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A Call to Study Environmental Effects : Health: While adult cancers are traceable, many in childhood are still a mystery--one that has been unanswered for far too long, experts say.

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TIMES HEALTH WRITER

It’s common for parents whose children develop cancer to suspect environmental factors, says Kathy Ruccione, a nurse researcher in oncology at Childrens Hospital Los Angeles.

When 500 parents were asked what they thought might have contributed to or caused their children’s cancer, the most common response was environmental exposures, says Ruccione, who directed the recent study.

These parents’ beliefs, however intuitive, should not be ignored, she says.

“What we learned from this study is that we need to talk to parents about what they believe caused their child’s cancer; not to correct them, but to see what the cancer means to them,” says Ruccione, whose study was published this year in the Journal of Pediatric Oncology Nursing.

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Moreover, she says, while many adult cancers can be linked to family history, the environment or diet, the cause of most childhood cancers is unknown.

Increasingly, cancer experts are studying environmental factors, fueled in part by a mysterious increase in childhood acute lymphocytic leukemia and brain cancer. Since 1973, the rates of those diseases have risen 20.7% and 35.3%, respectively, in people younger than 19, according to the National Cancer Institute.

“The explanation is murky, and no one is prepared to say that the increase is linked solely to environmental exposure. The most one can say is there is a strong finger of suspicion,” says Dr. Philip J. Landrigan, a pediatrician with New York’s Mt. Sinai School of Medicine who has led efforts to protect children from environmental toxins. “This suspicion, however, has been neglected far too long.”

The suspicion is not just among parents. On Nov. 1, the Leukemia Society of America convened its first panel of health and environmental experts to explore environmental factors, such as pesticides, secondhand smoke, high-tension wires (power lines) and industrial pollutants.

Food and water have also become major areas of concern. A National Academy of Sciences panel reported last year that because infants and children consume more of some foods and drink more water for their size than adults, their potential exposure to toxins is greater.

But government agencies use an adult model to determine “acceptable” levels of exposure, says Landrigan, who co-chaired the panel.

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“That approach ignores that kids have very different exposures than adults do. It ignores the obvious biological differences--that kids’ organ systems are undergoing rapid growth and development. And it ignores that children have 60 or 70 years of life ahead of them,” he says.

Few scientists dispute these differences among children and adults, says Lawrie Mott of the National Resources Defense Council.

But she and other environmental activists doubt that science or government will act decisively any time soon.

“My take now is there is not a lot of faith in government or legislation, so I’m not sure how successful something like (a new law or regulation geared toward children) would be,” says Mott, co-author of the new NRDC report titled “Handle With Care: Children and Environmental Carcinogens.” “But I think something with a powerful grass-roots base would be unstoppable.”

That is where the talents of Jim and Nancy Chuda will pay off, predicts Teri Swearingen, a West Virginia mother who has led a 15-year battle to close the WTI incineration plant in East Liverpool, Ohio.

“Jim and Nancy are so dedicated; they work with a passion,” Swearingen says.

“It’s the most devastating thing to happen to a parent: Your child is taken away from you. But they are turning their loss into everyone else’s gain. I think parents across the country should thank them.”

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Children and Cancer

Since 1973, cases of cancer in children under age 19 have increased 12%. In particular, the incidences of brain cancer and leukemia have risen dramatically for unknown reasons.

* In children age 19 and under:

(rates per 100,000 people; percent change)

All cancers: 12%

Brain and other nervous system: 35.3%

Leukemia (acute lymphocyte): 20.7%

Non-Hodgkin’s lymphoma: 29%

* Gradual increase in childhood cancers since 1973

1991: 12%

Source: SEER Data, National Cancer Institute

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