Pity the Ohio Health Department. It's a government agency, which means that its records are public, which means that when it screws up, people find out.
ODH officials don't particularly like this; nor do most government officials, for that matter. But it's not wise to admit this: Under the doctrine of astute politics, one mustn't appear to be withholding information from the people one supposedly serves. So it's no wonder that when the ODH decided to exempt itself from public records laws, it opted for a Trojan Horse instead of a press conference. And there could be no better cover than a bill designed to fight bioterrorism.
Officially, the Bioterrorism Bill updates Ohio's archaic public-health laws for the Age of Anthrax, giving ODH permission to buy and store certain antibiotics, requiring pharmacists to report spikes in medication sales, and allowing the agency's director to call for quarantine when his board isn't available to do so. Nothing too controversial.
Slipped inside is the kicker: All records of public-health investigations must be sealed until the inquiry ends, the department director releases them, or a subpoena is served. In other words, the ODH can essentially hang onto its records for as long as it wants -- unless a court orders otherwise.
None of the usual watchdogs noticed the add-on -- not the ACLU, not environmental groups, perhaps not even the senators voting for it. Other than a cursory reference, it wasn't even mentioned during committee testimony.
The Ohio Senate passed it unanimously.
Then people actually read the thing.
When Teresa Mills, director of the Buckeye Environmental Network, first heard about it, she almost dropped the phone. "It's like the health department has taken martial law."
It means that if there's an E. coli outbreak in Medina, the department won't have to tell anyone.
If it finds a cluster of leukemia cases in Marysville, its files will be closed -- until the director decides otherwise.
"The way it's written, it allows them to keep any information they want secret," says Chris Link, director of the ACLU.
Jodi Govern, chief counsel for the health department, says the bill will protect the innocent -- say, restaurants falsely accused of food poisoning. The director won't hide outbreaks of smallpox or E. coli, she insists. Sure, it gives him the power to decide what to reveal, but he'll wield it wisely.
Besides, Govern notes, the Bioterrorism Bill, now pending in the House, is based on recommendations from the Centers for Disease Control.
But, she admits, the feds' model doesn't include concealing records. And when it comes to the Ohio Health Department, skepticism comes honestly.
Whether it's refusing to answer questions about cancer in East Liverpool, delaying a study of mysterious illnesses in Middlefield, or denying the dangers of combustible water in North Royalton -- even after the feds pronounced it highly hazardous -- the department has a history of stalling and stonewalling. In case after case, it's seemed more intent on covering up health problems than revealing them to the public.
And so it's hard to blame the department for trying to make public records private. When it comes to keeping secrets, stalling and stonewalling aren't always enough. Activists are pesky. Public records requests are annoying.
In a sense, the Bioterrorism Bill would simply legalize what the ODH has been trying to do all along.
The department's purported goal is "leading all Ohioans to achieve optimal health." That might come as a surprise to the people of East Liverpool.
The aging city sits on Ohio's southeastern edge, minutes from West Virginia and Pennsylvania. It was once the proud "Crockery Capital of the World," thanks to the presence of a host of pottery companies. Today, industry dominates. There's an oil refinery. A steel mill is three miles up the Ohio River. The Beaver Valley nuclear plant is just beyond that.
When Waste Technologies Industries announced plans to build a hazardous waste incinerator in the city, a large group of residents opposed it from the start. No wonder: The plant, the largest of its kind in the world, would burn 60,000 tons of toxic waste every year -- just 1,100 feet from East Elementary School.
"We'd already had some health problems here," says Alonzo Spencer, president of Save Our County. "We didn't want to exacerbate the situation by putting in the WTI plant."
Stopping WTI became a liberal crusade. Greenpeace came to town. Martin Sheen managed to get arrested there twice. As veep-elect, Al Gore promised to halt the permit process, then backpedaled once he got elected.
The permit was granted. The plant started to burn.
Ten years later, East Liverpool has abnormally high cancer rates. Lung cancer is especially rampant, says Robert Indian, ODH's chief of community health assessments. The city, however, has a "legacy of air pollution" and a high percentage of smokers, he says. ODH has no way of knowing whether the cancer was triggered by the plant's toxic spew, or was always there, he says.
Yet Indian had the chance to study the city's cancer rate before WTI's arrival. He passed.
Before WTI first fired up, residents begged the department to study the city's cancer rate. "We wanted some data, so we'd have something to compare it to today," Spencer says. "But they always came up with some excuse. There was always some reason not to do it."
