Our Dirty Water

Nick Herringer claps along with a metronome. He draws lines on a big screen, repeating patterns drawn by the computer. He identifies icons of cars when they flash before his eyes. This is the 22-year-old's speech and cognitive therapy, which he has been doing at least twice a week. Every week. For three years.

Nick's thick brown hair hides a massive, ear-to-ear scar from his four brain surgeries for glioblastoma, an aggressive brain cancer he has battled since he was a teenager.

His mom, Tammy Herringer, drives Nick to therapy and back. She takes Nick along shopping and to community events. He can't go alone because of damage to his brain.

"I have worn the paths back and forth to town all these years," Tammy said.

Recently driving the gravel road from Hastings to their house northwest of town, she could barely peer beyond the endless rows of corn on both sides of the road, mile after mile, standing tall in the scorching sun.

Corn is the main crop of the number one industry in Nebraska. It's a plant so important it's in the name of Nick's favorite team: The Cornhuskers. And it's corn – what we spray onto it to make it thrive – that experts say may be the culprit behind many pediatric cancers like Nick's.

Nitrogen fertilizer powers the corn's growth. It also converts to nitrate as it seeps into the soil – right into the water.

This problem costs serious taxpayer money. Cities and small towns have spent millions treating their water, struggling and sometimes failing to meet the Environmental Protection Agency's drinking water standard for nitrate of 10 parts per million.

Fifty-nine of Nebraska's 500-odd community public water systems have violated that standard at least once since 2010, the Flatwater free press found during a months-long investigation into the safety of Nebraska's water. Those who live in the country and drink water from private wells, like the Herringers, continue to bear the cost of treating their own nitrate-laced water.

This problem is growing worse: The statewide median nitrate level has doubled since 1978.

Authorities have never fined or stopped anyone who uses too much nitrogen fertilizer, multiple leaders of Nebraska's Natural Resources Districts told the Flatwater free press.

The problem may have serious consequences.

Nebraska has the seventh-highest pediatric cancer rate in the country, according to the Centers for Disease Control and Prevention. It has the highest pediatric cancer rate of any state west of Pennsylvania.

High nitrate levels are closely linked to colorectal cancer and connected to thyroid disease. They're associated with neural tube defects, a birth defect that often kills young children who have it.

Pregnant people can be harmed by ingesting nitrates, experts say, spurring anemia, premature labor and even miscarriage.

And the risks may be increasing for Nebraskans, roughly 85% of whom use groundwater.

The Herringer family had no idea that their private well had tested at a nitrate level of 30 parts per million in 2010. That's 10 times higher than Eleanor Rogan, a University of Nebraska Medical Center researcher examining the link between high nitrate and childhood cancers, says she would allow children to drink.

Nick drank this water for years. He showered in it. He ate food cooked in it all his life.

The Herringer's water was worse than 99% of the wells then tested in and around Hastings – a few years before the family got Nick's 2015 cancer diagnosis.

When Nick and Tammy recently arrived home from one of Nick's appointments, they bumped into well driller Eric Jensen, who had been putting chlorine in their well. He told Tammy that high nitrate is common. A nearby feedlot and those cornfields that surround her house are culprits, he said.

Drilling a new well won't solve the problem. There's only one way to remove nitrate, the well driller told the mother: Install a complex filtration system.

It's about $1,000. He said it's worth it.

"Nitrate ain't good," he told Tammy.

***

Nick was healthy growing up. Tammy thought it was strange when he asked to stay home from school because of a headache in 2015. Tylenol didn't help.

He started complaining about sunlight. He wore sunglasses everywhere. He vomited inside a Walgreens kiosk as Tammy printed photos. Tammy drove him to the emergency room.

A doctor did a CT scan and found an orange-sized mass on Nick's brain. They rushed him to Omaha. The diagnosis: a grade 4 brain tumor, the most aggressive form of primary brain cancer.

Pediatric cancer cases like Nick's are becoming more common in Nebraska, especially childhood brain tumors. A study led by UNMC and the state health department found an increase in both between 1990 and 2013.

Areas of the state that have higher pediatric cancer rates and birth defect rates also have higher nitrate levels, researchers say.

"Over some time, we identified that there is something in Nebraska that's a little bit different," said Dr. Don Coulter, who participated in the statewide cancer study. "It's the Ogallala Aquifer."

