ORIGINAL PAPER Spatial patterns of tungsten and cobalt in surface dust of Fallon, Nevada Paul R. Sheppard Æ Robert J. Speakman Æ Gary Ridenour Æ Michael D. Glascock Æ Calvin Farris Æ Mark L. Witten Received: 28 March 2006 / Accepted: 26 January 2007  Springer Science+Business Media B.V. 2007 Abstract Spatial patterns of tungsten and cobalt are described for surface dust of Fallon, Nevada, where a cluster of childhood leukemia has been ongoing since 1997. In earlier research, airborne tungsten and cobalt was shown to be elevated in total suspended particulates in Fallon. To fine- tune the spatial patterns of tungsten and cobalt deposition in Fallon, surface dust was collected in a grid pattern within as well as outside of Fallon to establish background concentrations of metals. In surface dust, tungsten and cobalt show sharp peaks (934 ppm and 98 ppm, respectively) within Fallon just north of highway 50 and west of highway 95. These two peaks overlap spatially, and given the grid pattern used for collecting surface dust, the source area of these two airborne metals can be pinpointed to the vicinity of hard-metal industry located north of highway 50 and west of highway 95. Fallon is distinctive in west central Nevada because of high airborne tungsten and cobalt particulates, and given its cluster of childhood leukemia, it stands to reason that additional biomedical research is in order to test directly the leukogenicity of combined air- borne tungsten and cobalt particulates. Keywords Fallon  Nevada  Childhood leukemia  Tungsten  Cobalt  Surface dust chemistry Introduction Spatial patterns of tungsten and cobalt are described for surface dust of Fallon, Nevada (Fig. 1), where a cluster of childhood leukemia has been ongoing since 1997. Officially, 16 cases of childhood leukemia were diagnosed from 1997 to 2002 inclusive (Expert Panel 2004), and one additional case was reported in December 2004 (Nevada State Health Division 2004). Given Fallon’s pediatric population of ~2,500 children up to 19 years in age (U.S. Census 2000) and a national expected rate of childhood leukemia of P. R. Sheppard (&)  C. Farris Laboratory of Tree-Ring Research, University of Arizona, Tucson, AZ 85721, USA e-mail: sheppard@ltrr.arizona.edu R. J. Speakman Museum Conservation Institute, Smithsonian Institution, Suitland, MD 20746, USA G. Ridenour 625 W. Williams Ave., Suite B, Fallon, NV 89406, USA M. D. Glascock Research Reactor Center, University of Missouri, Columbia, MO 65211, USA M. L. Witten Department of Pediatrics, University of Arizona, Tucson, AZ 85721, USA 123 Environ Geochem Health DOI 10.1007/s10653-007-9085-1 4.1 cases per 100,000 children up to 19 years in age per year (US NCI 2003), the expected rate of childhood leukemia for Fallon should be only one case every 10 years. This cluster, deemed ‘‘one of the most unique ever reported’’ (Steinmaus et al. 2004), has prompted extensive research in an effort to determine if an environmental cause might be responsible. Prior research has included drinking water (Moore et al. 2002), jet fuel (US ATSDR 2002), pesticides (US CDC 2003a), surface water (U.S. ATSDR 2003a), outdoor air (US ATSDR 2003b), surface soil and indoor dust (US ATSDR 2003c), potential lingering effects of underground nuclear bomb testing in the area (Seiler 2004), and groundwater (Seiler et al. 2005). Although few definitive conclusions have been made, sig- nificantly elevated airborne tungsten and cobalt levels have been identified in airborne particu- lates within Fallon relative to comparison towns (Sheppard et al. 2006) and in lichens within Fallon compared to outlying desert areas (Shepp- ard et al., 2007). Toxicological research on effects of tungsten and cobalt on leukemia has been recommended, as has additional environmental research in Fallon to improve understanding of its airborne tungsten and cobalt. An additional environmental monitoring tech- nique that is applicable to Fallon is surface dust chemistry, the measurement and interpretation of element concentrations in fine sediments that accumulate on outdoor surfaces. Surface dust is an ideal indicator of atmospheric deposition, especially for heavy metals. Surface dust is easy to collect, so large spatial arrays of samples can be obtained quickly. Surface dust reflects the chem- ical composition of recent deposition, on the order