That failure, he says, makes information about today's cancer rates practically worthless.
Of course, the state has long fumbled its monitoring of cancer -- and not just in East Liverpool. Ohio established a cancer registry in 1992; the feds supplied a $2 million grant to supplement state funding.
Doctors were required to report all new diagnoses. But the health department didn't get around to issuing its first report until 1996 -- and that looked solely at 1992 data. Doctors and local health commissioners who requested more information were denied. Even former Ohio EPA official Michele Morrone says her agency's requests for registry data were denied.
No court order could change that. The department had collected the data, but its leaders protested that it was too busy and too cash-poor to analyze it. Never mind that the department hadn't asked the state for additional funds.
A frustrated Governor Taft finally tried to give registry duties to Ohio State in 1999. The university and the department now share the registry and have issued reports regularly since.
Still, the department remains proficient at ignoring information requests, Spencer says.
At a meeting of the city's cancer task force last May, an East Liverpool mother said her 11-year-old daughter was dying of a bladder cancer so rare, it was the only reported case in the country.
Spencer immediately wondered whether the cancer was indeed so rare and whether it was linked to toxins from WTI. But despite repeated requests for information, Indian never responded. The girl died a few months later.
Indian now says he contacted the girl's mother directly. But talking to the task force about a personal health problem -- even when the mother raised it there first -- would violate patient confidentiality.
Spencer understands. "But why not tell us that?"
But Spencer shouldn't feel too bad. Even the state's top lawyer has had no success in getting the goods.
A fleet of agencies showed up for pollution testing at WTI in fall 2000, says Mark Gribben, spokesman for the Ohio attorney general. The AG's environmental unit was there; so were the EPA and the ODH.
The unit asked ODH for the results soon after, Gribben says. Indian told them the results were being analyzed. (Indian denies being involved.)
Three years later, the attorney general is still waiting.
When sick people ask for help, flat rejection can seem a tad unfeeling. Stalling works much better. It only becomes ominous when a pattern develops.
That's Ron and Laura Duncan's story. The couple lives in Middlefield, an industrial village in Geauga County. They long suspected that the area harbored abnormal rates of leukemia, autism, and neurological disorders, so they were excited when the county promised to ask ODH for a thorough study.
Excitement quickly turned to frustration. First the couple was told that the study would be ready by November 2001. Then the date was postponed to March 2002, and Indian said his study would only cover cancer. He professed to be unaware of concerns about autism and neurological problems. He now claims he never agreed to study Middlefield until June 2002 -- even though he twice discussed his plans with Scene prior to that date.
No matter. The Duncans figured they'd get cancer data first, then push for a second survey. But a year and a half after the original work was due, it still hasn't materialized.
Still, though the health department won't produce the data, it seems convinced that Middlefield doesn't have a problem. When an Akron activist recently wrote to the department, pushing for results, Director J. Nick Baird responded directly. "The reported 'cancer clusters' and 'extensive pollution' are largely based on speculation and are not currently substantiated by any kind of credible scientific study."
Well, yes. That's the point of conducting the study.
Rev. Werner Lange believes the delay is intentional. "They don't like the results, so they're trying to figure out how to fudge them," he suggests. "They're playing a paper game. They just wear you out. Either the cancer kills you, or the frustration will."
Consider Galion, a sleepy town of 12,000 in the farmland between Cleveland and Columbus. In 1982, the department began collecting names of multiple sclerosis patients there. Resident Irene Huguenin had identified nearly two dozen people with the disease in the small, industrial town. One was her son, Terry.
But ODH took its time. In 1985, it admitted to losing the paperwork; the study didn't get moving again for two years. Indian finally filed his report in 1991, nine years after the original request.
His conclusion: Galion didn't have an abnormal rate of multiple sclerosis, except under the most liberal guidelines.
Of course, Indian's research was somewhat skewed. By the time he got around to his study, some of the people Huguenin identified had already died. Among them was her son.
When stonewalling won't work and stalling gets old, there's always downplaying. That, Toni Temple says, is an art the health department has mastered.
Temple suffers from acute chemical sensitivity, a much-debated condition that makes her extremely susceptible to smells ranging from gasoline to scented deodorant. Hoping to escape the grit of the city, she bought a house on North Royalton's scenic Cady Road in 1994. Only after she started having dizzy attacks and blackouts did she realize her paradise was troubled.
