The Breast Cancer Epidemic on Long Island 

From
Life's Delicate Balance: Causes and Prevention of Breast Cancer

by JANETTE  SHERMAN, MD 29feb00 

In this now universal contamination of the environment,
chemicals are the sinister and little recognized partners of radiation
in changing the very nature of the world-the very nature of life.
-Rachel Carson, Silent Spring'

[ Mindfully.org note: We highly recommend reading the whole book by going to www.janettesherman.com ]

The old story about the drunk searching beneath a glowing street light for his lost car keys bears retelling. When asked why he wasn't searching across the street, closer to his car, he said "the light is better here." It is becoming clear that much cancer research is conducted in the same way: not necessarily to find anything of significance, but that's where it's easier, and perhaps from the political point of view, safer as well. And of course, that's where the money is.

The Long Island Breast Cancer Study Project (LIBCSP) is a case in point. In the late 1980s, women on Long Island became increasingly aware that their mothers, daughters, sisters, neighbors, and friends were being diagnosed with breast cancer. Asking why, one answer was that the cancers appeared to be occurring in upper socioeconomic Jewish women; that must be the reason. Needless to say this explanation was unsatisfactory to everyone: Jewish, non-Jewish, rich, poor, and middle class. Fortunately, the women came together, formed groups, and pressed for answers, ultimately getting the attention of Congress.

The LIBCSP was initiated by Congress in 1993. The Congressional Act directed the National Cancer Institute (NCI), in cooperation with the National Institute of Environmental Health Sciences (NIEHS), to "conduct a case-control study to assess biological markers of environmental and other potential risk factors contributing to the incidence of breast cancer" in women living on Long Island? Elements of the study were to include:

"contaminated drinking water, sources of indoor and ambient air pollution, including emissions from aircraft, electromagnetic fields, pesticides and other toxic chemicals, hazardous and municipal waste, and, such factors as the director determines to be appropriate."

To date more than $19,000,000 has been appropriated to this project. The major portion, $7.36 million, has gone to Columbia University. Other players include Sloan-Kettering, that received $4.72 million; two awards totaling $4.28 million to the State University of New York (SUNY) at Stony Brook, Long Island; $1.2 million to the American Health Foundation; and lesser grants to Yale University, the Long Island Jewish Medical Center, and Cold Spring Harbor Laboratory.

In addition to the above main grant recipients, there are 32 subcontractors to the study. Major ones include personnel at Albert Einstein School of Medicine, Mt. Sinai School of Medicine, North Shore University Medical Center, University Medical Center at Stony Brook, Westat, Inc., and Winthrop University Hospital.

Given the way the LIBCSP is organized and being conducted there are serious omissions:

1. Not addressing adverse effects from exposure to chemicals known to have been used on Long Island

2. Not addressing radiation exposures

3. Not addressing the additive and synergistic effects from exposures to multiple chemicals and multiple radiation emissions

Concern about a conflict of interest arose when SUNY Stony Brook, along with Batelle, were awarded a $2 billion, 5-year contract to operate Brookhaven National Laboratory, a major source of radioactive pollution for Long Island ^.3 How managers and researchers from SUNY resolved their conflicting interests remains unresolved.

Having so many players in any project has several potential effects: diffusion of responsibility and accountability; increased likelihood of error; and spreading the money thin. It has another, little noticed effect, that which operates so well for such commercial projects as B-2 bombers and nuclear reactors for China: it spreads wide the financial interest to keep a project going, no matter how useless, dangerous, or inept.

A separate $542,997 grant, originally given to Brookhaven National Laboratory, was rescinded. The plan was for scientists at BNL to study the "feasibility of a geographical information system." There was criticism on two counts: BNL is one of the major contaminating facilities on Long Island, raising the question of objectivity; Geographical Integrative System (GIS) techniques have already been demonstrated to be feasible, applicable, useful, and most importantly, already available. Automated systems have been developed to integrate census and topographic information. These can be combined with biological and environmental samples to pinpoint sources of pollution and resultant illnesses. What is more, much of the information is already in the public domain with data available on the internet.

GIS techniques were clearly demonstrated by Colorado State University researcher Dr. Jay Nuckols, at an NCI seminar on the role of GIS-based techniques in cancer studies.^4,5 I later met Dr. Nuckols at his laboratory at Colorado State University in Fort Collins. He demonstrated the GIS process as a "stack of maps" overlain with different information. He showed how GIS methods can combine satellite images; census tract information; historical and current land-use data; location and path of water sources, incinerator and dumps sites; meteorological monitoring; birth, death, and sickness records; and combine them with computer storage programs to make essentially three-dimensional maps.

