MGH/Harvard Study of IBD Cases in Northport, WA

Community Survey Leads to MGH/Harvard Study Crohn’s and Colitis Study

The results of the 2011 Northport Community Health Survey, conducted by The Northport Project and Citizens for a Clean Columbia on past and current Northport residents caught the attention of Dr. Josh Korzenik , Director of the Crohn’s and Colitis Center at Brigham and Women’s Hospital (BWH)/Associate Professor of Medicine at Harvard and Dr. Sharyle Fowler,  Associate Professor in the Department of Medicine at the University of Saskatchewan/ Director of the Multidisciplinary IBD Clinical and Research Program.

As a result, they conducted a series of studies investigating an unusually high cluster of inflammatory bowel disease (IBD) cases in current residents of Northport, Washington. Their research was prompted by local concerns about elevated illness rates potentially linked to environmental pollution from the Trail smelter in British Columbia.

Summary of the Study on IBD Cases in Northport, WA

• Study Population:
  • 119 surveys were returned, with 17 confirmed cases of IBD diagnosed between 1976-2010. ¹
  • The cases represented mostly unrelated individuals (11) and 6 cases from two families. ¹

• Disease Characteristics:
  • 12 cases of ulcerative colitis (UC) and 5 cases of Crohn’s disease (CD). ¹
  • The average age at diagnosis was 24 years, with 53% of patients being female. ¹

• Treatment and Outcomes:
  • All patients received therapy for IBD, including 5-ASA (100%), steroids (71%), and antibiotics (41%). ¹
  • 47% of patients underwent surgery for IBD, including 6 UC patients with total colectomies. ¹

• Incidence and Prevalence:
  • The incidence of IBD was calculated at 95 per 100,000 person-years. ¹
  • In 2011, the prevalence of IBD was 4,857 per 100,000 population. ¹
  • These rates are 10-15 times higher than expected for a town of Northport’s size. ¹

• Environmental Factors:
  • Patients with IBD were more likely to be non-smokers compared to controls (88% vs 43%, p=0.007). ¹
  • 7 cases were concentrated on one street along the river (Mitchell Road). ¹

Additional Context

• The study was conducted in Northport, WA, a town of 297 people (2010 census) located downstream from a large lead and zinc smelter in Trail, British Columbia. ¹
• Dr. Korzenik emphasized that this is the largest IBD cluster described, with incidence and prevalence rates 10-15 times the expected rates. ¹
• The researchers suggest that the particular environmental exposures in Northport warrant further investigation to identify potentially novel environmental risk factors for IBD. ¹

Follow-Up Studies

Dr. Korzenik and his team conducted additional studies in 2016-2017 to investigate possible correlations between chronic exposure to specific heavy metals and IBD. The results of these studies, combined with data from another study on children recently diagnosed with IBD, are expected to provide stronger evidence on the role of heavy metals in causing or triggering Crohn’s disease and ulcerative colitis.

This unusual cluster of IBD cases in Northport continues to be a significant area of research, potentially holding key insights into environmental triggers for IBD on a broader scale.

UPDATE: The 2016-2017 study has not yet been published and is still in process. Due to funding, it is taking longer than planned.

Footnotes
     ¹   See AGA Abstracts, Tu1289, “An Unusual Cluster of IBD in a Town Downstream From a Potential
Environmental Risk Factor” Sharyle A. Fowler, Molly Nestor, Elisabeth B. Cole, Joshua R. Korzenik