A Descriptive Study of Cancer and Other Health Outcomes Around the Former Fresh Kills Landfill, Staten Island January 2020
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A Descriptive Study of Cancer and Other Health Outcomes Around the Former Fresh Kills Landfill, Staten Island January 2020 Aerial view of Staten Island. Photo by Alex MacLean. Image courtesy of Freshkills Park and the City of New York. Fresh Kills Landfill Area A satellite image of Staten Island overlaid with 2010 United States Census tract definitions. Table of Contents Executive Summary ........................................................................................................................................... iii Acknowledgments .............................................................................................................................................. vi I. Introduction ................................................................................................................................................... 1 A. Background ................................................................................................................................................. 1 B. Previous Research on Cancer, Asthma, and Mortality in Staten Island ..................................................... 4 C. Study Development .................................................................................................................................... 6 II. Methods .......................................................................................................................................................... 7 A. Objectives ................................................................................................................................................... 7 B. Fresh Kills Landfill Study Area and Comparison Areas ............................................................................ 7 C. Health Outcomes of Interest and Sources of Data ...................................................................................... 8 1. Selection of Specific Cancers for Analysis ...................................................................................... 9 D. Analysis .................................................................................................................................................... 10 1. Limitations ..................................................................................................................................... 12 III. Findings ................................................................................................................................................... 12 A. Cancer ....................................................................................................................................................... 13 1. Bladder Cancer ............................................................................................................................... 18 2. Breast Cancer (women only) .......................................................................................................... 20 3. Kidney Cancer ............................................................................................................................... 22 4. Lung Cancer ................................................................................................................................... 24 5. Non-Hodgkin Lymphoma .............................................................................................................. 25 6. Thyroid Cancer .............................................................................................................................. 27 7. Total Childhood Cancer ................................................................................................................. 28 B. Asthma ...................................................................................................................................................... 29 C. Cause of Death.......................................................................................................................................... 31 IV. Conclusions ............................................................................................................................................. 33 V. Appendices ................................................................................................................................................... 35 Appendix A. Scientific Advisory Committee Members ................................................................................. 35 Appendix B. List of Census Tracts .................................................................................................................. 36 Appendix C. Maps of the Areas of Interest for this Study ............................................................................ 37 Appendix D. Analysis Methods ........................................................................................................................ 39 Appendix E. Results of the Analysis of Cancer Incidence ............................................................................. 47 Appendix F. Results of the Bayesian Analysis ................................................................................................ 60 Appendix G. Results of the Analysis of Cause of Death ................................................................................ 72 Appendix H. Asthma ........................................................................................................................................ 74 Appendix I. Demographic and Behavioral Cancer Risk Factors ................................................................. 79 ii Executive Summary Introduction The former Fresh Kills Landfill site – once one of the world’s largest landfills – is being transformed into one of New York City’s largest parks. The landfill began operation in 1948. Both while the landfill was operating and since its closure in 2001, residents of Staten Island have had concerns about potential environmental exposures resulting in adverse health impacts, such as cancer and asthma. In response, the New York City (NYC) Health Department has conducted three descriptive studies. The first study in 1996, the second in 2000, and this study -- which examines cancer rates from 1995 to 2015, describe the incidence (new cases) of specific types of cancer in adults and total cancer among children living near the landfill compared with the rest of Staten Island. Given the community concerns about respiratory disease, this third study also looks at rates of asthma-related emergency department visits and hospitalizations, as well as deaths due to chronic lower respiratory disease, and deaths due to all causes other than injury (such as car crashes, suicides, poisonings, etc.). Study Objectives This study looked for patterns that could suggest a connection between living close to the landfill and health. We evaluated the strength of the evidence for increased risk of disease in the former Fresh Kills Landfill study area. If exposures from the former Fresh Kills Landfill increased health risks in nearby communities, we would expect to see consistent patterns in rates over time, as well as similar increases in rates in both men and women. Our objectives were to: 1. Compare the rates of new cases of total cancer and specific cancer types diagnosed from 1995 to 2015 among people residing in the 24 census tracts that make up the former “Fresh Kills Landfill study area” with rates in the rest of Staten Island for 1995-2015. For context, we also compared cancer rates in Staten Island with the rest of NYC. 2. Compare rates of asthma-related emergency department visits and hospitalizations in the neighborhoods near the former Fresh Kills Landfill study area, Staten Island as a whole, and the rest of NYC for 2012-2016. 3. Compare the rates of death due to causes other than injury or poisoning and death due to chronic lower respiratory diseases, among people living in the former Fresh Kills Landfill study area, in the rest of Staten Island and in the rest of NYC for 1995-2016. 4. Describe cancer incidence and mortality trends (over time) in the former Fresh Kills Landfill study area, the rest of Staten Island, and the rest of NYC. 5. Examine available data on known cancer risk factors, such as smoking, in neighborhoods next to the former Fresh Kills Landfill compared with Staten Island neighborhoods farther away and New York City. iii Methods The New York State (NYS) Cancer Registry provided data on total cancer and 17 specific types of cancer for adults by sex (e.g., male, female) and total cancer for children. We chose the 17 types based on their frequency in the general population, the potential for an association with landfill exposures, and community concern. The cancer types were: bladder, brain and nervous system, breast (women only), colon, Hodgkin lymphoma, kidney, larynx, leukemia, liver, lung, myeloma, non-Hodgkin lymphoma, pancreas, pharynx and oral cavity, prostate (men only), rectum, and thyroid. Age-adjusted cancer incidence rates were calculated separately for men, women, and children in the former Fresh Kills Landfill study area, the rest of Staten Island and the rest of NYC for 1995- 1999, 2000-2004, 2005-2009, and 2010-2015. The observed number of cancer cases in the Fresh Kills Landfill study area for 1995-2015 was compared with the number expected, based on rates for the rest of Staten Island. For cancer types identified as potentially elevated (using statistical criteria), we conducted a more rigorous proximity analysis over two periods