Sludge Watch ==> Milwaukee - Kids' illnesses raise red flag re discharged sewage

[maureen.reilly at sympatico.ca]

   Sludgewatch Admin:

Problems seem to be related to discharging 'blended sewage'.  Making 
Milorganite is the a very expensive way to dispose of Milkwaukee's sludge.  
Maybe if Milwaulkee spent less money on making sludge 'fertilizer' there 
would be more money for proper sewage treatment.  City staff want to suggest 
work done in Children's Hospital is lacking integrity!

.....................................................................

http://www.jsonline.com/story/index.aspx?id=419926

Kids’ illnesses raise ‘red flag’
But MMSD rips study that suggests link to discharged sewage

By MARIE ROHDE and SUSANNE RUST

mrohde at journalsentinel.com
Posted: April 30, 2006

A study presented Sunday at a national gathering of pediatric professionals 
raises a "red flag" about whether there is a connection between the dumping 
of partially treated wastewater into Lake Michigan and what researchers say 
is an increase in emergency room visits by children suffering from 
gastrointestinal illnesss.

There currently is no evidence of drinking water quality degradation at 
Milwaukee Water Works treatment plants as a result of secondary sewage 
bypasses at the wastewater treatment
plant.

- Bevan Baker,
Milwaukees health commissioner

We only found an association. We cant show a cause-and-effect relationship, 
but we think its worth further exploration.

- Marc Gorelick,
Senior author of study and head of Childrens Hospital emergency department



Officials at the Milwaukee Metropolitan Sewerage District hotly disputed the 
study, calling it flawed both in methodology and what they called a conflict 
of interest.

The study, which was presented at a gathering of the Pediatric Academic 
Societies in San Francisco, was conducted by researchers at Children's 
Hospital of Wisconsin, the Medical College of Wisconsin and Friends of 
Milwaukee's Rivers.

The authors were cautious in their conclusions and said their results 
warrant further investigation into the possible health consequences of 
discharging partially treated sewage into the lake.

"We only found an association," said Marc Gorelick, the senior author on the 
study and the medical director of emergency services at Children's Hospital.

"We can't show a cause-and-effect relationship, but we think it's worth 
further exploration," said Gorelick, also a professor of medicine at the 
Medical College.

Critics of the study are concerned about what they see as conflicts of 
interest.

One of the authors is Cheryl Nenn, a project director at the Friends of 
Milwaukee's Rivers - an environmental watchdog group - and Gorelick is 
married to Lynn Broaddus, the executive director of the group.

But the authors denied the association had an effect on how they approached 
or analyzed the study, a denial that didn't assuage the critics' concerns.

"They really don't have a clue what caused these cases of diarrhea," said 
Bill Graffin, a spokesman for the sewerage district.

Meanwhile, representatives of the Milwaukee Health Department and the 
Milwaukee Water Works were quick to say that the city's drinking water is 
safe.

"There currently is no evidence of drinking water quality degradation at 
Milwaukee Water Works treatment plants as a result of secondary sewage 
bypasses at the wastewater treatment plant," Bevan Baker, Milwaukee's health 
commissioner, wrote to Journal Sentinel editors.

The authors reiterated that their conclusions raised a "red flag."

They stressed they didn't know what was causing the children to become ill, 
only that there was an association between these secondary sewage bypasses 
and an increase in emergency room visits by children.

The study, which was conducted over a three-year period starting Jan.1, 
2002, and ending Dec. 31, 2004, focused on six episodes in which partially 
treated effluent was discharged into the lake. The authors looked at ER 
admissions records from Children's Hospital in the three to seven days after 
these events.

After two of the six events, Dec. 10, 2003, and May 14, 2004, they found a 
statistically significant increase - around 2.5 patients per day - in the 
number of ER admissions for diarrhea.

The authors said while that may not sound like a lot, it was a significant 
increase and couldn't be accounted for by season or rainfall - two variables 
they controlled for in the study.

These two were the largest of the six discharges, indicating that if the 
children did get sick from drinking tap water, the quantity of the blended 
sewage could have played a role.

In addition, visits to the emergency room were tallied by ZIP code, 
separating children living within the Lake Michigan drinking water area from 
those living outside. There was a significant increase only in visits by 
children living in areas where the drinking water came from Lake Michigan.

