In the early 1990s, the Maine Department of Environmental Protection (DEP) held a local public hearing on a seemingly routine permitting issue for the area’s major employer, a large pulp and paper mill. But the hearing quickly became the setting for a dramatic confrontation between the mill and area residents who voiced concerns about growing cancer rates among local citizens that they believed were caused by pollution from the mill. Others, equally vocal, vehemently denied that there was a health issue and warned that the region’s new label as “Cancer Valley” was unjustly tarnishing the community’s reputation and hindering economic development. As the mill was in compliance with all existing federal and state regulations concerning air quality, the mill managers were deeply alarmed by the charges leveled against them.

In the face of these growing environmental pollution and public health concerns, CBI was asked by the U.S. EPA  Region 1 to design and facilitate an issues assessment and stakeholder engagement process that included participation by the mill, agencies, and the surrounding communities.


CBI conducts an issues assessment to help reorganize a multi-stakeholder coalition, and works with the community to conduct a cancer incidence study, a radon monitoring program, an air toxics monitoring program, and other activities.

CBI conducted an issues assessment to better understand the concerns of the community and to identify how an existing multi-stakeholder group, the Northern Oxford County Coalition (NOCC), might be better organized to address these concerns. The assessment showed that, in order to be effective, the NOCC needed more active participation from the mill management and its union, assistance from the Maine Department of Public Health, and broader participation from the four affected towns’ residents, as well as other key stakeholders.

After making recommendations for reorganization, CBI designed and led a retreat to help NOCC develop a mission statement and a set of ground rules. To help NOCC implement its mission, CBI helped them conduct a joint cancer incidence study, hire an independent technical advisor from the Robert Wood Johnson Medical School at Rutgers, and establish a technical subcommittee that worked for seven months to develop a credible, legitimate, and informative cancer incidence study.

The community, with active assistance from the U.S. EPA, helped 500 homeowners conduct radon testing, another identified concern in the area. A subcommittee of the NOCC developed an air toxics monitoring plan, which the Maine DEP implemented. The NOCC also examined local pollution prevention programs, smoking rates, and smoking prevention programs. Finally, the NOCC explored the scientific controversy surrounding dioxin.


With CBI’s help, the mill’s standing in the community is elevated, air quality is improved, and a public health group forms.

After two years of diligent effort, a final report was distributed via the local newspaper to over 7,000 residences. With CBI’s help, not only was the mill’s relationship with the community bettered and the air quality improved, but a local nonprofit public health group was established. The NOCC’s final act was creating its successor, the River Valley Healthy Communities Coalition, to continue improving the quality of life and health in the region. A project participant concluded that the development of the ongoing health coalition was a “real success… it’s a major thing for this community.”