of days to weeks depending on precipitation frequency. By collecting surface dust in a grid pattern, it is possible to map differing concentra- tions of atmospheric deposition of heavy metals and thereby pinpoint sources of unusual airborne metals (Mielke et al. 1999; Lee et al. 2006). Paired studies of surface dust and total suspended particulates can be particularly fruitful for con- firming airborne chemistry and identifying spatial patterns of metals (Muskett and Jones 1980; Boudissa et al. 2006). Many case studies exist worldwide of using surface dust chemistry to quantify atmospheric loading of heavy metals and/or identify spatial patterns of deposition (Harrison 1979; Duggan 1984; Fergusson and Ryan 1984; Thornton et al. 1985; Rapsomanikis and Donard 1985; Davies et al. 1987; Tam et al. 1987; Wong and Mak 1997; Benin et al. 1999; Reid et al. 2003; Clark et al. 2005). Accordingly, surface dust chemistry in and around Fallon was used to establish the spatial patterns of tungsten and cobalt deposition, with the objective of pinpointing the source or sources of elevated airborne tungsten and cobalt particulates within Fallon. Methods Fallon is a small, rural farming community (Greater Fallon Area Chamber of Commerce 2005) located in west central Nevada (Fig. 1). Its climate is cool to mild and dry, with a mean annual temperature and precipitation of 10.7C and 127 mm, respectively, as typified from mete- orological data from Fallon (monthly data from 1931 to 2004 obtained online from the National Climatic Data Center, NOAA 2006). Along with service industries and small businesses, Fallon has Fallon Carson City NEVADA 100 km Fig. 1 Map of Nevada showing the location of Fallon Environ Geochem Health 123 an industrial facility that carries out hard-metal metallurgy, including tungsten carbide and cobalt (Harris and Humphreys 1983). This hard-metal facility has been suggested as a candidate source of tungsten within Fallon generally (Reno Gaz- ette-Journal, 5 February 2003) and more specif- ically for elevated airborne tungsten and cobalt in total suspended particulates of Fallon (Sheppard et al. 2006). The strategy for surface dust chemistry was to map concentrations of elements in outdoor dust deposits within and around Fallon. Fieldwork took place in March, 2005, at which time Fallon had not experienced a substantial rain storm for three weeks (daily data obtained online from the National Climatic Data Center, NOAA 2006), allowing surface dust to accumulate for that length of time. In total, 125 surface dust samples were collected along a grid pattern within Fallon as well as outside of Fallon to establish back- ground concentrations of metals (Amini et al. 2005; Rimmer et al. 2006; Biasioli et al. 2006). Within Fallon, the grid cell length was 0.5 km, which maximized the sampling density inside the town. Outside of Fallon, the grid cell length was relatively coarser (2.0–5.0 km), which maximized the spatial extent of sampling away from Fallon. The high density of sampling points and large overall spatial coverage throughout Fallon and outside of the town was intended to account for variation in surface dust chemistry that might be due to wind and/or unusual distribution of the population. Geographic coordinates were recorded for each sample to facilitate spatial analysis of metal concentrations across Fallon and the surrounding area and to map distributions of metals. Surface dust samples were collected mostly from paved surfaces using a clean brush and clean paper as a dustpan (Harrison 1979; Duggan 1984; Thornton et al. 1985; Harrop et al. 1990). Sam- ples were stored in clean polyethylene vials. Outside of Fallon, where surfaces are not paved, samples were collected from undisturbed desert and therefore contained some coarse sand. In all cases, samples were sieved to isolate the fine fraction (<0.150 mm) for analysis to make them comparable. Sieved samples were transferred to clean, glass, screw-cap vials and oven-dried at 100C for 24 h. Coarse and fine fractions from each sample are archived in the event that future analyses are necessary. Two aliquots of each sample were prepared for analysis by instrumental neutron activation analysis (INAA). Approximately 150 mg of powder was weighed into clean high-density polyethylene vials used for short irradiations. At the same time, 200 mg of