Nebraskans' water is often clear, cool and drawn directly from the aquifer. The 174,000-square-mile High Plains Aquifer is the largest source of groundwater in the United States, a lifeline for cattle, corn and families.

Crops need nitrogen to grow. But the nitrogen fertilizers applied to cornfields can't all be absorbed by plants. Roughly a third of nitrogen applied to corn is lost, according to the Nebraska Water Center. Some seeps into the water supply.

A UNMC research team headed by Rogan is now examining links between high nitrate and the three most common pediatric cancers.

Nebraska counties with slightly elevated nitrate levels showed a seven-fold increase in the leukemia rate above counties with minimal nitrate levels. Lymphoma rates were four times higher. These findings are preliminary, scientists caution.

But the cancer most consistently linked to elevated nitrate levels: Childhood brain cancers like Nick's. Brain cancers are eight times as high as in counties with low nitrate.

Nick's family didn't know the risks. Most Nebraskans don't.

The state's well water is rarely tested. Less than 4% of the roughly 180,000 registered wells are tested each year, excluding public water systems. Private wells, found in rural areas not connected to a community's water supply, aren't required by law to be tested at all.

The Herringers didn't know that nitrate levels in Hastings were high. They didn't know their own nitrate levels were much higher.

"You don't think that this is going to happen to you," she said. "I'm not saying that that's what caused Nicholas' diagnosis...How will we ever know?"

***

State leaders have been concerned about the nitrate seeping into Nebraska's water for half a century.

Nebraska's environmental agencies started testing nitrate levels in the 1970s.

In 1986, then-Sen. Loran Schmit, a Republican from Bellwood, spearheaded new state laws to address increasing nitrate. But in the decades since, the state has continued to approve bigger feedlots. Nebraska farmers have grown more and more corn.

"The bill was to prevent groundwater contamination, and I do not know we have made progress in that direction," Schmit, a lifelong farmer, now 94, told the Flatwater free press.

A few years after Schmit's bill, the EPA took its first major action to limit nitrate in drinking water in response to something called methemoglobinemia.

Its common name: "Blue baby syndrome."

To respond, the federal government, in 1992, enacted its first-ever rule for how much nitrate would be allowed in drinking water. Ten parts per million, the rule said.

It hasn't budged. But decades of further study suggests that nitrate, even at levels below the EPA standard, is linked to potential health risks.

Some 48% of private wells are over Rogan's suggested limit of three parts per million, according to publicly available state water data.

"I think there's just mounting evidence that the EPA standard for nitrate is too high," she said.

Water quality plays a pivotal role in community health, said Paul Black, former chair of the Department of Biochemistry at the University of Nebraska–Lincoln.

"Nitrate is the key problem in Nebraska," Black explained. "The kids are sicker so they don't learn as well in school. So your community's not as healthy because your kids now are having problems."

Imagine looking at a map and zooming out so you can see the whole country, Black said. The chemical follows tributaries all the way into the mighty Mississippi River and then the Gulf of Mexico.

Nebraska stands out on this map, Black said. It's in red, a "hot zone."

"I would say Nebraska is the epicenter in the upper Midwest."

***

This spring, Tylr Naprstek, assistant manager of the Lower Loup Natural Resources District, went to another NRD's meeting. There, he described the reaction when an area north of Columbus was designated a management area in 2019 – after nitrate readings skyrocketed to as high as 48 parts per million.

"Everyone was pointing fingers," he told the members of the Lower Elkhorn NRD board. "This half of the room says, 'Well it's the manure guys over there that are doing it all,' and ...(feedlot owners were) saying 'It's the commercial fertilizer guys.'"

It's the classic blame game, described to the Flatwater free press by multiple local officials, NRD board members and water quality experts.

Dan Snow, a lab director at the Nebraska Water Center, has a tool that can pinpoint who's to blame. A process called "fingerprinting" allows Snow's lab to identify whether it's coming from organic sources like manure, or commercial fertilizer.

In the case of the 48-parts-per-million test near Columbus, it's essentially, "all of the above."

Manure from feedlots played a role, Snow found. So did commercial fertilizer.

That's not the case across Nebraska.

Testing done by Snow's lab consistently shows that the majority of nitrate comes from commercial fertilizers – what we spray on our lawns, golf courses, but most of all corn.

