The debate as to whether environmental pollution caused a deadly cancer cluster in Toms River has gone on for decades.
In his new book, ‘Toms River: A Story of Science and Salvation,” journalist Dan Fagin reexamines the scientific evidence, refocusing attention on issues that may have been overlooked and stressing the role that epidemiology -- the study of the patterns and causes of diseases -- can play in arriving at new interpretations.
In one way, this is a book about establishing links and the near-impossibility of achieve "scientific certainty." In fact, one of the slipperiest concepts in Fagin's "Toms River" is how epidemiological information can often suggest a link between a given environmental source and cancer, without proving that link.
“It’s true that people think that, well, either there is or there isn’t [a link], but that’s not the way things work,” Fagin said.
“Any sort of pattern recognition is about probability it’s not about certainty,” he added, including epidemiology.
Still, scientific evidence suggests that there was a greater than 95 percent probability that girls exposed to water contaminated by a nearby chemical plant had an increased risk of leukemia.
For children with other forms of cancer, however, confidence fell below this scientific threshold.
But Fagin is interested in far more than epidemiology
His book introduces the dedicated researchers, parents, and activists who pushed investigators to take on a notoriously difficult challenge: whether there was a link between the town’s former Ciba-Geigy dye plant and other sources of pollution and cancer cases that occurrred a decade or more later.
“One thing that surprised me was how much luck and really personal bravery went into bringing this story to light,” Fagin said, noting that not only Toms River residents, but also researchers outside of the town and midlevel state officials pushed the issue.
It also draws a sharp picture of the many barriers that prevent similar studies of pollution in other towns, including the economic importance of industry and concerns from local residents over whether the allegations would hurt property values.
Fagin is a veteran environmental reporter for Newsday who currently serves as an associate journalism professor at New York University. He decided to take on the subject of Toms River because of the amount of scientific research that had been conducted there.
“The science was done here in Toms River and the science is almost never done, at least appropriately,” Fagin said.
The book, which was published by Bantam Books in March, explores how Ciba was welcomed into the town in 1952 and became a key employer as the quiet backwater quickly grew to having one of the largest populations in the state. Over time, several incidents raised concern about exposure to the chemicals used to make the dyes.
Things came to a head beginning in 1996, when the state launched a series of studies that investigated potential water and air pollution from the plant, as well as water pollution from a farm owned by the Reich family, where illegal dumping by Union Carbide contractor Nicholas Fernicola for four months at the end of 1971 led to decades of underground pollution.
Ultimately, these investigations would lead to multimillion-dollar settlement with the families of Toms River children with cancer.
“We always assume that the truth will come to light. There’s nothing predestined about the story of Toms River coming to light,” Fagin said. “While this is a story about Toms River there’s nothing really unique about the story of Toms River -- what’s unique is that it came to light.”
Fagin noted that while some cancers have been linked to specific causes, such as smoking with lung cancer, ultraviolet radiation with melanomas, and human papillomavirus with cervical cancer, the role that environmental pollution plays in causing cancer continues to be actively debated.
“There is huge public interest and real medical uncertainty about what explains cancer,” said Fagin, adding that the evidence points to pollution playing an important role in many cancer cases.
Fagin noted that the Ciba plant arrived in Toms River before the Garden State Parkway made much of the shore more accessible.
“The people in Toms River were very, very eager to welcome Ciba and its Swiss partners to town,” Fagin said. “They were thrilled to have them there because the economy really needed a shot in the arm . . . As long as people didn’t think about the long-term consequences, they were happy to have them there.”
But the town’s growth later became a potential source of danger. The insatiable demand for water led officials “not to worry overly about its quality,” which raised the risk of pumping contaminated water, Fagin said. “The priority for many years in Toms River was to make sure that the town didn’t run out of water.”
The Ciba plant has been closed for more than a decade and the cleanup of the site has been completed.
Despite the uncertainty, the studies did find a link between the pollution and some types of cancer in Toms River children. This was supported by the cases of leukemia being more common where the sources of the pollution were greatest.
“I just wanted people to understand how science really works -- science never delivers absolute truth, but it gets us closer and closer,” Fagin said of the challenges and possibilities in investigating cancer clusters. “It’s not something where we should throw up our hands and say this is hopeless.”
The reporting that Fagin did for the book -- which included interviewing 140 people -- took him to China, where much chemical production now occurs.
While the kind of illegal dumping that occurred at the Reich farm may no longer occur in New Jersey, Fagin shows in the book that it is occurring in the developing world.
“I wanted to show why the story of Toms River really matters and why it’s still relevant now,” Fagin said. “I could have gotten this book done a lot faster if I just wanted to show what had happened in Toms River.”
In visiting Chongqing Children’s Hospital, Fagin spoke with a doctor who said she thinks that pollution is causing cancer cases among children. In addition, amateur epidemiologists in China have been mapping “cancer villages” in smaller towns with settled populations and heavy industry.
“Even the [Chinese] Ministry of Health acknowledges that pollution -- industrial waste dumped into rivers and groundwater, plus air emissions from factories and power plants -- has made cancer the leading cause of death in China,” Fagin wrote in the book.
If residents become concerned that about a potential cancer cluster, Fagin encourages them to learn as much as they can about the science of cancer. If they still have concerns, “they shouldn’t just throw up their hands in despair and say no one will ever help me,” Fagin said. Instead, they can ask the state Department of Health to investigate the issue.
“Don’t panic, take things one step at a time, but also educate yourself, don’t let people patronize you,” Fagin said. “You can understand, you can learn, you can arm yourself with information, and you can be an involved citizen and decide how far you want to go.”
Fagin is scheduled to talk about his book and sign copies at the University of Pennsylvania bookstore in Philadelphia on June 12 at 6 p.m. and at the Barnes & Noble at the Monmouth County Mall in Eatontown on June 20 at 7 p.m.