ABSTRACT

1. Ratio of Female Breast Cancer Cases to Female Controls on Staten Island by Health Area 1980-1990 0.0851 – 0.095 0.081 – 0.085 0.071 – 0.08 0.06 – 0.07 Fresh Kills Landfill Staten Island Breast Cancer Research Initiative: Parity, length of residence on Staten Island, puberty, occupation, socioeconomic factors and mortality risk with respect to environmental justice D. B. Gerstle, MS, MA, JD1, A. M. Levine, PhD1 , J. Fata, PhD1, R. C. Silich, MD2, A. Benimoff, PhD1 , M. Kress, PhD1, E. C. McCoy, PhD1, M. Dresser, MPH1, K. Schwartz, MD3, A. Lubrano, PhD1, M. Devereaux, MS1, D. Dimitrov, MA, JD1, R. Pepe-Martorana, JD1, E. E. Hellstrom, MBA1, L. Holland, MLS, MA1, C. Roos, MA, CCBE1, C. Nichols, MS1, J. Colon, BS1, R.. Johnson, BS1, M. Segarra, BS1, B. Kelly BS1, A. Torino1, (1) Center for Environmental Science, College of Staten Island/CUNY, 2800 Victory Blvd., 6S-310, Staten Island, NY 10314, 718-982-3922, donna.gerstle@csi.cuny.edu, (2) Surgery/Division of Plastic Surgery, Cornell University Medical School/NY Hospital, 525 East 68th Street, New York, NY 10021, (3) Department of Endocrinology, North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030. ABSTRACT Staten Island, NY (SI) is downwind from the largest petrochemical industry in the world, Brookfield Landfill (EPA Superfund site) and for more than 50 years harbored the largest open dump, Fresh Kills Landfill. Using breast cancer incidence and mortality data from New York State Department of Health (NYSDOH) and New York City Department of Health and Mental Hygiene (NYCDOHMH) respectively, it has been determined that SI has among the highest female breast cancer age-adjusted incidence and the highest age-adjusted mortality rate in the metropolitan region. Researchers at the Center for Environmental Science developed and validated a methodology for obtaining data from a combination of newspaper obituaries and death certificates. Death certificate data for breast cancer deaths were obtained for 1980-1990 from NYCDOHMH as well as, a set of female controls. Life histories were compiled through obituary interviews for both cases and controls. Preliminary analysis using logistic regression demonstrated: [1] a statistically significant increase in the risk for breast cancer associated when residing on SI during puberty ( p<0.001) and length of residence on SI ( p< 0.001); [2] an increased risk for occupation (p<0.006); [3] no increased risk associated with socioecomic factors (poverty, p<0.786; education, p< 0.5467); and [4] no decreased risk with increased number of live births (parity, p< 0.46). All data were mapped using Geographic Information Systems (GIS). Learning Objectives: At the conclusion of the session, the participant (learner) will be able to identify cancer risk factors for urban populations due to environmental perturbations and discuss environmental justice issues. Female Breast Cancer - Deaths And Death Rates Per 100,000 Female Residents Source: 2003-2007 Vital Statistics Data As Of May, 2009 Adjusted Rates Are Age Adjusted to The 2000 United States Population http://www.nyhealth.gov/statistics/chac/cancer/ca_bre.htm RESULTS All of our analysis uses logistic regression on multiple random replicates and reports the median result. In this way we eliminate the biases associated with the matching procedure. Preliminary analysis using logistic regression demonstrated: [1] a statistically significant increase in the risk for breast cancer associated when residing on SI during puberty ( p<0.001) and length of residence on SI ( p<0.001); [2] an increased risk for occupation (p<0.006); [3] no increased risk with socioecomic factors (poverty, p<0.786; education, p<0.5467); and [4] no decreased risk with increased number of live births (parity, p< 0.46). CONCLUSION In an attempt to find out why Staten Island has higher breast cancer mortality and incidence rates than New York City, future work will include an analysis of female breast cancer cases and a set of controls who died between 1990 through 2006. Attention will be given to the proximity to the Fresh Kills garbage dump as well as other Superfund sites. Disparate impact will be examined across racial and socio-economic parameters in order to re-mediate past environmental injustices. METHODS Researchers at the Center for Environmental Science previously developed and validated the use of residence and occupation data from a combination of newspaper obituaries and death certificates. Death Certificate data for the calendar years 1980 through 1990 were obtained from the NYCDOHMH. Cases (female breast; ICD 174 n = 417) and controls (women who died from diseases other than cancer; n = 2771) were determined by NYCDOHMH. Life histories include: sex, age, date and place of birth, date of death, country of origin, religion, ethnicity, census tract, health area, zip code, number of live births, residential history and occupational history. Controls were assigned to cases by randomly matching to age (+ 1 year) and year of death (+ 3 years). All cases and controls were mapped using Geographic Information System [GIS]. A ratio of cases to controls was calculated for each 2 mile square. Where there was no street number, 99 was assigned. • ACKNOWLEDGEMENTS • This study was supported by: • New York State Special Legislative Grant (NYS 91041-00 01), sponsored by Senator Andrew Lanza • New York City Council Grant (NYC 58273-00 01) sponsored by New York City Council Speaker Christine Quinn, Councilman James Oddo, and Councilwoman Deborah Rose • Borough President James Molinaro • College of Staten Island • Private donations • The citizens of Staten Island