Introduction

This case study focuses on a childhood cancer cluster in Woburn, Massachusetts, a town 13 miles northwest of Boston. Between 1969 and 1986, twenty-one Woburn children were diagnosed with leukemia, and twelve died. Anne Anderson, the mother of one of these children, was the first to notice that too many children in her neighborhood were being diagnosed with leukemia. Since then, hazardous chemicals dumped by local industry, which subsequently contaminated the drinking water supply, have been linked with the excess incidences of cancer.

Throughout this case study, Woburn will be used as an example to illustrate how to find environmental and health data, and explain how rates of disease can be calculated to help answer the question: 'Is this community experiencing unusual health problems?' As you progress through the module, it is important to take time to review the various media elements as well as complete any activities (e.g. answering quiz questions).

Learning Objectives

After completing the module, the student should be able to:

• Describe sources of data used for disease surveillance.
• Identify and use multiple online resources providing information on hazardous waste sites in the United States.
• Identify multiple online resources providing information on hazardous substances.
• Identify and explain the key issues involved in human exposure assessment.
• Compute and interpret standardized incidence ratios.
• Compare and contrast legal and epidemiologic concepts of causation.
• Explain the impact of the Woburn case on surveillance systems, environmental policies and regulations.
• Indicate the challenges and potential benefits of community-based participatory research.
• Analyze the actions taken in the remediation of Wells G and H.
• Summarize several of the public health lessons learned from the cases in Woburn, MA.