Lee, who has a habit of smiling when pressing a point, shrugs off the setback, noting that plenty of worthy cancer research goes unfunded. Indeed, he even argues, hypothetically, that funds for a follow-up study might be better spent researching interventions that reduce smoking, improve diet, or target other harmful lifestyle choices. "The lion's share of cancer is caused not by exposure to toxins, but by behaviors under our control," he says.
However, he does not outright reject Old Smokey as a cause, or a factor, in the high rates of pancreatic cancer in the West Grove. Arsenic is indeed a principal toxic component of incinerator ash (and highly carcinogenic) and could have polluted the groundwater. And while the source of the arsenic in the wells is unknown — in fact, it could be naturally occurring — it's also possible that arsenic did cause the cancer but that the exposure occurred through other means: skin contact, ingestion, or inhalation. All valid theories.
Also uncertain is whether other cancer types — liver, lung, thyroid, for example — are abnormally high in the West Grove. Such clusters are not reflected in raw data collected by health officials; they are found only if tested for using sophisticated statistical modeling, explains UM epidemiologist Jill MacKinnon, a co-author of Lee's study and chief of the Florida Cancer Data System, which tracks cancer cases across the state. In other words, to find a cancer cluster, you need to look really hard. And that takes money. Researchers stumbled upon the West Grove pancreatic cancer cluster perhaps a decade ago while searching for tobacco-related illnesses. (But smoking has been ruled out as a cause of the West Grove cluster).
The City of Miami's Bravo said she was not aware of any cancer clusters in Coconut Grove. Florida's DOH has allegedly never been asked to look for one. (Lee's study appeared in the March 2013 edition of BMC Cancer, a peer-reviewed online medical journal, and has been cited in media reports.)
While rates and causes of cancer in the West Grove are unclear, the presence of arsenic is not. Soil tested in the immediate vicinity of the fire-rescue training center, a block off busy Grand Avenue, shows levels of arsenic many times the EPA's recognized limit for safe human exposure. Unsafe arsenic readings were also found at 18 of 42 sites sampled within a mile radius of the former incinerator. At a public meeting this past September, city and county officials obscured those findings by announcing only the average of all the samples, which, they assured residents, fell within a normal range.
But a closer look tells a different story: some readings, many at private homes in Coconut Grove and Coral Gables, reveal arsenic at two to three times the level considered safe for human exposure. An inspection of county reports shows no effort to notify property owners of toxic soil readings.
The accuracy of the city's testing has also come into question. At Miami's Douglas Park, for instance, one probe revealed arsenic in the soil at barely above the county's designated "cleanup target level" (CTL), perhaps attributable to naturally occurring deposits. Yet a follow-up test barely a month later showed arsenic levels ten times higher, forcing the shutdown of the park. Officials determined it had long ago been used as a dumping site for incinerator ash, most likely from Old Smokey. Today, the park remains fenced off.
Meanwhile, students at Carver Middle School are taking nothing for granted. To measure toxicity levels on the school's athletic playing field, a group of students earlier this year tested soils and compared them with city and county findings. Last month, their report, "Old Smokey's Dirty Secret," was named one of five grand-prize winners, from among more than 2,300 entries, in a nationwide science contest.
Roland Daniels never suspected the ash that rained on his home might have caused the asthma he and his brother suffered from as children. Nor did he think it initiated the emphysema that killed his mother. And maybe it didn't, he says. But there would be comfort in knowing whether Old Smokey's toxic legacy is following him into retirement, which he recently began at age 68 after a long and successful career as an auto sales executive. Daniels lived his first 18 years in a small house across the street from the incinerator. "We breathed in a lot of that ash," he says from his home in Tampa. "Should I be worried?"
Dr. Lipshultz has chased those kinds of questions for the past 35 years. He helps with the long-term studies of victims of the Chernobyl nuclear disaster and of survivors and families of Japan's atomic bomb blasts. Early in his career, he treated children stricken with leukemia after exposure to toxic chemicals illegally dumped into the water supply near Boston in the 1980s, an incident that spawned the bestselling book and film A Civil Action.