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Knox County, Nebraska: environmental and disease records

Cancer mortality in Knox County is 144.6 deaths per 100,000 people per year against a U.S. rate of 143.2. Federal databases place 85 regulated facilities, sites and hazards inside the county, led by Air permit holder (minor source) (31), NPDES wastewater discharge permit (28), Brownfield property (7). EPA AirToxScreen estimates a lifetime cancer risk from outdoor air toxics of 20 in a million, driven mainly by formaldehyde.

Rates are age-adjusted per 100,000 people. A cancer signal is marked significant when the lower bound of its 95 percent confidence interval is above the U.S. rate. Facility counts use active federal records located inside the county boundary. Approximate county center: 42.654, -97.8954.

How this county ranks in Nebraska

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Cancer deaths and new cases versus the United States

Source: NCI and CDC State Cancer Profiles, both sexes, all ages. Sorted by the ratio of the county rate to the U.S. rate.

Cancer rates for Knox County compared with the United States
Cancer	Measure	County rate	U.S. rate	Times U.S.	95% interval	Years
Lung & bronchus	Deaths	34.7	30.2	1.15x	22.9 to 52.3	2020-2024
All cancer	Deaths	144.6	143.2	1.01x	117.6 to 177.2	2020-2024
Lung & bronchus	New cases	48.5	51.8	0.94x	33.8 to 69.1	2019-2023
All cancer	New cases	350.7	453.4	0.77x	301.3 to 406.5	2019-2023

Mortality measures versus the U.S. county median

Source: County Health Rankings, built from CDC National Vital Statistics System death records. The comparison value is the median of all U.S. counties.

Mortality measures for Knox County
Measure	County	U.S. median	Difference	Unit
Premature death	8,014.1	9,842.6	-19%	years of life lost before age 75 per 100,000
Life expectancy	77.5	75.3	+3%	years
Child mortality	111.6	59.8	+87%	deaths under age 18 per 100,000
Infant mortality	n/a	6.2	n/a	deaths under age 1 per 1,000 live births
Injury deaths	71.8	96.9	-26%	deaths per 100,000
Drug overdose deaths	n/a	28.6	n/a	deaths per 100,000

Air toxics and air quality

EPA AirToxScreen 2020

Lifetime cancer risk from outdoor air toxics: 20 in a million. EPA treats 100 in a million as the upper end of acceptable risk and 1 in a million as the goal.

Formaldehyde13.35 per million
Carbon Tetrachloride2.88 per million
Acetaldehyde1.04 per million
Benzene0.52 per million

EPA Air Quality Index 2025

Monitored on 348 days: 320 good, 4 unhealthy for sensitive groups or worse. Median AQI 36, peak 115.

Regulated facilities, sites and hazards by type

85 active records inside the county from EPA ECHO, TRI, Superfund, Brownfields, NPDES, EIA, FAA, FRA and corrections data.

Air permit holder (minor source)31
NPDES wastewater discharge permit28
Brownfield property7
Auto repair or body shop (mapped facility)5
Public airport4
Gas station (mapped facility)3
EPA air quality monitor2
Wind power plant2
Wastewater plant (mapped facility)2
Scrapyard (mapped facility)1

Highest-severity records

The 25 records with the highest Envyrofax severity in the county, with the agency identifier to cite in a records request.

Crofton Wastewater Treatment Facility, Crofton
NPDES wastewater discharge permit.
EPA FRS registry ID 110006606672 (U.S. EPA ECHO) Agency record
Severity 4.5
Wausa Wastewater Treatment Facility, Wausa
NPDES wastewater discharge permit.
EPA FRS registry ID 110006579620 (U.S. EPA ECHO) Agency record
Severity 3.8
Creighton Potable Wtp, Creighton
NPDES wastewater discharge permit.
EPA FRS registry ID 110008887384 (U.S. EPA ECHO) Agency record
Severity 3.8
Nebraska Indian Community College, Niobrara
Brownfield property.
EPA FRS registry ID 110071969445 (U.S. EPA Brownfields (ACRES)) Agency record
Severity 3
Santee Sioux Casino/Golf Course Part A, Niobrara
Brownfield property.
EPA FRS registry ID 110071969450 (U.S. EPA Brownfields (ACRES)) Agency record
Severity 3
Mrbf-03/Mrsw-03, Santee
Brownfield property.
EPA FRS registry ID 110071969451 (U.S. EPA Brownfields (ACRES)) Agency record
Severity 3
Casino C, Niobrara
Brownfield property.
EPA FRS registry ID 110071969826 (U.S. EPA Brownfields (ACRES)) Agency record
Severity 3
Lcbf-01, Niobrara
Brownfield property.
EPA FRS registry ID 110071983740 (U.S. EPA Brownfields (ACRES)) Agency record
Severity 3
Bcbf-08, Niobrara
Brownfield property.
EPA FRS registry ID 110071983743 (U.S. EPA Brownfields (ACRES)) Agency record
Severity 3
Bcbf-16, