Public Meeting: MDPH Activities in South Weymouth and Neighboring Communities
Bureau of Environmental Health Assessment
Massachusetts Department of Public Health
February 13, 2002

Assessment of Cancer Incidence in Rockland, Weymouth, Abington, and Hingham, MA  1982-1998
Bureau of Environmental Health Assessment
Massachusetts Department of Public Health
February 13, 2002

Reason for Investigation
•	Concerns about increased cancer near the NAS
•	Requests by: 
o	Senator Michael Morrissey, 
o	Weymouth Board of Health, and
o	Concerned residents in Rockland, Weymouth, Abington, and Hingham

Figure: Map of South Weymouth Naval Air Station

Community Cancer Concerns
•	Suspected increases in cancer in the four towns
•	Possible link to environmental contamination present at NAS
•	Suspected increases in cancer in other areas of the four towns unrelated to NAS

Investigative Approach
•	Calculate cancer rates for each town and by smaller areas (census tracts) 
•	Evaluate available cancer risk factor information
•	Evaluate geographic patterns of cancer in each town
•	Evaluate patterns of cancer in relation to environmental sources (particularly NAS)

Massachusetts Cancer Registry
•	Population-based surveillance system established in 1982
•	Massachusetts law requires reporting of all newly diagnosed primary cancers in Mass. residents
•	Confidential database

Eight Cancer Types Evaluated
•	Bladder
•	Brain
•	Kidney
•	Leukemia
•	Liver
•	Lung
•	Non-Hodgkin’s Lymphoma (NHL)
•	Pancreas

Cancer Data Evaluated 
•	1982-1998 

•	Three smaller time periods 
o	1982-1986 
o	1987-1994
o	1995-1998

Statistical Methods
•	Standardized Incidence Ratio

		  Observed # of cases		
SIR =              ------------------------------    x 100
		  Expected # of cases		

•	95% Confidence Interval

Summary of Major Findings
•	The majority of cancer types evaluated occurred at or near the expected rates in the four towns and in their census tracts

•	Lung cancer was statistically significantly elevated in three of the four towns

•	In Weymouth, leukemia and pancreatic cancer were statistically significantly elevated in some time periods

•	Some isolated elevations in cancer types occurred in some census tracts during certain time periods

Statistically Significant Findings
•	Lung cancer elevated in Weymouth, Abington, and Rockland
•	Lung cancer lower than expected in Hingham
•	Pancreatic cancer elevated in Weymouth during 1982-1986
•	Leukemia elevated in Weymouth during 1987-1994

Figure: Lung Cancer Incidence in Weymouth, MA

Figure: Lung Cancer Incidence in Rockland, MA

Figure: Lung Cancer Incidence in Abington, MA

Figure: Lung Cancer Incidence in Hingham, MA

Factors Considered
•	Cancer may be caused by one or many different factors 
•	Review of MCR data on cancer risk factors 
o	age/gender
o	smoking history
o	occupation

Lung Cancer Risk Factors
•	Age
•	Smoking 
•	Second-hand smoke
•	Occupation/environmental exposures

Review of Risk Factors: Lung Cancer
•	Age and gender patterns did not appear unusual
•	Workplace exposures may have played a role in some diagnoses
•	Majority of those with lung cancer were current or former smokers

Figure 1: Smoking History of Individuals with Lung Cancer in Weymouth, 1982 - 1998

Figure 2: Smoking History of Individuals with Lung Cancer in Weymouth, 1982 - 1998

Figure 3: Smoking History of Individuals with Lung Cancer in Rockland, 1982 – 1998

Figure 4: Smoking History of Individuals with Lung Cancer in Rockland, 1982 – 1998

Cancer Rates by Census Tract
SIRs were also calculated for the census tracts that subdivide each of the four towns
•	8 CTs in Weymouth
•	3 CTs in Abington
•	3 CTs in Hingham
•	2 CTs in Rockland