each sample was weighed into clean high-purity quartz vials used for long irradiations. Individual sample weights were recorded to ±0.01 mg. Both vials were sealed prior to irradiation. Certified standard reference materials of SRM-1633a (coal fly ash), SRM-1648 (urban particulate matter), and SRM-688 (basalt rock) were similarly prepared, as were quality-control samples (e.g., standards treated as unknowns) of SRM-1648 (urban particulate matter), SRM-278 (obsidian rock) and Ohio Red Clay (a standard developed for in-house applications). INAA of sediments, which consists of two irradiations and a total of three gamma counts, constitutes a superset of procedures used at most INAA laboratories (Glascock 1992; Neff 1992, 2000). A short irradiation was carried out through a pneumatic tube irradiation system (Glascock 1992). Samples in polyvials were sequentially irradiated, two at a time, for 5 s by a neutron flux of 8 · 1013 n cm–2 s–1. The 720-s count yielded gamma spectra containing peaks for nine short-lived elements: aluminum, barium, calcium, dysprosium, potassium, manganese, sodium, tita- nium, and vanadium. For the second irradiation, samples were encapsulated in high-purity quartz vials and were subjected to a 12-h irradiation at a neutron flux of 5 · 1013 n cm–2 s–1. This long irradiation is analogous to the single irradiation utilized at most other laboratories. After the long irradiation, samples decayed for five days and were then counted for 1,800 s (the middle count) on a high-resolution germanium detector coupled to an automatic sample changer. The middle count yielded determinations of eight medium- half-life elements: arsenic, lanthanum, lutetium, neodymium, samarium, tungsten, uranium, and ytterbium. After an additional three-week decay, a final count of 10,000 s was carried out on each sample. The latter measurement yielded 17 Environ Geochem Health 123 long-half-life elements: cerium, cobalt, chromium, cesium, europium, iron, hafnium, nickel, rubid- ium, antimony, scandium, strontium, tantalum, terbium, thorium, zinc, and zirconium. Data were standardized using the standard-comparator method in which the concentrations of the unknown samples (i.e., dust samples) were deter- mined by ratioing the measured activities per unit weight of the unknown sample to those for a reference standard (SRM-1633a, SRM-1648, and SRM-688) with known concentrations. The med- ian recovery from the urban particulate matter SRM for all measured elements with a certified value was 96%, indicating excellent performance of INAA on surface dust. Based on the analyses of thousands of separate quality control measure- ments made during the past 15 years, the preci- sion of INAA for this matrix is generally better than 5% for most elements (with the exception of As, Nd, Ni, Sr, Zn, and Zr). Results Most of the elements measured in surface dust show little variability across sampling points within and around Fallon, with coefficients of variation (standard deviation standardized to the mean, Sokal and Rohlf 1981) of less than 50% (Fig. 2). This establishes a background pattern with little spatial variability in atmospheric depo- sition of metal particulates across the greater Fallon area. In sharp contrast to this pattern of little spatial variability, tungsten shows large spatial variability, with a coefficient of variability of 732%. After tungsten, cobalt has a coefficient of variability of 77% followed by arsenic at 71%. Tungsten and cobalt have several sampling points with high values, but arsenic has only one high value. Tungsten and cobalt show sharp peaks (934 ppm and 98 ppm, respectively) within Fallon just north of highway 50 and west of highway 95 (Fig. 3). Spatially, these two peaks overlap exactly, with the same sampling location having the highest value for both metals. Adjacent sampling locations in north-central downtown Fallon also have notably high concentrations of tungsten and cobalt. The other sampling locations in and around Fallon have concentrations of <10 ppm tungsten and <15 ppm cobalt, which establishes natural background levels for these two metals in the area. These background values are roughly similar to typical crustal values of 1.2 ppm for W and 22 ppm for Co (Krauskopf 1995). Discussion Previous environmental research related to the cluster of childhood leukemia in