A less elegant technique of overlaying a map with see-through plastic pages of home sites and illnesses was used by Lois Gibbs and the residents of the Love Canal area and their scientific advisors. Using this technique and filling in data with color markers, Dr. Beverly Paigen and Dr. Marvin Schneiderman found that illnesses followed the path of swales, long covered over, but still transporting toxic chemicals.

The principal investigator for the LIBCSP is epidemiologist Dr. Marilie Gammon. She estimated that approximately 2029 women will be diagnosed to have breast cancer during the 12-month recruitment period. Given an equal number of women to be included as controls, the total number of women in the study will be around 4100, which allots about $4634.15 for each woman.

The enormous cost of the LIBCSP is one factor of concern, but the decision to choose the control women from the Long Island population stretches all scientific credibility. In choosing control groups, whether humans for epidemiological studies or animals for laboratory studies, a control group is selected that does not have the exposure factor(s) under consideration. The stated purpose of the LIBCSP is to determine what unique factors on Long Island are resulting in cancer, not what is unique about the women developing cancer. If we live to the ripe old age of 85, one-in-eight of us will develop breast cancer in our lifetime. Given these odds, how can one be assured that of the 2000 control women, 8% or 160 women, don't already have undiagnosed cancer? After all, the control women have lived in the same milieu as the women with cancer.

Since learning of the unconventional choice of a control group, I have asked many different people, with and without scientific training, from where they would choose a control group to compare with Long Island. Without exception, no one chose Long Island. And more than one person remarked, incredulously, "not Long Island?!" But Dr. Gammon and her associates did.

It is true that our world is becoming increasingly contaminated, and as explained by Dr. Steingraber, "there remains no unexposed control population to whom cancer rates of exposed people can be compared. Moreover the exposures themselves are uncontrolled and multiple."⁶ Still, why did the NCI-sponsored researchers set up the project this way? As the story unfolds, it will become more clear to the reader, as it has to many Long Island women, that the LIBCSP has serious, if not fatal, flaws.

The LIBCSP is conducted as a case-control study, that is, choosing a person without breast cancer to match with a woman who has breast cancer, taking into consideration such factors as age, race, etc. A case-control study is one of the most blunt of research instruments, especially given the way this one is being conducted, with cases and controls living in the same area. Given the same level of funding, if the inappropriately chosen control subjects were not included, there would be over $9000 to do thorough biological and environmental testing for each and every woman with breast cancer.

Another issue of concern is who is eligible to be in the study. The study defines the participants as women "newly diagnosed with primary breast cancer, and whose physician has given consent for contact."⁷ Some women feel that this arrangement was condescending and controlling, and wonder why the women were not recruited directly. There are 136 participating physicians, making patient enrollment cumbersome, variable, and incomplete.

The study design expects 1623 cases and the same number of controls to be interviewed. Of these, 60% "are expected to provide biological specimens," and approximately 325 of each group (650 total) who have resided 15 years or longer in their current residence will have home assessments of dust, drinking water, and soil. Of the 974 women with cancer (60% of 1623) who provide blood and urine specimens, fewer than half of the samples will be analyzed, the rest "banked for future use."8

The Long Island women have expressed serious concerns over the handling of blood samples: insufficient quantities drawn; clotting of some samples; lack of coordination with environmental sampling; and samples obtained from women after radiation and/or chemotherapy treatment had begun. This last issue, comparing biological data from women without cancer to biological data obtained from women undergoing cancer treatment, is folly, and questionable science at best.

More numbers, and the numbers tell the story: 60% of the total number of women interviewed equals 1951, and 650 women are to have three different environmental assays, for a total of 1950 assays or a grand total of approximately 3900 biological and environmental samples to be analyzed.

The following is a direct quote as of December 1996: "That of the 650 participants (325 cases and 325 controls) with environmental samples, approximately 60 percent (n = 390) will have donated blood and urine specimens. Of that 390 (175 invasive cancer cases, 20 in situ cases, and 195 controls), about 40 percent (n = 148); 70 invasive cases and 78 controls) will be randomly selected for the lab assays of their blood and urine."⁹

Those are confusing numbers to comprehend, but if the numbers are correct, of some 1600 women who develop breast cancer during the period of study, roughly 4% can expect to have a full assay of both biological and environmental samples. Stated another way, after the expenditure of all the money, time, and effort, 96% of women will have no meaningful information. For the rest of the participants, the study design gives no assurance that biological and environmental samples will be taken from the same woman.

