Pulmonary Paradox Did environmental factors contribute to deaths on Louis Lane? BY KERA ABRAHAM Three men living on the same street in southwest Eugene developed pulmonary fibrosis within five years of one another. They died in rapid succession between April 2005 and February 2006. All were between 70 and 80 years old. None was a smoker. Was this coincidence? Or could there be a common cause to their symptoms? "This is an impossible problem," said Grier Starr bluntly, stretched out on a cot in his home, wearing pajamas and wire-rimmed glasses, hit feet bare, oxygen tubes in his nose. Starr, a pathologist and former CEO of the Oregon Medical Labs, spoke with EW on Jan. 23, about a month before his death at age 79 from pulmonary fibrosis. His neighbor, former UO professor William Mitchell, 80, had passed away from the same condition two weeks earlier, on Jan. 12. Another neighbor, former UO business professor Kenneth Ramsing, 70, died of the disease on April 27, 2005. Ginny and Grier Starr Starr and his wife, Ginny, lived at 2455 S. Louis Lane for 41 years. Mitchell lived next door, at 2450 S. Louis Lane, for 8 years. Ramsing lived at 2280 S. Louis Lane for 33 years. All were diagnosed with pulmonary fibrosis between 2000 and 2003. Starr, speaking as a pathologist as well as a patient, identified a number of possible causes for his disease, but stressed that he was unable to draw any firm conclusions.   Pesticides. Several orchards and a Christmas tree farm were established on S. Louis Lane around 1909, and pesticides may have been sprayed on them from the 1950s on. While most of the historic orchards have now been developed, some remnants remain. The Starrs had a small orchard in their own backyard, and Grier sprayed them with Agent Seven every spring. He also sprayed Roundup and other herbicides on yard weeds. Starr said he often sprayed with Ramsing, who was his close friend. "It would blow from the sprayer across our faces," Starr recalled. It's unclear whether the third pulmonary fibrosis victim, Mitchell, was regularly exposed to pesticides. Mitchell's sister, Jeanine Watts of Iron River, Mich., said that he didn't do much yard work. Arsenic. Well testing around S. Louis Lane reveals a high concentration of naturally occurring arsenic. In 1974, Starr and others did a study which concluded that that a "hockey-stick-shaped piece of land" in southwest Eugene, including most of S. Louis Lane and Twin Oaks Elementary School, is contaminated by sulphurous arsenic, which has been linked with skin cancer. Starr's study found higher-than-usual instances of melanoma within the contaminated region. The Starrs drank well water for about six years before hooking up to the municipal water system in 1965, but both Mitchell and Ramsing's homes were already connected to city water by the time they moved in. HealthUSA.com links pulmonary fibrosis with arsenic exposure, but pulmonary fibrosis experts Dr. Norman Edelman of the American Lung Association and Dr. Ganesh Raghu of the University of Washington Medical Center said they know of no such link.   Moldy hay. Starr raised horses and cattle for about 35 years, frequently breathing in the dust from moldy hay. According to Dr. Edelman, some people are allergic to certain proteins in moldy hay, which may cause a form of pneumonia that can progress to pulmonary fibrosis. Local allergist Craig Jacobson, who worked with Starr to investigate the link between moldy hay and pulmonary fibrosis, said that perhaps a site-specific kind of mold — one more likely to cause the disease — grows on the hay in southwest Eugene. "But the other men [Mitchell and Ramsing] weren't necessarily exposed to that," Jacobson pointed out. Ramsing may have handled hay infrequently for garden mulching, according to his son, Stuart Ramsing of Eugene. But Mitchell hasn't handled hay since he lived on his family's farm as a youth, said Mitchell's sister Watts.   Welding. Both Starr and Ramsing did some art welding as a hobby. According to Dr. Edelman, silica dust from welding has been linked with pulmonary fibrosis. But Mitchell didn't do any welding, Watts said.   Air pollution. The Hynix semiconductor plant at 1830 Willow Creek Circle is just down the road from S. Louis Lane. Although the factory emits more than 50 toxic chemicals annually, none of its listed emissions have been linked to pulmonary fibrosis. According to LRAPA Public Affairs Officer Sally Markos, other industrial air pollution sources in the area include the Western Structure laminated beam plant, Rexius Forest By-Products, a crematorium, a cabinet-makers' workshop and a coffee roaster. Because LRAPA does not maintain emissions inventories for those industries, Markos could not provide greater detail about their specific emissions.   "I have identified to you a significant number of possible sources for products that some individuals could be immunologically responsive to," Starr said, in typical pathologists' language. "I am indicating to you a tremendous number of etiologies for this particular disease." Pulmonary fibrosis is characterized by the production of a fibrous tissue that replaces the air spaces between a patient's lungs. Starr was diagnosed with idiopathic pulmonary fibrosis, which means that its causes are unknown. Pulmonary fibrosis can be mild, and some patients can live with the conditions for decades, but there is no cure other than a lung transplant, Dr. Edelman explained. Dr. Edelman said that while pulmonary fibrosis may be linked with air pollution, welding fumes and moldy hay, he is not aware of such links with arsenic or pesticide exposure. Still, he wouldn't rule out the possibilities. "The list of causes of pulmonary fibrosis is very long. More often than not, doctors cannot assign a cause," he said. "Having three [cases] on one block is a little unusual, but I'm sure statisticians will tell you it's well within the realms of chance." Dr. Raghu, like Dr. Edelman, stressed that doctors are unable to pinpoint any specific environmental factors causing idiopathic pulmonary fibrosis. That said, he acknowledged that pesticides, moldy hay, welding fumes and air pollution may all contribute to symptoms of the disease. "Respiratory symptoms are so non-specific," he said. "Any potential irritants in the environment that people inhale could potentially cause the symptoms." Despite his caution to not draw overbroad or alarming conclusions, Raghu said that the fact that three non-smoking neighbors all died of pulmonary fibrosis does merit follow-up. "Three people on the same street — that is a very interesting, intriguing coincidence," he said. "That means that there are environmental factors that should be looked into, or at least associations that are worth exploring."   In fall 2000, the Starrs moved off S. Louis Lane and into east Eugene. During EW's interview with Starr in January, he was weak but cogent and extremely pragmatic. "Number one, I accept the science," he said slowly. "I come from a religious family, and I accept a certain inevitability of what is happening. My main concern is that I go through the process without an extreme amount of pain." When Starr passed away in late February, the community remembered him as a brilliant pathologist, an ardent lover of horses and family and a good friend. But the question of what gave him, Ramsing and Mitchell pulmonary fibrosis remains unanswered. "There's a lot of intrigue and mystery here regarding what might have happened on Louis Lane," said Jacobson, the allergist. "We can conjecture about a lot of things, but there are certainly no firm conclusions that we can draw. Starr, an exceptionally brilliant person with access to all sorts of information, was searching [for the cause of his disease], but he was frustrated that we didn't come up with an answer."
		Table of Contents | News | Views | Calendar| Film | Music | Culture | Classifieds | Personals | Contact | EW Archive | Advertising Information | Current Issue |