Fallon, Nevada, has noted elevated tungsten. Tungsten has been high in drinking water (US CDC 2003b), in groundwater (Seiler et al. 2005), and in blood and urine samples of residents (US CDC 2003b). However, a consensus has been that tungsten is not unusual enough in Fallon to merit additional concern related to the cluster of childhood leukemia there. Tungsten is ubiquitous through- out northern Nevada (Stager and Tingley 1988), and elevated tungsten in and around Fallon has been suggested to be a result of the natural geology of the region (Expert Panel 2004; Pardus et al. 2005). However, the high peak values of tungsten and cobalt in the surface dust of central Fallon are not likely to be a result of tungsten and cobalt found in rocks and/or soils of the area. Rocks collected within Fallon as well as from desert sites around Fallon show normal concentrations of tungsten and cobalt (Sheppard et al., 2007). Soils of residential Fallon and nonresidential outlying 0 200 400 600 800 E u S r R b S m C e L a S c N d T b Y b F e C r L u C s Z r H f U Z n T h T a S b A s C o W Element ) %( n oit air aV f o t n eici ff e oC Fig. 2 Coefficients of variation (standard deviation stan- dardized to the mean, Sokal and Rohlf 1981) of elements measured in surface dust of Fallon. For all elements, n = 125. Bromine, molybdenum, and nickel are not included here because they had many values below the detection limits Environ Geochem Health 123 desert areas are also not notable for high levels of any metals, presumably including tungsten and cobalt (US ATSDR 2003c). Alternatively, the peak sampling location coincides spatially with the hard-metal facility located within Fallon, which supports the suggestion that the hard- metal facility in Fallon be considered as a candidate source of Fallon’s elevated airborne tungsten and cobalt particulates (Sheppard et al. 2006, 2007). Fig. 3 Surface dust concentrations of (a) tungsten and (b) cobalt Environ Geochem Health 123 Conclusions Fallon is distinctive from nearby comparison towns in Nevada as well as from outlying desert areas because of significantly elevated tungsten and cobalt in total suspended particulates and in lichens (Sheppard et al. 2006, 2007). This present study fine-tunes the spatial patterns of tungsten and cobalt using surface dust within Fallon. Ele- vated levels of these two metals, which are otherwise unrelated geologically in Nevada, sug- gest a local point source instead of widespread co- occurrence. Given the grid pattern used for collecting surface dust, the source area of these two metals can be pinpointed to the area of the hard-metal facility that is located just north of highway 50 and west of highway 95. This area merits direct monitoring to determine the exact source of airborne tungsten and cobalt particulates. It cannot be concluded from only environmen- tal data that elevated airborne tungsten and/or cobalt cause childhood leukemia. Such a connec- tion requires biomedical research. Nonetheless, given that childhood leukemia in Fallon is the ‘‘most unique cluster ever reported’’ (Steinmaus et al. 2004) and that Fallon is distinctive because of elevated airborne tungsten and cobalt partic- ulates, it stands to reason that additional biomed- ical research is in order to test directly the leukogenicity of airborne tungsten and cobalt. Acknowledgements Angelika Clemens assisted with fieldwork, and Nicole Little, Tessa Schut, and Jon Dake assisted with sample preparation and analysis of surface dust samples. INAA measurements were conducted at the University of Missouri Research Reactor Center. This project was supported in part by the Gerber Foundation and the Cancer Research and Prevention Foundation, neither of which is otherwise responsible for any content of this paper. References Amini, M., Afyuni, M., Khademi, H., Abbaspour, K. C., & Schulin, R. (2005). Mapping risk of cadmium and lead contamination to human health in soils of Central Iran. Science of the Total Environment, 347, 64–77. Benin, A. L., Sargent, J. D., Dalton, M., & Roda, S. (1999). High concentrations of heavy metals in neighbor- hoods near ore smelters in northern Mexico. Environmental Health Perspectives, 107, 279–284. Biasioli, M., Barberis, R., & Ajmone-Marsan, F. (2006). The influence of a large city on some soil properties and metals content. Science of the Total Environment, 