Review of the "Results" portion of the "Background" document of Dr. Marilie Gammon's part of the study reveals another interesting point of view: the very narrow approach taken to the issue of cancer-causing chemicals, limiting the categories to "possible human breast carcinogens" and further limiting the list to DDT, DDE, PCBs, and chlordane.'° Moreover, there is no provision to assay body fat samples for suspect chemicals.

Aside from being chlorinated organic chemicals with known toxic effects, what do these chemicals have in common? These named chemicals have already been banned! That means no corporate entity will be embarrassed and on-the-line to stop production of any of the products in the United States. It also means that other carcinogenic and hormonally active chemicals, known to have been used on Long Island, are not under scrutiny in the Long Island breast cancer epidemic.

Citing lack of funds to include chemicals other than DDT, DDE, PCBs, and chlordane poses the question of whether this decision was to avoid offending a chemical manufacturer, supplier, or user of other candidate chemicals. Given that breast cancer is not the only cancer or the only serious medical problem on Long Island, this restricted view suggests a certain lack of perspective about connections between environmental factors, endocrine disruption, birth defects, other cancers, and other illnesses.

The scientific literature survey given in the "Background" document" shows a paucity of sources and a remarkable lack of historical information about chemical pesticides known to have been used on Long Island. Until the early 1970s there were 80,000 to 100,000 acres of potatoes grown on Long Island. Suffolk County was the third largest potato grower in the world, behind Maine and Idaho. Because of fear of a Colorado potato beetle infestation, pesticides were sprayed as often as every 10 day, from May to August. This was told to me by Dr. Robert Simon, who himself did spraying, applying Temik (aldicarb), dieldrin, endrin, chlordane, parathion, and DDT.¹²

Adding to Long Island's toxic chemical load were PCBs, which Dr. Simon related to have migrated from multiple sites, the major contributor being the General Electric (GE) plants near Fort Edwards and Hudson Falls, New York.¹³ By 1977, GE estimated there were 137 metric tons of PCBs on the river's floor,¹⁴ which has led to advisories against eating fish from the river.¹⁵ Flowing southward along the east border of New York state, the Hudson River is deceptively beautiful as it passes the state capital in Albany, the Roosevelt and Vanderbilt estates near Hyde Park, and further south, the West Point Military Academy. Near its mouth, the river flows by the west side of Manhattan and the borough of Brooklyn, which makes up the western end of Long Island.

So contaminated is the river that the federal government has designated the entire stretch of the Hudson River, downstream from the GE plant to New York Harbor, as a Superfund site!¹⁶

In addition to exposures from contaminated water and soil is the potential for even wider exposure as a result of air dispersion of PCBs. Citizens have voiced concern that delays in addressing the contamination may have played a factor in the transfer of Department of Health researcher Dr. Brian Bush. Dr. Bush had been with the New York research post for 25 years when he was told to "cease PCB analyses" immediately.¹⁷

In support of their decision to eliminate DBCP, toxaphene, and styrene from testing, the Columbia researchers cited as "the most comprehensive source of information"18 documents prepared by subcontractors of Agency for Toxic Substances and Disease Registry (ATSDR) some time before 1990.¹9-21 By and large, ATSDR documents are not historical compendia, but reviews of relatively recent publications. The most recent citation in the styrene document was 1989, but even that publication cited three studies that were positive for mammary cancer in test animals.²² Dibromochloropropane (DBCP) is a soil "sterilant" and is widely used in agriculture. Though now banned in the United States, DBCP remains detectable in the water supply of many communities. So far, this issue has been ignored.²³

Dr. Gammon's memo that "no meaningful data has [sic] been published with regard to the carcinogenicity of methoxychlor," and regarding 2,4-D and 2,4,5-T, "there is insufficient evidence to conclude that they are human carcinogens"²⁴ escapes credibility. The components of Agent Orange, 2,4dichlorophenoxyacetic acid (2,4-D) and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), were used extensively in agriculture, and while 2,4,5-T has been largely banned in the United States, 2,4-D remains in common use on lawns and golf courses. Methoxychlor is similar in structure to DDT and is documented to be carcinogenic.25 Criticism of ATSDR and its methods has been documented in the publication Inconclusive by Design, the last citation in this chapter.

