Editor's note: This story has been updated to reflect the fact that the date of Suzanne McDermott's talk as part of Montana's Tech's Cafe Scientifique has been moved to Oct. 18 at 6 p.m. at the Copper Lounge in the Student Union Building.
New research indicates that from 2000 to 2015, adults living in Butte-Silver Bow and Anaconda-Deer Lodge counties died from cancer and several other diseases at significantly higher rates than residents of all other counties in Montana.
A team of researchers based at the Arnold School of Public Health at the University of South Carolina-Columbia studied death certificates from an online database kept by the Atlanta-based Centers for Disease Control last year. They found that among adults in Butte-Silver Bow and Anaconda-Deer Lodge counties, deaths from stroke, heart disease, cancer, and organ failure were elevated.
Overall, in the two counties over the 15-year period, adult deaths from stroke and heart disease were 36 percent higher than in the other counties, deaths due to kidney and liver failure were 24 percent higher, and cancer deaths were 19 percent higher.
Within those overall numbers, there were many variations of the death rates, depending on age and gender.
For instance, when comparing stroke or heart disease:
• Deaths among men ages 35 to 54 were 71 percent higher
• Deaths among men ages 55 to 74 were 46 percent higher
• Deaths among women ages 35 to 54 were 62 percent higher
• Deaths among women age 55 to 74 were 67 percent higher
• Deaths among men ages 55 to 74 were 59 percent higher
• Deaths among men ages 55 to 74 were 29 percent higher
• Deaths among women ages 55 to 74 were 31 percent higher
The team, led by Suzanne McDermott, a professor of epidemiology at USC, published its findings in Environmental Geochemistry and Health journal last month. The paper was peer reviewed.
The silver lining is that although the death rates for those diseases were higher in Silver Bow and Deer Lodge counties compared to the rest of Montana, overall there has been modest, consistent improvement over the 15-year study period.
Another positive note is that neurological disorders were not elevated for the four neurological conditions the researchers studied. Those neurological disorders were Alzheimer's disease, motor neuron disease, multiple sclerosis, and Parkinson's disease.
There has long been a concern about neurological disorders in both Butte and Anaconda. Many say anecdotally that there is an elevated incidence of multiple sclerosis in both towns, but that theory has never been documented.
The paper, titled "Population-based mortality data suggests remediation is modestly effective in two Montana Superfund counties," suggests that due to the Superfund remediation, there has been a 3- to 5-percent decrease in mortality each year since 2000.
The authors state: "Our study suggests that while remediation is conveying some reduction in negative health consequences, these efforts have not protected the residents of these two counties as a whole, and further remediation is required to protect human health."
Doug Benevento, EPA Region 8 administrator, said from his office in Denver last week that he doesn't disagree with that criticism.
"I think they (Butte and Anaconda) have been on the National Priorities List a long time. I think that's the basis for us paying so much attention to these sites. We want to get them done. Perhaps it was a failure of political leadership to not emphasize these sites (in the past)."
Charlie Partridge, EPA Region 8 toxicologist, said from his Helena office last week that he was encouraged by the conclusions the authors of the paper had reached.
"We've hit a turning point," he said. "While still in the midst of a cleanup, you would expect to see a downward trend. It's modest, but as we get close to the finish, we'd expect the trend to significantly decrease."
Karen Sullivan, BSB public health director, said Friday that the good news from the study is that "remediation is working."
Sullivan recalled the denuded hills, open tailings where children played, and a fishless Silver Bow Creek before the EPA entered the picture in 1983.
Bill Everett, Anaconda-Deer Lodge County chief executive, said his county lacks the expertise to properly evaluate the new study but he is "extremely interested and anxiously awaiting" the results from a study the Agency for Toxic Substances and Disease Registry and the Montana Department of Public Health and Human Services are planning to begin later this year or next year.
"They have the necessary resources, funding, and independence," he said of the two agencies.
