PEDIATRIC CANCER CLUSTER Cancer survey gets poor response Many families opting out; water tests raise concerns

PORTSMOUTH — Several members of the task force studying the Seacoast Pediatric Cancer Cluster questioned why state officials have only received six questionnaires from families of children diagnosed with two childhood cancers the group is studying.

State Epidemiologist Dr. Benjamin Chan told the task force they’ve received six questionnaires from 42 sent out in New Hampshire, northern Massachusetts and southern Maine.

That means just over 14 percent of the families sent questionnaires by officials from the state Department of Health and Human Services aimed at potentially identifying common environmental exposures have been completed and returned.

Task force member Kelly Halldorson of Rye said the feedback she’s received from family members of children diagnosed with the two rare cancers is that it's a “very long survey” that asked parents “very, very tough stuff.”

“These are people, these are kids, these are families,” Halldorson said during Wednesday’s meeting of the task force that was held at Portsmouth City Hall.

Some parents told her the questionnaires came off as “very accusatory.”

“That just adds to the whole stress of the situation,” she said.

NH Department of Health and Human Services identified a small pediatric cancer cluster in 2016.

Then Gov. Maggie Hassan formed the task force on the Seacoast Pediatric Cancer Cluster in 2016 after state officials determined there was a small cancer cluster of rhabdomyosarcoma or RMS, which several area children have died from.

While looking at the RMS cases, the state also identified "a small excess of pediatric lung cancer cases," all of which "were of a single rare type called pleuropulmonary blastoma (PPB)."

Several area parents believe the cancers could have been triggered by environmental factors.

Chan told task force members on Wednesday that DHHS sent out reminder letters to families in January asking them to send the questionnaires in by mid-February.

Chan also reported that N.H. officials have been working with the Maine and Mass. Departments of Health to contact families of children who were diagnosed with either RMS or PPB.”

“Each state wanted to message their own residents their own way,” Chan said and noted that Maine and Massachusetts officials told their residents to contact state DHHS officials if they wanted to participate in the surveys.

State Rep. Mindi Messmer, D-Rye, asked Chan if they planned to follow up with the families who have been sent questionnaires, “either by calling or going to see them.”

Chan replied that they don’t plan to do either, and said state health officials have heard from families of some children “who don’t want to be involved” with the questionnaires.

“We don’t want to be perceived as harassing or intruding in a very sensitive area,” Chan said.

Halldorson said some families she’s talked to “do want privacy and that should really be respected.”

“If they’re not ready and not willing, back off,” she said.

Dr. Tom Sherman, the chair of the task force, said he’s heard that “one of the reasons responses are not more robust is the feeling nothing is going to happen with the data.”

Sherman asked if there were “additional steps that might be done with extreme caution and compassion” to encourage people to complete the questionnaires.

Chan stressed that if families didn’t want to fill out the questionnaires, “they can call us and talk to us and share information over the phone.”

Task force members also received updates about testing done on residential wells around the Coakley landfill.

Andrew Hoffman of the N.H. Department of Environmental Services told task force members about the high levels of PFCs found in surface water around the Coakley landfill, a Superfund clean-up site in Greenland and North Hampton.

The Portsmouth Herald reported last week that five water samples taken from Berry's Brook in Greenland and Rye tested higher, and in some case dramatically higher, than the Environmental Protection Agency's health advisory levels for PFCs in groundwater.

There is not yet a surface water standard for PFCs in New Hampshire.

The smallest amount of PFCs found in the samples was 90 parts per trillion, according to the report, which is still higher than the EPA's health advisory level of 70 parts per trillion (ppt).

The highest level of PFCs tested at 1,250 ppt, with other results coming in at 311, 410, and 297/308, according to the report.

Hoffman said “closer to the landfill higher concentrations,” of PFCs were found in surface water and farther away the DES tests found “lower concentrations like you would expect.”

The test results, Hoffman said, have raised “several concerns and issues that the agencies are working to address.”

“First, could these surface waters be recharging and possibly impacting groundwater use and drinking water further down gradient from the site,” Hoffman said.

Regulators will also work to study what, if any, harm these levels of PFCs could cause to people living around the landfill, particularly “children playing in Berry’s Brook.”

The third concern is what the PFCs could do to the trout that are stocked in the brook by the state Department of Fish and Game, although Hoffman said most are quickly caught by fishermen.

Jim Murphy of the EPA’s Boston Office said his agency, working with DES, has developed surface water screening levels for PFOS and PFOA at the Coakley landfill.

He stressed that screening levels are different than a health advisory, but if sampling discovers chemicals above a screening level, that usually results in “further evaluation of the potential risk.”

The EPA set a conservative screening level or PFOS in surface water at 760 parts per trillion and 760 for PFOA for children who might play in Berry’s Brook and ingest some water.

The less conservative screening level is 2030 parts per trillion for both PFOS and PFOA, Murphy said.

“Under the more conservative one, all results are below the screening level expected for the PFOA sample taken between the landfill and culvert at the intersection of Breakfast Hill Road,” Murphy said. “In order to be protective, EPA has decided to do further sampling of surface water. I don’t think there’s anybody in the room that’s going to disagree with that.”

Mike Wimsatt of DES’ Waste Management Division, also acknowledged during Wednesday’s meeting that the “lion’s share of PFCs we’re seeing in Berry’s Brook come from the landfill.”

Likewise, Hoffman said test results done on residential wells “do provide some guidance that the landfill is contributing to the contamination of the water north of the landfill.”