was likely to be one for which science may not ever have an answer. He explained steps had been taken to connect the residents with mental health resources, specifically to assist the residents with the soul-searching and decision-making.

 

From her standpoint, Chairman de Braga observed increasing uncertainty and panic among the residents of Churchill County. That situation dictated the need for providing truthful and timely updates on the investigation. Chairman de Braga stated there was an immediate need for a town hall discussion during which the residents could speak and not just listen. Reassurance of public fears had to be a high priority, and the meeting should be scheduled for early June.

 

Dr. Todd concurred with the idea and added his agency had already discussed the possibility of conducting a town meeting for that purpose. He added that the Fallon NAS had conducted periodic meetings for their personnel and families. Chairman de Braga suggested the Naval Air Station and the USGS could be included in those meetings.

 

Assemblyman Mortenson commented that several years ago there was publicity about the low frequency electromagnetic waves (ELF) from power lines. The
National Academy of Science could find no conclusive findings either way. On the other hand, microwaves were high frequency radiation and presented a different set of problems. It was known to be detrimental at high levels. The household source for the worst low frequency radiation was determined to be the electric meter on the outside of the home.

 

Chairman de Braga added there was a low frequency radar site at the U.S. Coast Guard station in Fallon.

 

Seeing no further comment, the meeting was adjourned at 3:31 p.m.

 

 

RESPECTFULLY SUBMITTED:

 

 

 

                               

June Rigsby

Committee Secretary

 

 

APPROVED BY:

 

 

 

                                                                                         

Assemblywoman Marcia de Braga, Chairman

 

 

DATE: