1. FALLON, NEVADA, CHILDHOOD LEUKEMIA: A CASE STUDY IN MEDICAL GEOLOGY Paul Sheppard Laboratory of Tree-Ring Research (dendrochronology)

3. But Wait, There’s More … AHSC colleagues –Dr. Mark Witten, Pediatrics (ret.) –Dr. Clark Lantz, Anatomy (admin.) Joint faculty, Zuckerman Public Health ACC –CPC Huh?

4. Medical Geology (Re)-emerging interdisciplinary scientific field Study of exposure to, or deficiency of, trace elements, e.g., in dust, water, food Effects on human health Hydrobiogeochemoepidemiopathoecology

5. Ron Fuge: Editor, Applied Geochemistry Olle Selinus: My working editor

6. Fallon Leukemia 17 cases, 1997-2004 27x national rate 1 in 232 million “Most convincing cluster ever reported”

7. Environmental Analysis Ecologic study vs. case-comparison Multi-element analysis Controls Multiple lines of evidence Replication Airborne environment

8. Airborne Dust

9. Fallon Airborne Dust Many samplers Many days Five towns Project repeated −New equipment

10. Tungsten and cobalt Elevated in Fallon Variable through time

11. Surface Dust

13. Tungsten, cobalt Variable across space, mostly low Elevated near town center Hard-metal industry Fallon Surface Dust

14. Lichens

15. Fallon Lichens 10 in town −Rattlesnake Hill 20 out of town −All directions

16. Most Elements –Slightly higher in Fallon Tungsten, cobalt –Much higher in Fallon Fallon Lichens ` ` –Not higher in Fallon rocks

17. Tree Leaf Chemistry 1.Clip a branchlet of leaves 2.Rinse leaves in water, save water 3.Measure rinsate for contaminants 4.Divide through by mass of dried leaves 5.Map out concentrations 6.Repeat every year, citizen science

18. Fallon Leaf Chemistry

20. Tree rings

21. Fallon Tree Rings Trees in Fallon Trees in other towns Last 15 years

22. Fallon Tree Rings Tungsten increased since mid 1990s Cobalt high through- out Other metals not noteworthy

23. Environmental Research (me) Fallon distinctive environmentally –Tungsten and cobalt elevated relative to other towns, outlying desert –Airborne particles

24. Biomedical research (Witten) Public health theory Research by others Biomedical Side Tungsten can’t be linked to leukemia from en- vironmental data alone –Biomedical research suggestive –IARC: W and Co probably carcinogenic

25. Relevant title Appropriate journal Independent authors

26. High tungsten burden in Fallon Tungsten exposure in Fallon Leukemia cluster in Fallon

27. Tungsten biomedical treatment level based on environmental finding

28. Tungsten of high interest in cancer research

29. EPA Earmark: Fallon

30. What’s next? Other sites with illness Other sites with pollution

31. Funding Cancer Research & Prevention Foundation Gerber Foundation

32. Funding Dilemma NIEHS: Understand how combined environmental exposures affect disease pathogenesis EPA: Protect human health and the environment Research, or mere monitoring?

33. Thanks for having me. Comments, questions?