Long Island women have requested that dioxins be included in the assays because of known carcinogenicity and endocrine disruption and the high probability that dioxins, as well as the carcinogen cadmium, are emitted from incinerators located on Long Island. To date this valid request has not been done.

The considerable data on endocrine disruption, researched by Dr. Theo Colborn²⁶ and her associates, applicable to the cancer problem for the chemicals 2,4-D, 2,4,5-T, atrazine, endosulfan, and alkyphenols, were dismissed with the statement "no meaningful data exists [sic] in regard to their carcinogenicity, either in humans or animals."²⁷ And so, these chemicals, along with the phthalates and aldicarb also will not be looked for.

Why the decision was made not to assay for other chemicals is not known. One would expect that simple curiosity would have driven a broader perspective. The women activists proposed more thorough chemical testing. In response to their proposals, the researchers labeled their requests a "wish list," a condescending and dismissive reply to their legitimate concerns.

The soil-sampling plan and soil assay for polycyclic aromatic hydrocarbons (PAH) and nitro-PAH also pose problems for the LIBCSP participants. The original idea was to collect a single soil sample. Because this was inadequate, the protocol was expanded to collect four samples-two samples from the yard, and two obtained within 15 inches or less from the house foundation. The latter is thought to be where chemicals accumulate: chemicals such as paint components, termite and other pesticide treatments, and rainborne chemicals from roof runoff. The soil protocol says analysis "will be carried out on every fourth sample received, the remainder being stored frozen for later analysis if and when funds become available."²⁸ The protocol does not state which "every fourth sample" will be analyzed. Will it be a sample from close to a house, from the yard, where?

The soil collection data form asks for information on herbicide and pesticide use, but the protocol does not include analysis for herbicides and pesticides. No other assays are indicated, other than for polycyclic aromatic hydrocarbons, the PAHs, and their nitrated relatives, the N-PAHs.

The entire soil assay problem begins with the method for collecting the soil. The protocol is illuminating. It says to put each soil sample into a plastic baggie, with a preprinted self-adhesive label, put two rubber bands around the baggie, and "place the four baggies next to each other, and band them together as well. Place the four banded baggies inside a larger zip-lock bag" with a pink laboratory copy form inside the last bag. The soil samples are then to be shipped with a frozen cold pack inside another baggie, with newspaper stuffed inside the packing box. Furthermore, the protocol states that if Federal Express is closed, to keep the samples "in your refrigerator or cooler."

Think about the above. Plastics leach into samples, samples decrease in amounts as they leach into plastics, rubber bands are made of chemicals, self-stick labels are manufactured with chemical glues, newspaper ink has solvents and other chemicals, the samples can be stored in a home refrigerator, and we don't even know what's inside the cold pack! Is this any way to conduct research? I've checked my own knowledge of soil chemistry with two industrial hygienists, and the word is glass. Yes, as with blood and urine samples, soil samples must be collected and stored in tightly sealed glass to maintain integrity of the samples and to avoid cross-contamination.

Why was this not known by officials at NCI and Columbia University and by the people at American Health Foundation, where the assays are to be done?

The carcinogenic effects from exposure to polynuclear aromatic hydrocarbons (also called PAH's) have been known for decades.²⁹ These chemicals are released from incinerators and various industrial operations.³0 One such PAH is methylcholanthrene, having both estrogenic and carcinogenic properties. When combined with x-ray exposure, PAHs caused leukemia in several strains of mice.31 On Long Island, such combined exposures, involving multiple chemicals and nuclear radiation, is a reality. Why is this situation not being addressed by the NCI-sponsored study?

A portion of the LIBCSP that follows sound scientific methodology and procedure is the work of Drs. Bradlow and Kabat. Previous work by Drs. Bradlow and Davis has demonstrated an increased risk for breast cancer with alteration of the ratio between 16-alpha- and 2-hydroxyestrone, the metabolites of estrogens.³² Dr. Bradlow's group is researching several common pesticides that appear to increase production of the 16-alpha-hydroxysterone as a link to breast cancer. It is likely that research directed to this problem may produce some valid and useful results.

Of the many shortcomings of the LIBCSP, perhaps the most serious is the failure to collect data on nuclear radiation as a factor in the Long Island breast cancer epidemic. Extensive research links low-level radiation, alone and combined with chemical exposure, to cancer.

Unequivocally, Long Island is a place with a history of toxic chemical and radiation releases. In addition to the Brookhaven National Laboratory and its nuclear facility. Long Island is in close proximity to the Millstone and Haddam Neck reactors in Connecticut; the Indian Point reactor in Peekskill; and downwind from New Jersey's Oyster Creek reactor. Perhaps it is too much for citizens to expect million dollar governmental-sponsored multisite studies to provide either information or prevention.