Figure: Pancreatic Cancer Incidence in Weymouth, MA

Review of Risk Factors: Pancreatic Cancer
•	Age patterns were as expected
•	More women than men were diagnosed with pancreatic cancer 
•	Workplace exposures possible
•	Smoking may have played an important role for some individuals

Figure: Smoking History: Pancreatic Cancer

Figure: Leukemia Incidence in Weymouth, MA

Review of Risk Factors: Leukemia
•	Age and gender patterns did not appear unusual
•	A variety of different leukemia subtypes were reported
•	Workplace exposures may have played a role in some diagnoses

Evaluation of Geographic Distribution
•	Place of residence at time of diagnosis was mapped for each individual 
•	Patterns of individuals diagnosed with cancer were evaluated spatially
•	Other factors that may indicate a cluster were considered

Community Environmental Concerns
•	Naval Air Station
•	Potentially hazardous waste sites (21E sites)
•	Weymouth Neck Landfill
•	Specific community environmental concerns in Weymouth and Hingham
•	Suburban Auto and two landfills in Rockland

Sources of Environmental Information
•	ATSDR Public Health Assessment
•	Environmental Baseline Study
•	ATSDR Private Well Survey
•	Modeled Flight Track Patterns
•	Recent Investigations in NW corner of NAS

Summary of Geographic Distribution Analysis
•	With the exception of lung cancer, no consistent spatial patterns were observed in any one area of the four towns

•	The geographic pattern of cancer did not show a clear pattern suggesting a common environmental exposure related to the NAS

•	Patterns of cancer near other areas of community environmental concern were not atypical

Conclusions
•	Majority of cancer types occurred at or near the expected rates in the four towns between 1982-1998

•	Lung cancer is increasing in Weymouth and Rockland, particularly in CTs near the NAS

•	Evaluation of risk factors showed smoking likely played a role in increased lung cancer rates

•	Occupation also played a role in lung cancer for some individuals

•	With the exception of lung cancer, patterns by census tract showed no consistent elevations of cancer over time

•	The geographic pattern of cancer did not show  a clear pattern suggesting a common environmental exposure related to the NAS

MDPH Recommendations
•	The MDPH should further investigate the pattern of lung cancer with respect to length of residence, particularly among non-smokers, to determine if a clearer pattern of this cancer emerges

•	Results should be considered by town Boards of Health when planning future prevention or intervention strategies in the four towns

•	Tobacco control efforts should be focused accordingly in the towns of Weymouth, Abington, and Rockland

•	Cancer incidence will continue to be monitored in these four towns through the use of the MCR

Weymouth Health Needs Assessment
February 2002

•	Weymouth Board of Health Sponsored
•	Purpose to identify health needs of Weymouth residents
•	Purpose to design programs to improve the health of residents
•	Confidential mailed survey to 5000 Weymouth residents
•	Survey conducted by JSI Research and Training Institute of Boston
•	Identify respiratory problems in the household
•	Identify risk factors for heart disease in the household
•	Identify health care services needs
•	Identify possible environmental health outcomes 
•	Questions designed to address specific arsenic and SWNAS concerns
•	Identify the occurrence of Multiple Sclerosis and other types of neurodegenerative diseases
•	Identify the occurrence of Lupus Erythematosus and other types of autoimmune diseases
•	Identify the occurrence of aplastic anemia and myelodysplastic syndrome
•	Identify the occurrence of diseases of the kidney
•	Identify the occurrence of birth defects

The environmental health outcome component of the survey will tell us if these outcomes occur at rates greater than would be expected or if they occur more often in certain areas of the community. 

How to Contact BEHA
Massachusetts Department of Public Health
Bureau of Environmental Health Assessment
250 Washington Street, 7th floor
Boston, MA  02108

Telephone:  (617) 624-5757
Fax:  (617) 624-5777
www.state.ma.us/dph/beha