Tracing Cancer's Cause

Firefighters Exposed to PCBs While Training More Than 20 Years Ago In Anne Arundel Seek a Study of Their Illness -- and Help With Coping

By Daniel de Vise
Washington Post Staff Writer

Saturday, July 15, 2006; B01

Dave Fowler spent a week in winter 1974 learning to fight fires inside a blackened structure called the Dollhouse. Trainers filled the basement with spent transformer oil and hay, and set them ablaze. Twenty trainees sat upstairs and ate smoke until they were about to vomit or pass out.

"It was like a macho thing -- who was the last one standing," Fowler recalled.

These days, Fowler feels as though he's the last one standing. Thirty friends from the Anne Arundel County Fire Department have died of cancer. Fowler's 19-year-old daughter, Amanda, lost the vision in her left eye to cancer as a baby. And he is dying of lymphoma.

At least 120 firefighters who graduated from the fire training academy in Millersville between 1968 and 1985 have been diagnosed with cancer, and at least 40 have died, according to a Montgomery County legal team that is assembling a potential case.

The firefighters believe they are a classic cancer cluster. A wave of premature deaths triggered memories of oil burned and fumes inhaled at the academy in the 1970s. The trainees didn't know then that the oil contained polychlorinated biphenyls, or PCBs, compounds later found to cause cancer.

But linking cancer to its cause is notoriously difficult, particularly among firefighters, who breathe toxins whenever they fight fires. A Johns Hopkins University researcher spent most of a year on a limited study of the Anne Arundel firefighters and found nothing conclusive.

The firefighters, joined by the Hopkins expert and U.S. Sen. Barbara A. Mikulski (D-Md.), seek a definitive study. More than that, though, they want help: cancer screenings for the healthy, medical coverage for the sick, burial for the dead.

A man of 20 has a 1 percent chance of contracting cancer by age 40 and a 3 percent chance by 50. Among the 2,000 recruits who trained at the fire academy between 1968 and 1985, most of whom were in their twenties, about 5 percent have contracted cancer, according to research by Cindy Ell, a retired firefighter who keeps a database of victims.

"Every time we bury somebody else, it creates a lot of anger and a lot of emotion," said Ell, a Delaware resident who has emerged as the Erin Brockovich of Anne Arundel firefighters. Much like the film and real-life heroine, Ell has almost single-handedly built a case for the firefighters while working for a lawyer sympathetic to her cause.

Accounts vary on exactly when the Anne Arundel firefighters came to regard PCBs as a ticking oncologic time bomb. Some say it was the day in 1997 that Fowler, then 43 and a robust engine driver, received his diagnosis.

Fowler started volunteering at the firehouse at age 16 and graduated from the academy at 21, just before Christmas 1974. He married a woman whose mother volunteered in the fire department's ladies' auxiliary. He returned to the academy at least four times as a trainer, each time exposing himself to tainted oil.

In 1989, the Fowlers noticed a change in their 18-month-old daughter: Her left eye seemed to protrude. Doctors found a malignant tumor. Amanda survived the cancer, called rhabdomyosarcoma, but lost some of her vision.

The firefighters believe they passed a cancer risk to their children. Precisely how is unclear.

About 200 cases of rhabdomyosarcoma are diagnosed each year in the United States in children younger than 10. Amanda was the second child of an Anne Arundel firefighter to contract the disease.

Fowler learned he had non-Hodgkin's lymphoma eight years later, when he arrived home from a shift one January morning.

Three times since, doctors have told him he was about to die. Each time, he focused on some future date -- a holiday, a graduation, an anniversary -- and toughed it out. Fellow firefighters joke that he's too stubborn to die. The fact that he is alive at 52 is one of the things they have to celebrate.

But Fowler lives in a perpetual morphine haze. He can no longer drive. He used to walk the four miles to his old fire station in Earleigh Heights and back again. Now, he can barely make the half-mile to the neighborhood gas station.

"C'mere, Pumpkin," he said, scooping his 15-month-old granddaughter, Gabriella, into his arms on the patio of the family home. "If it wasn't for her," he said, "I think I'd be dead now."

Exposure to Tainted Oil

The old Dollhouse still sits on the grounds of the training academy, set against a sweep of forest behind fire headquarters. The academy opened in 1968. Firefighters from Anne Arundel, Howard and Prince George's counties, Annapolis, Fort Meade and the U.S. Naval Academy trained there, according to Ell.

