Pediatrician rebuffs colleague's letter on Titan Cement's impact

In the Oct. 30 edition, my colleague Dr. Dennis Nicks published a letter entitled, “In letter to medical society, doctor questions Titan opposition.” This letter, modified from a version he sent to members of the New Hanover-Pender County Medical Society, is riddled with errors both factual and conceptual. Having lectured to both the Medical Society and the North Carolina Pediatrics Society on this issue, I would like to respond to some of his assertions. Let’s start with the facts.

Earlier this year the New Hanover-Pender County Medical Society held a meeting at which members and representatives from Titan were invited to speak. I was among the presenters, along with fellow pediatrician Dr. Edgar Horger and former environmental consultant Dr. Bob Parr.

Carolinas Cement declined multiple invitations to present their side of the issue. Likewise the Medical Society offered Carolinas Cement a table at the CME by the Sea conference in October, where I spoke on the medical implications of air pollution. Again they declined the invitation.
Now for the conceptual errors. First, Dr. Nicks states, “We are physicians, not experts on mercury emissions.” Actually, many physicians are experts on mercury emissions. While mercury toxicity is not a major issue in Dr. Nicks’s field of plastic surgery, general pediatricians must be versed in the toxicology of mercury and air pollutants to do our jobs.

Dr. Nicks compares the bulk methyl mercury emissions from cement plants to the microscopic quantities of ethyl mercury found
in vaccines until 2002. This is like suggesting we shouldn’t be afraid of great white sharks since we’ve never had a problem with our pet goldfish.

Second, Dr. Nicks suggests that since the Ideal Cement plant appeared to cause, “no jump in cancer rates or conditions related to mercury poisoning,” we should be reassured about the health risks of the proposed Titan plant. The Titan plant is a much larger operation than Ideal ever was, so he’s not comparing apples to apples, he’s comparing currants to watermelons. More importantly, no agency has collected the population-based data to back up Nicks’s assertion. We may have seen a very significant spike in cancer rates and mercury toxicity related to the operation of the Ideal plant. We simply don’t know.

Third, Dr. Nicks asserts, “Scientists with the EPA and the North Carolina Department of Environment and Natural Resources (DENR) are much more qualified than any of us to assess Carolinas Cement’s impact on our community.” There are several problems with this statement, but I’ll keep it short.

Since Carolinas Cement has gone to pains to avoid review under the State Environmental Protection Act (SEPA), no expert has the job of measuring the collective impact of Titan’s pollution on our environment. Instead, we have a classic “blind men and the elephant” situation, where various agencies look at disparate elements, but no one sees the whole animal.

Additionally, EPA regulations lag far behind our current medical understanding of the environmental risks that this plant poses. Air quality standards under the Clean Air Act were last revised in 1997.

In 2002, 146 million Americans lived in communities that failed to meet these standards. In the last decade, we have learned that levels of air pollutants allowed under the act are much higher than the levels we know make children and adults sick, and even kill them.

We have also learned about new toxic air pollutants not addressed at all by the Clean Air Act. I am surprised Dr. Nicks or most readers of this paper would put such complete trust in the federal government to protect their personal interests.

Finally, Dr. Nicks suggests that we should support any and all economic development in the region in the name of creating jobs. As a small business owner, I want all the jobs this community can get. But at least one economic model of the proposed Titan plant demonstrates the costs to this community will far outweigh the benefits.

As a doctor who has studied the relevant literature, I can state unequivocally and without exaggeration that pollution from this plant will kill some people, hospitalize many more, and cause illness in children who otherwise would have been healthy.

I join my voice with those of hundreds of my pro-development, business-owning colleagues when I say this price is far too high for ourselves and our children to pay. The proposed Titan Cement plant is bad for business and horrible for health.

Dr. David L. Hill is vice president of Cape Fear Pediatrics and an adjunct assistant professor of pediatrics at the University of North Carolina Medical School. He is also on the executive committee of the North Carolina Pediatric Society.