BINGHAM TOWNSHIP - Nancy Holt bulldozed trees and blocked the path to the creek behind her house after her grandson and his friend went wading in the water and got staph infections.

Myra Dotson developed red bumps on her knees and forearms after gardening. When they became infected, a doctor diagnosed her with MRSA, the antibiotic-resistant "super bug."

Both women blame the infections on sewage sludge applied on nearby fields. Now an advisory board's concerns are raising questions the county had hoped to begin answering two years ago.

In 2006, Orange County agreed to pay the UNC School of Public Health $10,000 to test air and water quality where sludge, also known as biosolids, was being spread.

"Since Orange County is one of the counties with the largest number of application sites, a ... study would help establish the relative risks associated with biosolid application sites and afford better information with which to inform county communities, policymakers and partners," according to a county memo.

The study never happened.

"We had several obstacles along the way," said Tom Konsler, the county's environmental health services director.

They included the loss of one of the researchers and the reluctance of local farmers to provide land for testing. Farmers take sewage sludge, rich in nitrogen and phosphorus, as free fertilizer.

"The first farmer who agreed to it got to talking with his family and said he couldn't put the family farm at risk if a group got hold of the information and decided to do something about it," Konsler said.

In the news

Sludge, the byproduct of the sewage treatment process, has come back up for two reasons.

First, the Orange County Commission for the Environment, a citizens advisory board, wants the county to establish a task force to study biosolids.

Second, the county's search for a solid waste transfer station site has narrowed to two top contenders. One is privately owned. The other belongs to the Orange Water and Sewer Authority, which refuses to sell or even let the county on its land for testing because it disposes of sludge there.

Orange County ranks fifth among the state's 100 counties in permitted biosolids application sites, according to the county. In addition to OWASA, land owners in the county accept sludge from Durham, Burlington, Mebane and Hillsborough.

A March 9 draft memo from the Commission for the Environment reports that permitted land in the county is getting up to 17 million gallons of biosolids per year, or an average of 5,000 gallons per acre. At least one of the sites is located within the critical area of the Cane Creek watershed.

David Stancil, the director of the county Environment and Resource Conservation Department, said the commission examined the issue for several months at the county's request, talking with people on all sides of the issue.

"Clearly there are different ideas and different perspectives," he said. "It's not so much a question of how many people are there [blaming sludge for their health problem], it's is there an environmental impact?"

"And the answer is we just don't know."

Broken sign

Myra Dotson calls the grass on sludge application fields "electric green."

As she pulls off Orange Grove Road, a broken sign lying in the woods tells passersby that biosolids are spread here. The field just past the trees is a bright, emerald green. She says the deer won't touch it.

Farther up the road, Dotson, an electron microscopist, used to walk her dogs down a gravel path until OWASA one day put up a No Trespassing fence.

"Nobody knew what was going on," she said. "At that time, it was real quiet. The Nutters used to walk their cows across the road. You just stopped and waited."

She would watch trucks go down the gravel road, followed by an awful smell. She eventually learned the trucks were spreading sewage sludge, but aside from the smell didn't think much more about it.

"I think we all felt it was very benign," she said. "As time went on we just came to expect springtime would bring these OWASA trucks."

Later, Dotson began getting bumps on her knees and arms after doing yardwork. She went to the doctor, thinking she'd been bitten by some kind of insect. The doctor told her she had MRSA, an infection resistant to antibiotics, and asked if she belonged to a gym or went to a swimming pool. She did not.

"Then one day I heard the OWASA truck going by, and it just dawned on me," she said. "Could I possibly be getting it when they sprayed?"

A 'win win'

The OWASA wastewater treatment plant on Old Mason Farm Road treats nearly 8 million gallons of sewage a day.

It comes from toilets, bathtubs, and sinks in homes, businesses, the university and hospital. When it reaches the plant it flows into giant tanks that separate liquids from solids.

The liquids move on for additional treatment before being discharged into Morgan Creek and eventually Jordan Lake.

The solids get heated at prescribed temperatures and lengths of time. The process produces methane gas -- OWASA uses it to fuel the plant and burns off the excess -- and thick, black biosolids.