ATSDR took a big-picture look in 2007 at Anaconda's urinary arsenic and blood lead test results across the decades and, seeing both in decline, said that Anaconda's remediation was working. ATSDR also criticized a Ph.D. dissertation written by then-Montana Tech student Stacie Barry Peterson about Butte's health in 2012.
Barry Peterson's dissertation found that Butte had higher mortality rates for cancer and some other diseases.
Barry Peterson did not respond to a request for comment.
ATSDR said they could not respond to questions about the McDermott paper in time for The Montana Standard's deadline. BP, parent company of Atlantic Richfield, did not respond to requests for comment.
Benevento said that the EPA will start delisting parts of Anaconda next year and plans to have all of Butte and Anaconda delisted by 2024 and 2025 respectively.
But McDermott also said that dust emanating from Montana Resources could be a part of the problem, but she did not collect data to support that theory. She cited a recent study conducted by Katie Hailer, an associate professor of chemistry at Montana Tech, as a reason to think that current mining could also be a contributing factor. (See related story.)
"It's a funny situation Butte is in," McDermott said during a conference call that included junior researcher Bryn Davis last week over the phone. "Remediation is simultaneously going on with active mining. Usually mining ceases when you expect to clean a place up."
Mark Thompson, Montana Resources vice president of environmental affairs, said he questioned McDermott's conclusions since they don't match up with what state epidemiologists have been saying.
The Montana Department of Public Health and Human Services has a fact sheet that says that for Butte-Silver Bow County, "incidence rates for all cancers and for each of the four most common cancers (prostate, breast, colorectal, and lung) were not elevated in Butte-Silver Bow County from 1981 through 2010."
DPHHS has also said in the past that there is no significant difference in the cancer incidence rates in Deer Lodge County compared to all of Montana.
Jon Ebelt, public information officer for DPHHS, said via email that the state's information on cancer and the McDermott paper "do not allow for an apples-to-apples comparison.
"The (McDermott) study calculates cancer mortality using a different method than DPHHS."
McDermott said one big difference between her work and the state's is due to her university having biostatisticians, allowing for more sophisticated analysis, while Montana does not. Andrew Ortaglia, clinical assistant professor at USC-Columbia, performed that work on the McDermott study.
McDermott lumped Anaconda-Deer Lodge County and Butte-Silver Bow counties together in her research. She did that, she said, because it "added power to our study." She said the two counties are exposed to the same five contaminants of concern listed by the EPA: lead, arsenic, cadmium, copper, and zinc.
But there are differences, however subtle, with that contamination. Arsenic has been the greater worry in Anaconda. Arsenic is a known carcinogen. Lead, which is not, is the toxin of most concern in Butte.
Butte's damage is from more than 100 years of historical mining and smelting. Anaconda's environmental degradation is due to smelting Butte's ore.
The two counties have another important difference. Anaconda-Deer Lodge County does not have an active mine. Smelting in Anaconda stopped in 1980.
Montana Resources' mining activity has been nearly continuous since shortly after the Berkeley Pit closed in 1982. Montana Resources is 26 miles from Anaconda.
McDermott posited that exposed tailings in Anaconda continue to get picked up by the wind.
The black slag piles along Montana Highway 1 are considered to be inert by the EPA, but hills lining Anaconda still show exposed waste areas. There are also uncovered historical mine dumps and areas that have not been properly capped all around Butte.
Ebelt characterized the McDermott study as using multiple causes of death listed on the death certificate — which he said added more numbers to McDermott's death count.
"DPHHS uses (one death count), which is the underlying cause of death," Ebelt said via email. He also said DPHHS follows CDC guidelines for calculating their statistics.
Davis, one of the junior researchers, explained how she tabulated death records for the USC team.
"We count two deaths for a person who dies of heart failure with cancer as a contributing cause, when this is likely being counted by the DPHHS as heart failure as the only cause of death," Davis said via email.
