Polycythemia vera and the Links to Radon and Radium (Pennsylvania Case Study)

Brian Oram, Licensed Professional Geologist
Featured Water Professional

Polycythemia vera is a rare blood disorder in which there is an increase in all blood cells, particularly red blood cells, which makes the blood thicker. This can lead to strokes or tissue and organ damage. Polycythemia vera (PV) is caused by a genetic change (mutation) that develops during your lifetime; it is not an inherited genetic disorder. It occurs more often in men than women, and is rare in patients under age 40.

In most cases it is not known why this happens, but the Agency for Toxic Substances and Disease Registry (ATSDR) has suggested there may be a link to Radon and Radium in drinking water and the environment since the radiation from these radioactive elements can cause mutations.  

Some of the symptoms most commonly associated with Polycythemia vera (PV)  are itchy skin (often after a hot bath), gout (arthritis), numbness, and high blood pressure.   In addition, the individual may show symptoms associated with other blood disorders or health problems such as:  lack of energy (fatigue) or weakness, headaches, dizziness, shortness of breath, visual disturbances, nose bleeds, bleeding gums, heavy menstrual periods, and bruising.  

The diagnosis for polycythemia vera will likely be based on a combination of blood testing, bone marrow biopsy, and DNA testing.  If you have PV, blood tests may have the following properties:  Elevated levels of iron, red blood cells or platelets higher than normal, and an increase in white blood cells.

Always see your healthcare provider for a diagnosis (Source).

Treatment may include:

Phlebotomy - removes blood from your body. 

(Thought – I wonder if this is why leeches became a medical practice used by the Greeks . Also, did you know that leeches and maggots are still used in modern medicine? See Discover Magazine Article

Certain medicines, including chemotherapy. These are medicines that help to stop your bone marrow from making too many blood cells and help to maintain proper blood flow.

Northeastern Pennsylvania Connection (Community)

Cases of Polycythemia vera were discovered on Ben Titus Road, Rush Township, Schuylkill County by the Keystone Clean Water Team, formerly the Carbon County Groundwater Guardians, who made their findings public at a press conference on June 2, 2004 at the Quakake Volunteer Fire Co, Tamanend Road, Quakake. The “Polycythemia vera” articles provide a chronology of events as documented by the media.  Media articles are from 2004 Articles, 2005 Articles, 2006 Articles, 2007 Articles, 2008 Articles, 2009 Articles and 2010 Articles.

In 2014, the ATSDR found elevated Levels of radon gas, radium in their Polycythemia Vera (PV) Study Area in Pennsylvania. According to a 2022 ATSDR release, some homes in Carbon, Luzerne, and Schulykill counties, Pennsylvania, also had elevated levels of indoor radon gas and radium in soils. Researchers were unable to determine if a cluster of cases of PV in people living in the counties is related to exposures to those radioactive elements.

This recent report provides an analysis of radiologic sampling information researchers reviewed to learn more about the possible cluster of PV cases in northeastern Pennsylvania. 

“Based on analysis of the samples, ATSDR considers the exposures to radon gas in indoor air at these homes to be of public health concern and encourages residents living in the study area to have their homes tested,” said Lora Werner, Director, ATSDR Region III. “The elevated levels of radium in soils are not considered to be a health risk, but may be worthy of further study.”

At the request of ATSDR, the Pennsylvania Department of Environmental Protection (PADEP) collected and analyzed environmental samples within the tri-county area and ATSDR evaluated the possible health effects of exposure to the radiological elements in the samples.

The ATSDR report also found:
  • Some houses in the study area had elevated levels of radon gas in indoor air. Radon gas was also found in the private well water of some homes.
  • Soils from the study area had slightly elevated levels of radium.
  • Without additional information, ATSDR cannot determine if the cluster of cases of PV disease in the tri-county area is related to the radiological exposures observed in the environmental sampling information.

This report is part of a larger investigation of the cluster of cases of PV in northeast Pennsylvania. Overall, there are 18 projects in four areas for investigation: epidemiology, genetics, toxicology, and environmental analysis. The findings of these projects will provide information about PV and other blood disorders, as well as share information on environmental investigations in the study area.

ATSDR recommends:
  • All residents in the study area should have their homes tested for radon gas. Houses with elevated radon levels should be retested. If a home is retested and elevated radon levels continue, residents should contact the state of Pennsylvania radon program hotline at 1-800-237-2366 and request additional information on how to reduce the radon levels in their home.
  • People in homes with high levels of radon in their drinking water should contact the PADEP Radon Program for assistance. Home water supplies can be treated to reduce radon levels.

The health consultation report on radon gas and radium in the PV study area (PDF).

Because of a possible link to radon and radium, airborne sources of radon and waterborne source of radon in the drinking water might contribute to incidents of PV.

Know Your H2O Recommendations

  1. Learn about the background levels of Airborne Radon Gas in your area – For USA residents, check out our Radon by Zip Code Data.
  1. If you are located in an area that has high background levels of radon in air and use a private well or spring or groundwater source learn about radon and radionuclides and get your drinking water tested. 
  1. If you have symptoms associated with Polycythemia vera, please seek medical advice and visit the NIH Website on Polycythemia vera. 
  1. Order a Neighborhood Environmental Hazard Report and learn about the historic and current hazards around your home or future home.
  1. Seek help from a licensed professional and speak openly and honestly with your physician. 

More information

ATSDR on Polycythemia vera

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