Most becomes sludge loaded onto six or seven tankers a day. Some becomes drier "cakes" used as compost.

"It's a win-win situation," said Damon Forney, wastewater treatment and biosolids recycling manager. "I know the process start to finish, and I'm very comfortable with the beneficial use of biosolids."

OWASA produces class A biosolids. The process reduces disease-causing organisms to such low levels there are no restrictions on where the sludge may be applied.

Class B biosolids also reduce pathogen levels -- as measured by the presence of fecal coliform or Salmonella bacteria -- but have stricter rules that limit how and where they can be applied. For example, animals may not graze on land for 30 days after biosolids have been applied.

Forney concedes wasterwater treatment does not measure for pharmaceuticals, a growing concern of OWASA and environmental activists worried about prescription drugs flushed down toilets. He also acknowledges biosolids from industrial areas may carry more pollutants than OWASA's residential waste stream.

Still, he doesn't discount those who say living near application fields makes them sick.

"It's their opinion, which they're entitled to."

'The same church'

Nancy Holt, a 65-year-old retired nurse and health care administrator, lives 400 feet from a field where sludge is spread off Bradshaw Quarry Road.

Her concerns abut her grandson and great nephew helped persuade the county commissioners to fund the study that never got done. She thinks sludge may also be responsible for her and her husband's poor health. She has giant cell arteritis, in which the blood vessels in her brain swell, and encephalomalacia, a softening of brain tissue caused by inflammation. Her husband, a nonsmoker, has chronic obstructive pulmonary disease and asthma.

Holt says neighbors are sick but won't speak up in the close-knit community where farmers depend on sludge for their livelihood.

"They belong to the same church, and they cannot go against their neighbors and church members," she said. "So they shut up."

Dotson, who is holding a community sludge forum June 4 at the White Cross Recreation Center, has run across similar resistance.

"I think a lot of people don't want to get on the bandwagon where there's no easy solution," she said. If sewage treatment plants didn't spread it, they would have to burn or bury it.

Soon after she began trying to organize her neighbors, Dotson got an anonymous phone call.

"'Get your nose out of something you don't know anything about,'" she said the caller said. "It was kind of concerning, 3:30 in the morning. It only made me more mad."

Health problems

A 2005 report by the state Occupational and Environmental Epidemiology Branch cited concerns near the Orange/Alamance county line, including odors, health problems and contaminated wells that residents blamed on biosolids.

The report said sludge rules are based on risk assessments done in the 1980s and 1990s. It said staff could not determine how setbacks from application sites were determined and that more research was needed to make sure sludge wasn't reaching water supplies.

More recent research, the report said, suggests pathogens in Class B biosolids may grow after they've been applied and infect grazing animals. Workers exposed to sludge have reported nasal irritation, gastrointestinal complaints, respiratory problems and skin and eye irritation, it said.

"At the moment we really can't say," said branch head Douglas Campbell, M.D. "We don't know if there's a direct link between the health complaints and sewage sludge."

"We wanted to get a study off the ground, but there weren't the resources."

The report, submitted to the state Department of the Environment and Natural Resources, recommended monitoring wells around application sites, a doubling of setback distances and a survey to determine health effects.

Campbell said as far as he knows none of the recommendations was incorporated in DENR rules.

Konsler, the county environmental health services director, also wants to see more research. He plans to meet with UNC's School of Public Health about possibly reviving the 2006 study.

"There's wide opinion," he said. "I certainly feel there needs to be more science behind the regulations."

THE STORY SO FAR

Background: Sludge, the byproduct of sewage treatment, has been spread on farmland for decades. In 2006, Orange County agreed to pay for a study to assess the practice's safety. The study never happened.

What's new: The Commission for the Environment, an appointed citizens group that advises the Orange County Board of Commissioners, has asked the county to appoint a task force to study sludge, also known as biosolids.

What's next: The commission is drafting a letter to the county commissioners to formalize its request. Meanwhile, the county's environmental health services director wants to try to get the study back on track.