"I'm guessing more than 90% (comes) from commercial fertilizer," Snow told the Flatwater free press.

Some conditions make it worse: shallow water tables, sandy soil texture and heavy irrigation, Snow explained.

Nebraska Farm Bureau President Mark McHargue knows that his hometown Central City fits this profile.

"We live in those communities. I have eight grandchildren. I want them to have good drinking water," he said.

The Nebraska Farm Bureau president points out that he and others have changed for the better. His family farm has tested the nitrate in their soil. He factors in what's already there when calculating how much the crop needs.

His family applies hog manure, a method known as "split application." "Quite frankly, it's a hassle. But we know in our sandy soils we can't hold as much nitrogen," he said.

Snow hopes his "fingerprinting" findings will help Nebraska move beyond years of finger-pointing. Recent tests show an increase of nitrate in soils of large swaths of the state.

His study in the Hastings area – the area where the Herringers live – revealed that nitrate there increased by 30% between 2011 and 2016.

Statewide, public water systems are hemorrhaging money to treat the problem.

Creighton, pop. 1,147, spent $1.3 million in 1993, building the state's first reverse osmosis treatment system to filter out nitrate.

Seward, a city just west of Lincoln, spent $5 million.

Hastings spent $15 million.

To Norfolk Mayor Josh Moenning, Creighton's response felt like a "canary in the coal mine" moment.

"If we don't get to some kind of solution here and get a handle on this problem, it's only going to cost us more and more and into the future," he said. "And it's going to cost us in terms of negative health impacts."

***

A few months before Nick Herringer's diagnosis, the Adams Central Patriots, the high school down the road from the Herringers' home, played an away game against the Aurora Huskies. It was Childhood Cancer Awareness Night. Gary Peters, an Aurora father who lost his son Jacob to lymphoma in 2011, walked onto the field.

"Stand up if you knew Alyssa Sandmeier."

"Stand up if you knew Tyler Larson."

"Stand up if you knew Jacob Peters."

"Stand up if you knew Sydnee Owens."

By the end, almost everyone was standing.

All were children. All died of childhood cancer. To him, the seven pediatric cancer cases from 2005 to 2013 seemed like a "waterfall" of different cancer diagnoses.

UNMC researchers have also found an association between pediatric cancer and atrazine, a herbicide many farmers say they have already phased out. Rogan's team is further expanding to study uranium and arsenic.

After seeing the UNMC research, Peters wondered if Jacob's death was related to the water he consumed.

"How long is it gonna (take to) change, to get legislation that outlaws these chemicals that could give our kids cancer?" Peters said. "...There's just too many dollars involved. And the people making those decisions are only concerned about the bottom line. They're not really concerned about kids getting cancer."

He's frustrated at the status quo. Policymakers have known about nitrate for decades. Little has changed.

Natural resources districts in the state, created 50 years ago for local management of water resources in each watershed, have been taking painstaking steps toward battling nitrate.

"It takes tough decisions," said Mike Sousek, manager of the Lower Elkhorn NRD in northeast Nebraska. He and his team have been encouraging farmers to adopt practices that help, such as growing cover crops. Farmers can receive government funding for doing so.

"I got millions of dollars. I can't even spend it. I can't get people to sign up just to try to change (their practices)," he said. "Money isn't enough of a carrot."

The stick isn't there either.

Schmit designed a mechanism to protect groundwater safety – the state environmental protection authority and local NRDs should work together.

They're not. Neither the Nebraska Department of Environment and Energy nor NRDs have issued a cease and desist order to or fined a single person for using too much nitrogen fertilizer or applying excessive manure in the state, NRD leaders said.

***

After almost a year of stable health, Nick recently learned his tumor has again grown. His family is exploring his next treatment plan.

He won't have another surgery.

"Nick always says 'I'm in a win-win situation. If I beat this cancer, then I beat a cancer that's very aggressive. And if I don't, then I will be in heaven with Jesus, and that is a win-win,'" Tammy said.

Nick, sitting nearby, nods his head. "That gives me goosebumps," he said.

For now, Nick continues the fight that many other Nebraskan children have already lost.

"Experts are telling us this is affecting our children. There are real life-and-death situations being played out here," Sousek said. "We have to start paying attention. It's our kids."

[This article was produced as a project for the University of Southern California Annenberg Center for Health Journalism's 2022 National Fellowship.]