The problem, Temple decided, was the well water. She used bottled water for everything but dishes and showering, but even that was enough to wreak havoc. Her tap water was milky and smelled of gas. If she held a match to the tap, it exploded in flame.
A little digging revealed a series of gas wells behind the houses. But everyone Temple contacted, from City Hall to the EPA, insisted that she not worry.
ODH even ran a battery of tests. Its conclusion: Everything was AOK. Based on that, North Royalton refused to connect the street to city water.
When her blackouts persisted, Temple again contacted ODH. They told her she'd been taken care of, according to records. "They kept saying it was all in my head," Temple says. "I don't know how I could make water burn, just by something in my head!"
Sick and annoyed, Temple abandoned Cady Road for Parma Heights. But she wouldn't shut up. It took years to get the federal Agency for Toxic Substances and Disease Registry to do its own tests. Its study, completed in August 2002, vindicated her.
"The combustible gas levels measured . . . at homes along Cady Road are hazardous and are present at explosive levels," the agency concluded. "A fire and explosion hazard exists for any enclosed area in which private well water is used."
Possible side effects: dizziness, headaches, nausea, and fatigue.
Nonetheless, Bob Frey, ODH's chief of health assessments, still stands by his department's findings. "Residents there have been living with this for 20 or 30 years," he says. "Outside of Ms. Temple, most of the residents don't seem to have any concerns."
Urgent health hazard solved.
When lines are drawn between health and business interests, ODH can always be counted on to side with the latter. In its eyes, no industry causes serious contamination. No lawsuit is ever valid. And there is no such thing as a conspiracy.
Take the leukemia cluster at Marion County's River Valley High School. In 1997, parents identified numerous graduates with leukemia. The school had been built on an old military depot; parents fretted over a possible connection.
It was hard to blame them. EPA tests revealed toxic chemicals onsite, including trichloroethylene (TCE) and its byproduct, vinyl chloride. TCE can damage the nerves and liver; vinyl chloride causes cancer. The army had dumped them in the area now used for River Valley's playing fields.
ODH did three studies, finally concluding that graduates suffered leukemia at three times the normal level.
Indian's final study, released September 2001, said the common denominator was "tobacco exposure." Never mind that he doesn't assert that Marion has an abnormally high percentage of smokers. And never mind that the majority of River Valley alumni with leukemia had played or worked on the contaminated fields.
Indian saw no link. His conclusion: "Continued study of leukemia among Marion County residents and RVHS graduates is unlikely to identify additional factors that will explain the leukemia in these populations."
Except . . .
Bruce Molholt, a toxicologist and part-time professor at the Institute for Environmental Studies at the University of Pennsylvania, reviewed Indian's reports at the request of residents. He found serious problems with Indian's research.
Though only 40 percent of alumni responded to his survey, Indian originally treated the data as if it included the entire alumni pool -- thus comparing apples to oranges, making the number of leukemia patients far less significant.
When Molholt pressed him, Indian was "defensive," he says, arguing that leukemia victims were more likely to respond than healthy grads. Yes, Molholt agreed -- but they were also more likely to have died.
And despite Indian's conclusion that the River Valley leukemia cluster couldn't be explained, Molholt thought Indian's own data explained it just fine. The data showed that River Valley leukemia patients tended to be much younger than leukemia patients elsewhere in the county; they were also much less likely to have smoked.
What they showed, Molholt says, was exposure to the contaminated fields. ODH's conclusion should have been obvious.
"I think they knew what was going on, but they had to hide their heads in the sand," Molholt says. "And it isn't just ODH. You get this with the Agency for Toxic Substances and Disease Registry, too. I've read 200 of these studies. In only two have they 'found a problem.'"
Indian rejects the criticism. "It's not unusual for scientists to disagree on information like that. Nobody likes to find a link more than me. If there was one, I'd be the first in line to make it."
Still, the department often seems hell-bent on doing just the opposite. Even when it confirms a high rate of disease, it's none too eager to investigate its cause.
By 1999, Sally Giar, a Wellington woman with multiple sclerosis, had found 22 people afflicted with the same disease who had either lived or grown up in the town of 4,200.
The Lorain County Health Department's count was even larger. It documented 24 cases, and that didn't include those who had moved or died.
The number, ODH confirmed, was five times the expected rate.