A case in point is the small, independent research group, Radiation and Public Health Project, Inc. (RPHP) headed by Dr. Jay Gould. Data collected by RPHP concerning radiation nationwide can be found on the internet at www.radiation.org.

Dr. Gould and his associates accessed information from the New York Health Department's Statewide Planning and Resource Cooperative System (SPARCS). When they analyzed data for hospital discharges for breast malignancy for Suffolk County, the home of Brookhaven National Laboratory, they found that for the 1990 Suffolk population of 692,000 women, the rate of breast cancer for the county was 1.99 cases per 1000. This was somewhat higher than the corresponding rate of 1.91 cases per 1000 in New York City, and the nationwide rate of 1.7. In five zip code areas representing parts of five towns surrounding BNL, the breast cancer rate was 3.64 cases per 1000 population They calculated that more than half of the female population of Suffolk county lives within a 20-mile radius of BNL. By dividing the circle into quadrants, they were able to add three other zones east and west of the circle to display the full variation in cancer discharges. The highest breast cancer rate (4.0 per 1000) is found in women living on the north fork of Peconic Bay, downstream from BNL and only 11 miles downwind from the troubled Millstone nuclear reactors.³³

To coordinate the findings of cancer and nuclear pollution in areas of Long Island and elsewhere, as Toms River, New Jersey, the RPHP has initiated the "Tooth Fairy Project" to collect baby teeth for measurement of strontium 90. By calling 1-800-582-3716, parents, teachers, and public health personnel can get instructions on how to send baby teeth for analysis. Perhaps the most critical aspect of the study is the realization that measuring levels of radionuclides in baby teeth gives irrefutable clinical and geographic evidence of prior contamination.

As if radiation pollution were not of sufficient concern, a 1996 survey of Peconic River silt found mercury and silver at levels more than 1000 times the criteria for the New York State Department of Environmental Conservation. Copper and lead were detected in seven of 12 samples of fish, and DDD, a metabolite of DDT and the PCB Aroclor-1254, was found in all four fish that were sampled. Additionally, tritium and cesium 137 were found in all three samples analyzed for radionuclides.³⁴ A 1998 survey of fish from the Peconic River, both on- and off-site of the BNL property, found lead, mercury, nickel; the DDT metabolites DDE and DDT; and strontium 90 and cesium 137 in nearly all fish samples.³⁵

A New York Department of Health document calculated radiation doses for those who consumed fish, clams, or mussels harvested from Peconic River waters. "Due to the long residence within the body of Sr 90 and Cs 137, the radiation dose is delivered to body tissue over a long period of time [some 50 years] following ingestion. "³⁶

These findings were reported in the press throughout 1997 and 1998. Groundwater from BNL was contaminated with plutonium, uranium, americium, strontium, and cesium; tritium had been released into the air;³⁷ plutonium from BNL had infiltrated the Peconic River,³⁸ with measurable quantities 1 mile from the laboratory;³⁹ and in 1996, radioactive cesium had been measured in deer living near the site.⁴⁰

Given the many surveys and historical data that have demonstrated significant chemical and radiological pollution on Long Island, and the avowed purpose of the NCI-led LIBCSP to specifically address environmental factors contributing to the high incidence of breast cancer on Long Island, the result of the research may be that the LIBCSP will not find any connection between breast cancer and the environment. With its narrow, unimaginative approach, it appears it may discover little else of interest as well.

Many on Long Island ask why research into factors causing breast cancer in Long Island women, as done by the NCI-sponsored, Columbia-led research, is being conducted in such an unfocused and incomplete manner. They ask too when all the time, money, and effort have been exhausted, will the LIBCSP be another example of "Inconclusive by Design?"⁴¹

REFERENCES

1. Carson, R. Silent Spring. Crest Books. New York. p.16,1962.

2. Public Law 103-43, June 10, 1993, Section 1911.

3. Lawler, A. SUNY Batelle team to run Brookhaven. Science. 278:1702,1997.

4. Nuckols, J. National Cancer Institute seminar, held March 7,1996.

5. Nuckols, J.R. Use of remote sensing technology in a health assessment of rural agricultural communities. Amer. Inst. Aeronautics and Astronautics. pp. 1-10. 1995.