356, 154–164. Boudissa, S. M., Lambert, J., Mu¨ller, C., Kennedy, G., Gareau, L., & Zayed, J. (2006). Manganese concen- trations in the soil and air in the vicinity of a closed manganese alloy production plant. Science of the Total Environment, 361, 67–72. Clark, C., Thuppil, V., Clark, R., Sinha, S., Menezes, G., D’Souza, H., Nayak, N., Kuruvilla, A., Law, T., Dave, P., & Shah, S. (2005). Lead in paint and soil in Karnataka and Gujarat, India. Journal of Occupa- tional and Environmental Hygiene, 2, 38–44. Davies, D. J. A., Watt, J. M., & Thornton, I. (1987). Lead levels in Birmingham dusts and soils. Science of the Total Environment, 67, 177–185. Duggan, M. J. (1984). Temporal and spatial variations of lead in air and in surface dust-implications for moni- toring. Science of the Total Environment, 33, 37–48. Expert Panel (2004). Final Report and Recommendations to the Nevada State Health Division, Expert Panel on Childhood Leukemia in Churchill County, Nevada. Available: http://www.health2k.state.nv.us/healthof- ficer/leukaemia/FALLONexpertpanel022304.pdf. Fergusson, J. E., & Ryan, D. E. (1984). The elemental composition of street dust from large and small urban areas related to city type, source and particle size. Science of the Total Environment, 34, 101–116. Glascock, M. D. (1992). Characterization of archaeolog- ical ceramics at MURR by neutron activation analysis and multivariate statistics. In H. Neff (Ed.), Chemical characterization of ceramic pastes in archaeology (pp. 11–26). Madison, Wisconsin: Prehistory Press. Greater Fallon Area Chamber of Commerce (2005). History of Fallon, available: http://www.fallonchamber.com. Harris, P. M., & Humphreys, D. S. C. (1983). Tungsten: A Review. Occasional Papers of the Institution of Mining and Metallurgy, Paper 2, Institution of Mining and Metallurgy, London, England, 1983, 42 pp. Harrison, R. M. (1979). Toxic metals in street and household dusts. Science of the Total Environment, 11, 89–97. Harrop, D. O., Mumby, K., Pepper, B., & Nolan, J. (1990). Heavy metal levels in the near vicinity to roads in a north London Borough. Science of the Total Environ- ment, 93, 543–546. Krauskopf, K. B. (1995). Introduction to geochemistry. New York: McGraw-Hill, 647 pp. Lee, C. S.-L, Li, X-D, Shi, W.-Z., Cheung, S. C.-N, & Thornton, I. (2006). Metal contamination in urban, suburban, and country park soils of Hong Kong: A study based on GIS and multivariate statistics. Science of the Total Environment, 356, 45–61. Mielke, H. W., Gonzales, C. R., Smith, M. K., & Mielke, P. W. (1999). The urban environment and children’s health: soils as an integrator of lead, zinc, Environ Geochem Health 123 and cadmium in New Orleans, Louisiana, U.S.A. Environmental Research, 81, 117–129. Moore, L. E., Lu, M., & Smith, A. H. (2002). Childhood cancer incidence and arsenic exposure in drinking water in Nevada. Archives of Environmental Health, 57, 201–206. Muskett, C. J., & Jones, M. P. (1980). The dispersal of lead, cadmium and nickel from motor vehicles and effects on roadside invertebrate macrofauna. Environmental Pollution Series A, 23, 231–242. Neff, H. (1992). Introduction. In H. Neff (Ed.), Chemical characterization of ceramic pastes in archaeology. Madison, Wisconsin: Prehistory Press, pp. 1–10. Neff, H. (2000). Neutron activation analysis for prove- nance determination in archaeology. In E. Ciliberto, & G. Spoto (Eds.), Modern analytical methods in art and archaeology (pp. 81–134). New York: John Wiley and Sons, Inc. Nevada State Health Division (2004). New Childhood Leukemia Case Confirmed. News Release, December 20, 2004. Available at: http://www.health2k.state. nv.us/pio/releases/122004PressRelLeukemia.pdf. NOAA (2006). National Climatic Data Center. U.S. Department of Commerce, National Oceanic and Atmospheric Administration. Available at: http:// www.ncdc.noaa.gov/oa/ncdc.html. Pardus, M. J., Sueker, J. K., & Gass, T. E. (2005). Tungsten: Occurrence, environmental fate, potential ecological and health effects. Abstracts of Papers (GEOC 37, [886912]), 230th America Chemical Soci- ety Meeting, Washington, DC. Rapsomanikis, S., & Donard, O. (1985). Lead and zinc in roadside dust from a suburb in Athens, Greece. Environmental Technology Letters 6, 145–148. Reid, E. A., Reid, J. S., Meier, M. M., Dunlap, M. R., Cliff, S. S., Broumas, A, Perry, K., & Maring, H. (2003). Character- ization