Giar suspects a link to the Sterling Foundry. The now-closed plant sits just across Prospect Street from the biggest cluster of victims. There's an eight-acre landfill onsite; the foundry never got a permit for it, according to EPA records.
When the feds supplied a grant to study Wellington's cluster, Giar wanted Prospect's soil tested for contamination.
Instead, ODH officials decided to survey the entire county, though there was no indication of unusual multiple sclerosis rates anywhere but Wellington. The study won't even examine the issue of soil contamination or look for possible links.
"I say, 'That's not going to do anything for the people in Wellington,'" says Giar. "We go around and around. But I'm the voice crying in the wilderness over here."
The study was originally slated for August 2002. Giar is still waiting.
Department critics say there's a pattern here: If there's a problem, ODH won't find it. If someone else does, the last thing it wants to do is follow up.
So it's hard to blame the women of Kiwanis Lake for their suspicions. They're new to the game, but they catch on quickly.
Their effort started two years ago, when Angie Grysho was getting chemotherapy. A fellow patient stopped by her bed and begged her to listen.
He, too, was from Kiwanis Lake, a cluster of 151 homes in Geauga County. He, too, had cancer, and he was convinced the community had too many cancer cases. "Please do something about this," he begged.
The man died soon after, and Grysho, who is now in remission, took up his cause. She documented 142 cancer patients who'd lived at Kiwanis Lake in the last 20 years.
She also discovered horrifying Ohio EPA records. For three decades, residents griped to the state about Manfredi Motor Transit. They suspected the company was dumping toxic chemicals nearby. But requests of residents who asked ODH to test their wells were denied.
"There have been no additional reports of similar health problems to those that you and your family are experiencing," a department worker wrote in 1983. "I cannot justify chemical testing at this time."
At the same time, the Ohio EPA already knew that Manfredi had buried two fluid-filled tankers on land adjoining the neighborhood, according to records. One chemical engineer on staff was quoted in files saying, "In my entire career, I have never seen anything as dangerous as this."
The site was marked "medium" priority. Nobody did much of anything.
Grysho has a cheerleader's energy and a nun's sternness. Her pleas for help from township leaders led to coverage by a local paper; FOX-8 and WKYC were only too happy to run with the story.
And that -- not the tankers they'd always known about, not their own engineer calling it dangerous -- got the state's attention. Grysho was delighted when the Geauga County Health Department promised a thorough study, the EPA vowed to clean up the tankers, and, last fall, ODH promised to share its cancer data.
On the first two counts, she remains optimistic. But, as for cancer data, Grysho and her fellow activists are convinced ODH is studying the wrong thing.
They believe cancer cases spiked in the late '80s. But Indian's study is designed to look only at diagnoses made in the last four years and only at current residents.
"I think it's just a waste of time and money," says Cindy Chambers, a lifelong resident.
Indian's response is always that environmental health studies are difficult. Most cancers are due to lifestyle, not the factory down the block.
Nor are 200 cases of cancer an epidemic in a town of 2,000, no matter how awful it seems. Two out of five people will get cancer in their lifetimes, Indian says.
But Kiwanis Lake has just 151 homes. The residents keep track of neighbors, even those who leave. It shouldn't be too difficult to go door to door -- or to document patients from the last 20 years who have since moved away or died.
"We've got agencies that we pay that are supposed to take care of this," Grysho says. "I would suggest that any agency so busy covering their behind with two hands certainly can't reach out to help anybody."
In the month since the Senate's unanimous vote, criticism of the Bioterrorism Bill has multiplied. Environmental groups plan to lobby. Ohio Citizen Action will canvass the district of the bill's House sponsor, Republican Steve Stivers, explaining to his suburban Columbus constituents why it's a bad thing.
Battles over public records tend to inflame the media, but draw little passion from the average Joe. Catherine Turcer, an Ohio Citizen Action staffer, thinks this is different. "I would imagine this would get people's attention. You want to protect yourself and protect your family."
The best argument against ODH's power grab is its own record.
"Even when they didn't have a legal shield, the Ohio Health Department still has refused to inform the public of what people are being exposed to," says Mike Griffith, a Marion parent. "And they refused to reach the conclusions that are right in front of their face.
"If they get to wait to release any information until they have a definitive 'guilty,' how many people are they going to continue to expose to the problem?" Griffith asks. "An informed public keeps the casualties reduced."
In Marion, they learned that lesson the hard way. Griffith only hopes the rest of Ohio won't need to do the same.