6. Steingraber, S. Living Downstream. Addison Wesley. Reading, MA. p. 29.1997.

7. Gammon, M., Neuget, A., Santella, R. Long Island Breast Cancer Study Project. Columbia University Case-Control Study. 6 pages. No date.

8. Gammon et al. Op. Cit.

9. Gammon, M. D. LIBCSP. Year 2 Progress Report Summary. December 1996.

10. Gammon, M. "Background" document. pp. 1-14. No date. 11. Gammon, M. Op. Cit.

12. Simon, R. Telephone interview. September 24,1997.

13. Sack. K. G. E. To stop flow of PCBs into the Hudson River. New York Times. p. 38. July 18,1993.

14. Sullivan, W G.E., whose plants spilled PCBs, sees signs of natural breakdown. New York Times. p. 18. June 9,1987.

15. Gold, A. R. After 15 years, Hudson still has PCBs. New York Times. p. B-1. May 16,1990.

16. Rivlin, M. A. Muddy Waters: GE, PR and PCBs. Amicus 119(4):30-37,1997.

17. Anon. Poughkeepsie Journal. N. Y forces scientist to stop work on PCB-health link. p. 1-A. September, 27,1997.

18. Gammon, M. Op. Cit.

19. ATSDR. Toxicological Profile for 1,2-dibromo-3-chloropropane. Prepared by a Syracuse Research corporation, under subcontract to: Clement Associates, Inc.  1990.

20. ATSDR. Toxicological Profile for Toxaphene. Prepared by Clement Associates. 1990.

21. ATSDR. Toxicological Profile for Styrene. Prepared by Life Systems, Inc., under subcontract to: Clement Associates, Inc. 1990.

22. Gammon, M. Op. Cit.

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24. Gammon, M. D. Memo to: Community Activists Request for a "Wish List" for the LIBCSP April 24,1997.

25. Sherman, J. D. Structure-activity relationships of chemicals causing endocrine, reproductive, neurotoxic, and oncogenic effects-A public health problem. Toxicol. Indust. Health. 10(3):163-179,1994.

26. Colborn, T., Clement, C., Eds. Chemically-Induced Alterations in Sexual and Functional Development: The Wildlife/ Human Connection. Princeton Scientific Publishing Co., Inc. 403 pages. 1992.

27. Gammon, M. Op. Cit.

28. Beyea, J., Hatch, M., Grimson, R., Stellmaq, S., Gammon, M. Draft of soil sampling protocol. 8 pages. January 8,1997.

29. Lee, S. D., Grant, L., Editors. Health and Ecological Assessment of Polynuclear Aromatic Hydrocarbons. J. Environ. Pathol. Toxicol. 5(1):1-376,1981.

30. Santodonato, J., Howard, P, Basu, D. Health and Ecological Assessment of Polycyclic Aromatic Hydrocarbons. J. Environ. Pathol. Toxicol. 5(1):1-364, 1981.

31. Kirschbaum, A., Shapiro, J. R., Mixer, H. W. Induction of leukemia in mice by estrogenic hormone, methylcholanthrene and x-rays. Cancer Res. 12:275,1952. 32. Davis, D. L., Bradlow, H. L. Can environmental estrogens cause breast cancer? Sci. Amer. 166-172, October 1995.

33. Gould, J. M. Radiation and Public Health Project, Inc. April, 1998.

34. IT Corporation. Operable unit V-Fish tissue bioaccumulation study report. Submitted to Brookhaven National Laboratory Associated Universities, Inc. BLN Contract No. 710617. December 9,1996.

35. IT Corporation. Operable Unit V-Additional fish bioaccumulation study report. Submitted to Brookhaven National Laboratory Associated Universities, Inc. BLN Contract No. 710617. May 27,1998.

36. New York State Department of Health, Bureau of Environmental Radiation Protection. Radioactive Contamination in the Peconic River. p. 7. September 12,1996.

37. Pleven, L. Isotopes in lab water. Newsday. p. A-1. October 24,1997.

38. Rau, J. Calls to widen pollution probe: Plutonium spurs push for Peconic cleanup. Newsday. p. A-1. June 17,1998.

39. Rau. J., Zehren, C. Plutonium in Peconic River. Newsday. p. A-1. June 11, 1998.

40. Rau, J., Cesium is found in deer at BNL. Newsday. p. A-6. April 30,1998.

41. Environmental Health Network and National Toxics Campaign Fund. Inconclusive By Design-Waste, Fraud and Abuse in Federal Environmental Health Research. P O. Box 16267, Chesapeake, VA 23328-6267.