of African dust transported to Puerto Rico by individual particle and size segregated bulk analysis. J Geophys Res-Atmo 108(D19), No. 8591. Reno Gazette-Journal (Frank X. Mullen), 5 February 2003. No pollution controls in tungsten plant. Rimmer, D. L., Vizard, C. G., Pless-Mulloli, T., Singleton, I., Air, V. S., & Keatinge, Z. A. F. (2006). Metal contamination of urban soils in the vicinity of a municipal waste incinerator: one source among many. Science of the Total Environment, 356, 207–216. Seiler, R. L. (2004). Temporal changes in water quality at a childhood leukemia cluster. Ground Water, 42, 446–455. Seiler, R. L., Stollenwerk, K. G., & Garbarino, J. R. (2005). Factors controlling tungsten concentrations in ground water, Carson Desert, Nevada. Applied Geochemistry, 20, 423–441. Sheppard, P. R., Ridenour, G, Speakman, R. J., & Witten, M. L. (2006). Elevated tungsten and cobalt in airborne particulates in Fallon, Nevada: possible implications for the childhood leukemia cluster. Applied Geochemistry, 21, 152–165. Sheppard, P. R., Speakman, R. J., Ridenour, G, & Witten, M. L. (2007). Using lichen chemistry to assess airborne tungsten and cobalt in Fallon, Nevada. Environmental Monitoring and Assessment, doi:10.1007/s10661-006-9440-1. Sokal, R. R., & Rohlf, F. J. (1981). Biometry. San Francisco: WH Freeman and Co., 859 pp. Stager, H. K., & Tingley, J. V. (1988). Tungsten Deposits in Nevada. Nevada Bureau of Mines and Geology. Bulletin 105, University of Nevada-Reno School of Mines, Reno, Nevada, 256 pp. Steinmaus, C., Lu, M., Todd, R. L., & Smith, A. H. (2004). Probability estimates for the unique childhood leuke- mia cluster in Fallon, Nevada, and risks near other U.S. military aviation facilities. Environmental Health Perspectives, 112, 766–771. Tam, N. F. Y., Liu, W. K., Wong, M. H., & Wong, Y. S. (1987). Heavy metal pollution in roadside urban parks and gardens in Hong Kong. Science of the Total Environment, 59, 325–328. Thornton, I., Culbard, E., Moorcroft, S., Watt, J., Wheatley, M., Thompson, M., & Thomas, J. F. A. (1985). Metals in urban dusts and soils. Environmental Technology Letters 6, 137–144. U.S. ATSDR (2002). Evaluation of potential exposures from the Fallon JP-8 fuel pipeline. U.S. Department of Health and Human Services, Agency for Toxic Substances and Disease Registry. Available: http:// www.atsdr.cdc.gov/HAC/PHA/fallonpipe/fallon_toc. html U.S. ATSDR (2003a). Surface water, sediment, and biota human exposure pathway analysis for Churchill County: Fallon Leukemia Project, Fallon, Churchill County, Nevada. U.S. Department of Health and Human Services, Agency for Toxic Substances and Disease Registry. Available: http://www.atsdr.cdc.gov/ HAC/PHA/fallonwater/finalwater.pdf. U.S. ATSDR (2003b). Air exposure pathway and assessment: Fallon Leukemia Cluster Investigation. U.S. Depart- ment of Health and Human Services, Agency for Toxic Substances and Disease Registry. Available: http:// www.atsdr.cdc.gov/HAC/PHA/fallonair/finalair.pdf. U.S. ATSDR (2003c) Pathway assessment for Churchill County surface soils and residential indoor dust: Fallon Leukemia Project, Fallon, Churchill County, Nevada, U.S. Department of Health and Human Services, Agency for Toxic Substances and Disease Registry. Available: http://www.atsdr.cdc.gov/HAC/ PHA/fallonsoil/finalsoil.pdf. U.S. CDC (2003a). A cross-sectional exposure assessment of environmental exposures in Churchill County, Nevada, U.S. Centers for Disease Control and Pre- vention. Available: http://www.cdc.gov/nceh/clusters/ fallon. U.S. CDC (2003b). Exposure to tungsten in three Nevada communities, report to the Nevada State Health Division. Available: http://www.cdc.gov/nceh/clus- ters/fallon/tungsten_report.pdf. Environ Geochem Health 123 U.S. Census, (2000). United States Census 2000. Available: http://www.census.gov/main/www/cen2000.html. U.S. NCI (2003). Age-Adjusted SEER Incidence and the U.S. Death Rates and 5-Year Relative Survival Rates by Primary Cancer Sites, Sex, and Time Period. SEER Cancer Statistics Review, 1975–2000, Table XXVII-3: Childhood Cancers, U.S. National Cancer Institute. Available: http://www.seer.cancer.gov. Wong, J. W. C., & Mak, N. K. (1997). Heavy metal pollution in children playgrounds in Hong Kong and its health implications. Environmental Technology, 18, 109–115. Environ Geochem Health 123