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What's Killing the Babies of Kettleman City?

Maybe it's the toxic waste dump. Maybe the pesticides, or the diesel fumes, or the arsenic. How a small-town mystery could change the way we look at pollution.

THE TROUBLE IS that science is not likely to back them up. To find a chemical culprit for the birth defects would require not just identifying substances in the air, water, or soil that are capable of causing such defects, but also tracing their pathway to townspeople's bodies. The odds of achieving either are low. For one thing, Kettleman City isn't big enough to support meaningful epidemiological statistics. Scientists know relatively little about how individual chemicals affect health, and next to nothing about their effects in combination. Kettleman City exists within such a thick chemical soup that it would be hard to identify an individual substance as the culprit—and the precise combination of exposures could be different for each family. Dr. Rick Kreutzer, who heads California's Division of Environmental and Occupational Disease Control, says that even though the most common defect is a cleft palate, the differences in the other defects indicate that there is no single cause. "We don't really expect that we're going to find that one big thing," he says.

Even more confounding, clusters—of birth defects, cancers, and other health problems—are not necessarily evidence of environmental harm. Richard Jackson, chairman of the environmental health sciences department at the University of California-Los Angeles and a leader in the creation of California's first birth-defect monitoring program, says "hard-learned experience" has taught him that "clusters are a statistical inevitability...If you throw a bunch of beans on a tile floor, some tiles are going to have five beans, and a bunch of them are going to have none." Kettleman City's accumulation of birth defects could be the result of nothing more than chance—though that possibility dwindles with each new case. Heredity, diet, and lifestyle could also play a part.

The I-5 Kettleman City exit, about halfway between LA and San Francisco The I-5 Kettleman City exit, about halfway between LA and San Francisco.

In the face of all this uncertainty, some scientists are arguing for a new approach to environmentally vulnerable areas called "cumulative impacts." They maintain that since chemical-by-chemical health studies don't reflect real-world circumstances, it makes sense to think more broadly, taking into account everything from polluted air and water to poverty, poor health care, and proximity to hazardous facilities.

"We think of biology more as a network now," says Amy D. Kyle, a University of California-Berkeley public health researcher and cumulative-impacts advocate. "There are lots of things going in your body at the same time, things get turned on and off, they can be interfered with to varying degrees by different chemical stressors. It's not like a road from A to B—it's more like traffic. If you have a crash, it doesn't stop all traffic. The whole system readjusts itself in ways that aren't linear. [In biology], the outcome depends on what else is going on—how old you are and what your other susceptibilities are, and the likelihood that multiple things can perturb these same pathways is greater than what we thought."

Magdalena Romero's daughter Alondra, 6 (second from left), with friends. Magdalena Romero's daughter Alondra, 6 (second from left), with friends.

What this means for scientists and regulators, Kyle says, is that "we ought to think about more than one environmental factor at a time. That's different from the current paradigm, [where] policies are addressed at one pollutant at a time. When you get out into communities and you look around, and you see hazardous wastes, less health care, lead paint in their houses, you can't really think that that collection of environmental factors and [individual] sensitivities don't often matter. It's not really scientifically believable."

Rachel Morello-Frosch, an environmental health researcher at UC-Berkeley, calls Kettleman City "a poster child for cumulative impacts" because residents' health is compromised in so many ways. "Waste Management needs to be aware that its operations are adding to an already burdened community," she says. "The facility can't just pretend it's operating in a vacuum."

Tanks outside town hold the oil extracted in the Kettleman Hills. Tanks outside town hold the oil extracted in the Kettleman Hills.

In the absence of a cumulative-impacts analysis—something that has yet to be attempted by any regulator anywhere in the US—Kettleman City is now the subject of a state-run epidemiological investigation (PDF), almost certainly a bittersweet accomplishment. The likeliest outcome—continued uncertainty about the birth defects' cause—could in fact help Waste Management by reinforcing its contention that no harm from the dump has been shown.

Jackson concedes that in Kettleman City, where "there's no way the public will be satisfied without a serious investigation," an epidemiological study is required—but that doesn't mean it will have any meaningful impact. "Communities are often led to believe that a scientific investigation will lead to some answers," Jackson says. "But my own experience is that oftentimes an enormous amount of resources is put into an investigation, and at the end of it we really don't know much more than we did at the beginning, except that we now know the residents have terrible medical care, terrible dental care, the kids are way behind in school, they're way behind in immunizations and nutrition." In some ways, he argues, spending money "to give them an epidemiological study rather than care is really not the right thing to do."

Because their tap water contains arsenic and benzene, most families rely on bottled water. Because their tap water contains arsenic and benzene, most families rely on bottled water.

Yet even if the study does not identify a culprit, the attention on Kettleman City still may yield benefits, such as the increasing likelihood that the federal government will fund a water-treatment plant for the town. And the federal investigation of the Waste Management dump may yet lead to tighter monitoring of the facility; this spring, the probe turned up violations (PDF) in handling PCBs. In response to the revelations, Waste Management issued a press release asserting that the chemicals were at "very low levels" and that "the health and safety of Kettleman City residents...are our highest priority." (The company says the contamination has since been cleaned up.)

But try telling that to 26-year-old Maura Alatorre, whose second child, Emmanuel, was born in May 2008 with numerous problems, including a cleft lip and an enlarged head. Surgery corrected some of the problems, but he continues to have allergies so severe that his doctor prescribed medication usually reserved for older children. He's had a seizure, and his parents have been told to expect many more because of his most serious problem, a defect in his corpus callosum—a vital portion of the brain that orchestrates communication between its two hemispheres. Emmanuel's right side lags behind his left, and he is likely to face intellectual deficiencies as he grows. Despite all this, he looks lively and curious and has clearly overcome some of his maladies. "God has made a miracle of my child," Maura says, sitting on her living room sofa with a smiling Emmanuel on her lap, "but I don't want to take the risk of having another one."

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