Starting in spring 1971, the academy accepted annual shipments of used transformer oil from Baltimore Gas and Electric Co. Trainers pumped oil into the Pit, a pool of water that would be set ablaze; the Christmas Tree, a rectangular steel structure that spat flame; and the Dollhouse.

"For days, you would just be blowing that stuff out of your nose," Fowler recalled.

Production of PCBs ceased in 1977 after the government declared the substance a carcinogen. Two years later, state officials detected PCBs in a tributary to the Severn River and traced them to the academy, which is near a creek bed.

Katherine Farrell, a state health official at the time, made inquiries and learned recruits "were very heavily exposed" to the tainted oil, "kind of wading around in it, breathing it, with and without respirators." She asked the county to warn its fire department.

The firefighters knew about PCBs and had asked the utility as early as 1976 whether the donated oil contained them. According to an internal department memo, BGE officials repeatedly told them the oil did not. One fire official cited in the memo said a BGE official in 1977 told him, "That stuff won't hurt you anyway, my guys wash their hands in it."

By the end of 1980, BGE had stopped delivering transformer oil to the academy and the fire department had stopped burning it. But firefighters contend the site wasn't thoroughly cleaned until five years later.

Linda Foy, a spokeswoman for the utility, noted that BGE employees trained at the fire academy. "We would never knowingly put people at risk," she said.

Compiling a Case

Cindy Ell had been researching cancer for the firefighters union when, in August 1996, she blew out two discs in her neck. While laid up, she took to researching full time. In summer 2002, she went to work for Kenneth Berman, a Montgomery lawyer who was preparing workers' compensation cases for widows of Anne Arundel firefighters.

By 2004, they saw a potential case against those they deemed responsible: Monsanto Co., which manufactured the PCBs; General Electric Co., which sold them; and BGE, which provided them to the fire department. Suing the county is forbidden under state law unless the firefighters can prove intentional wrongdoing.

In June 2004, someone tipped off a reporter to what Berman and Ell were doing. In the resulting crush of publicity, the county hired Jonathan Samet, a Johns Hopkins University epidemiologist, to look for a link between cancer and PCBs.

Samet concluded that the firefighters faced an elevated risk for cancer, but he found nothing to link their illness to PCBs or any other specific cause.

Samet, working with limited funds, found and interviewed 17 firefighters. Berman and Ell had offered the researcher the identities of many more cancer victims, living and dead. Samet contends he followed proper procedure for conducting impartial research.

"It's very difficult to pinpoint that a specific cancer was caused in a specific firefighter by a particular environmental exposure," Samet recalled.

He recommended further study. Mikulski requested a national investigation of cancer in firefighters. The Centers for Disease Control and Prevention responded this spring that it was aware of the Anne Arundel study and "prioritizing research needs."

Berman has won 17 workers' compensation cases. Each ruling amounts to a concession by the state that the firefighter's job made him sick. There is no need to prove how the firefighter got sick.

A victory entitles firefighters and their families to recover medical expenses, two-thirds of lost wages while the firefighter is alive and the cost of a funeral.



Techniques for Preventing Disease

Monday, July 24, 2006; Page A18

   Regarding "Tracing Cancer's Cause," the July 15 Metro story about firefighters in Anne Arundel County:

   The firefighters are asking the right question -- what is the link between cancer and exposure to toxic chemicals?

  The National Cancer Institute says the incidence of non-Hodgkin's lymphoma has nearly doubled since the early 1970s. While the causes of cancer are complex, many scientists believe the increased exposure to chemicals in our environment is an important factor.

  It's more than just firefighters at risk daily. Chemicals linked to cancer are found in schools, on lawns, in auto repair shops and in drinking water.

  People can take steps to protect themselves. The Lymphoma Foundation of America has published two research reports on the relationship between chemical exposure and cancer: "Do Pesticides Cause Lymphoma?" and "Solvents and Lymphoma." They can be found at .

  Its unfortunate that it takes the bitter experience of firefighters and their families to focus attention on a widespread public health problem.


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Lymphoma Foundation of America

Ann Arbor, Mich

Lymphoma Foundation of America
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