Ebelt also said McDermott included both benign and malignant (cancerous) tumors in her statistics, but McDermott said that benign tumors were not included in her work.
McDermott and her team looked at deaths potentially caused by heavy metal exposure besides cancer. Because the only national disease registry that exists in the U.S. is a tumor registry, the state has largely focused solely on cancer rates.
A national study put together by the largest U.S. nonprofit focused on health, the Robert Wood Johnson Foundation, recently ranked Silver Bow and Deer Lodge counties as 35th and 38th among Montana's 56 counties for overall health.
The Robert Wood Johnson Foundation considered more universal health issues, such as the number of DUIs and sexually transmitted infections. The New Jersey-based foundation also took into account premature deaths.
McDermott's team counted death records provided by the CDC. Barry Peterson also used the CDC's death records when she did her dissertation research.
McDermott also had Davis and another junior researcher, Maggie McCarter, simultaneously perform the same data investigation without knowledge of the other's work to ensure accuracy.
McDermott has experience doing research about the health impacts of Superfund sites in the past. She has spent her 30-year career as an epidemiologist at USC studying the health effects of heavy metal byproducts from energy plants and industrial sites in South Carolina. Her particular interest has been studying pregnancy exposures to metals and neuro-developmental delays in children.
McDermott said she got interested in looking into Butte because of stories that ran in The Montana Standard last year saying EPA didn't know if residents are being exposed to heavy metals in certain sections of Butte.
McDermott also has family in the Mining City. (See editor's note.)
She said that her team got started with its investigation by reading Barry Peterson's 2012 doctoral thesis. The thesis created a furor at the time.
McDermott said Barry Peterson's work was "very good," but she and her team realized "we could do better."
Barry Peterson told the Standard in the midst of the controversy five years ago that she intended her work to be a starting point for other studies.
She got her wish.
McDermott doesn't intend to stop with this one paper on the largest Superfund complex in the nation. She already has another study focused solely on cancer in the works, and she is planning a third study for which she is seeking grant funding.
In addition, there is now a short list of other health studies in the making:
The EPA recently announced a second lead study for Butte. The first one, which found lead in Butte's children on a downward trend, was completed in 2014.
DPHHS is also planning its own epidemiological study on cancer in Butte and expects to "drill down" by mapping cancer mortalities by census tract. This type of mapping for cancer has never been done before.
The research will be important, Sullivan said. Zip code can have more impact on health than genetic code, she said.
A volunteer health board was formed earlier this year as part of the EPA's now-mandated appraisal of Butte's health. Two members of the new health board are surveying Butte residents to see if locals are more worried about issues such as mental health, which has no known connection to Butte's Superfund status. Both Butte and Anaconda have some of the highest suicide rates in the state.
Anaconda has its own upcoming health studies. There is the ATSDR and DPHHS study Everett is excited about. That investigation will test for lead in blood and arsenic in urine sometime later this year or early next year. The federal agency based out of Atlanta and the state hope to get 200 participants. This new Anaconda study, unlike ones in the past, will allow adults as well as kids to participate.
The EPA is also testing vegetables and fruit grown in Anaconda soil for heavy metals and are asking residents for help with that. (See information box.)
The Anaconda-Deer Lodge County Public Health Department is gearing up for its own look into Anaconda health concerns. In response to recent public comments about issues such as mental health and aging in Anaconda, the health department will study those and other non-Superfund related health worries.
Meanwhile, McDermott is planning to give a talk in late October at Montana Tech to discuss her paper as well as her findings. (See information box.)
"This nationally available data (from the Centers for Disease Control) give us an important insight into the causes of death in these counties; this is, in fact, what these counties experienced," she said. "There's little nuance to that."
Editor's note: Professor Suzanne McDermott is the mother of Ted McDermott, Montana Standard reporter and assistant editor. Ted McDermott was not involved in any way in the production of this story.
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