The children ranged in age from younger than 1 to 18, the authors said.

The authors cited several limitations to their study: They did not take 
bacterial or viral cultures of the children, so they do not know precisely 
what caused the illness, nor could they determine if children had used 
bottled water or come in contact with water during recreation.

Despite the limitations, Marty Kanarek, professor of population health 
studies at the University of Wisconsin-Madison, said the study warranted 
further investigation. He was not connected to the study.

Milwaukee Health Department officials agreed that more study is needed.

"The authors' specific conclusion that further study should occur to 
investigate if a secondary bypass event may have human health effects can be 
supported by public health," wrote Baker in his letter to the newspaper. 
However, he stressed that such a study must be "rigorously designed" to 
control for "confounding variables" that are inherent in studies that 
"explore correlations between environmental exposures and human health 
outcomes."

The study is the latest episode in a longstanding debate over the practice 
known as "blending," a process that allows sewage to skip one of the steps 
in the treatment process as long as some state standards for the effluent 
are met, something district officials say they have always achieved.

The Environmental Protection Agency withdrew a proposed policy in May 2005 
that would have liberalized use of the procedure across the country. The 
move came just before Congress withdrew money for its implementation and 
after more than 95,000 comments - most opposed, said Kevin Weiss, a chemical 
engineer with EPA's wastewater permits division in Washington D.C.

Weiss said a new proposal that would require that wastewater treatment 
plants show that there was "no feasible alternative" to blending is expected 
to be implemented this summer. The alternative was supported by both 
environmentalists and the association that represents treatment plants.

The state Department of Natural Resources allows the district to dump up to 
60 million gallons a day of partially treated sewage at the Jones Island 
Wastewater Treatment Plant during heavy storms. "We know sewage - 
particularly poorly treated sewage - carries with it large concentrations of 
waterborne pathogens," said Joan Rose, a microbiologist at Michigan State 
University who has done research for the Natural Resources Defense Council. 
"It is quite clear that large outbreaks occur when sewage impacts 
recreational or drinking water systems."

Paul Biedrzycki, the Health Department's manager of disease control and 
prevention, said workers at the treatment plant collect samples during most 
blending events. His department then tests for Cryptosporidia and Giardia in 
its own lab. On May 1, 2003, they found Cryptosporidia and Giardia. On four 
other occasions, they found Giardia.

In 1993, about 403,000 Milwaukeeans were sickened and 100 died during an 
outbreak of disease caused by Cryptosporidia, the largest outbreak of 
waterborne disease in U.S. history. While the cause of the outbreak has not 
been definitively determined, a large amount of melting snow and the dumping 
of untreated sewage were suspected. The intake pipe for the water that went 
through the Howard Ave. water treatment plant was located in the plume of 
the Milwaukee River that contained discharges from the Jones Island 
Treatment Plant.

The intake pipe was later moved 1.25 miles farther out into Lake Michigan, 
and many improvements were made at the water plants.

But little is known about how to destroy some viruses, the largest 
contributor to gastrointestinal illnesses, said the study authors.

Biedrzycki said his department would support further study of the impact of 
blending, and while the preliminary study conclusions are "gentle and 
well-placed," the hypothesis is "somewhat spurious and misleading."

Michael McCabe, the top lawyer for the sewage district, was harsher in his 
criticism.

"They made no connection between the blending and the disease," McCabe said. 
"That is the case because they don't know the cause of the outbreak."

McCabe said the Children's Hospital researchers "falsely stated" that the 
blended sewage was under-treated, because the effluent met the standards set 
in the district's permit. He said preliminary treatment of blended sewage 
removes 60% to 70% of the contaminants; the second step, the one skipped in 
blending, brings that to 85% to 90%.

In any case, McCabe said the district was conducting its own study in 
collaboration with Water Environment Research Foundation to study the effect 
of blending. The foundation is a subscriber organization funded by 
utilities, government agencies, equipment manufacturers and industrial 
organizations, according to its Web site. McCabe said the district study 
would not have the same conflict of interest concerns as the Children's 
Hospital study because the water foundation is a "highly respected research 
foundation."