Quick onset of blood cancers puzzles experts
Researchers wonder if burn pits sped disease development
By Kelly Kennedy
kellykennedy@militarytimes.com
When Army Staff Sgt. Danielle Nienajadlo arrived at Joint Base Balad, Iraq, in April 2008, she had a clean medical history and recent blood work to prove it.
But three months later, after weeks of muscle fatigue, nausea, headaches and coughing up black phlegm, she went to the base emergency room after she spent a night vomiting and in pain. On July 26, 2008, she was diagnosed with acute myeloid leukemia.
“I am now a number, a statistic, a secret that no one wants to face,” she told Military Times last fall. “I know that I got my disease in Iraq.” The 32-year-old mother of three died March 20.
Her case, and those of 70 other cancer victims who contacted Military Times or Disabled American Veterans in recent months, have left experts debating whether their leukemias and lymphomas could have developed so quickly.
Dr. Shira Kramer, an epidemiologist who co-authored a textbook about the subject, says yes. “The burn pits really began seven years ago, so we have a number of years of exposure,” she said. “And the latency period can be quite a bit shorter [for blood cancers] than for solid tumors.” Of the 70 service members who developed cancer after exposure to the burn pits, 30 have a form of blood cancer, including 10 with leukemia. Typically, leukemias make up 2 percent of all cancers.Kramer said latency periods vary but can be as short as two years.
The National Institute for Occupational Safety and Health says several factors contribute to the chances of getting cancer: age, sex, race, diet, family and smoking history, and exposure to cancer-causing agents in the workplace and environment.
When looking for a cancer cluster, institute researchers check to see whether the cancer rates are higher than expected, if people have the same kind of cancer, and if a certain kind of exposure would be expected to cause the cancer. Though latency periods vary by type of cancer, 15 to 20 years is the norm, according to the institute.
Military mortality data shows that cancer rates have remained stable or decreased in most categories, including blood and lung cancers. Only brain and thyroid cancers have increased significantly over the past seven years, according to Armed Forces Health Surveillance Center data.
But “all other neoplasms” — abnormal tissue masses that may or may not become malignant — increased from 12,588 in 2001 to 23,913 last year. Richard Clapp and David Ozonoff , professors in the Department of Environmental Health at Boston University School of Public Health, said it’s too soon for cancers linked to the burn pits to appear. “I definitely think it’s early to be seeing cancers — even leukemia and other blood-related cancers — from exposures since 2003,” Clapp said.
But he said service members should be closely monitored for cancers he would expect to see form in the future. For dioxin exposure, he said he would expect cases of non-Hodgkins lymphoma, soft-cell sarcoma and lung cancer.
And, he added, the burn pits should be addressed now. He called the military’s claim that no known long-term health concerns are associated with the burn pits “too dismissive.” “One of the lessons we learned from Vietnam is that we exposed soldiers to things that were harmful and then we denied it for years and years,” he said. “I’d support tightening up restrictions on the burn pits and tracking those who have been exposed.” At press time, defense officials had not responded to a request for comment after a team of Army doctors linked a soldier ’s lung disease to burn-pit exposure and a Vanderbilt University doctor linked bronchiolitis in 56 soldiers to “inhalational exposure.” An initial study of the Balad burn pit has been classified, and a second military study found toxin levels at acceptable levels.
In a last note to Military Times, Nienajadlo, who died waiting for a bone-marrow transplant, said she wanted to make sure other people know about the dangers of the burn pits.
“People are dying out there, and this needs to be discussed,” she said.
Thursday, July 16, 2009
Researchers wonder if burn pits sped disease development
