Public health partnerships addressing childhood cancer investigations: case study of Toms River, Dover Township, New Jersey, USA

Toms River, located in Dover Township, Ocean County, New Jersey, USA, experienced an increased incidence in childhood leukemia, brain, and central nervous system cancers from the mid-1980s through the early 1990s. These findings initiated a series of community-based activities that lead to the establishment of a successful partnership between the community, public health, and environmental agencies. The common goal of this partnership was to investigate linkages between environmental exposures and childhood cancers. The investigation was comprehensive in nature and a product of an extensive collaborative effort on the part of community, local, state, and federal health agencies, and university research organizations. Central to the success of this partnership was development of a public health response plan. This response plan served to coordinate activities of various entities and ensure that actions to cease or reduce ongoing exposures were implemented in addressing the incidence of childhood cancers using the partnership paradigm. The authors propose six rules of engagement: (1) seek out willing participants, (2) establish an equitable partnership, (3) consider each partner's perspective, (4) define goals and roles for each partner, (5) seek out innovative opportunities, and (6) assure scientific credibility. The application of these rules of engagement led to innovations and advances in the fields of environmental health science and public health practice.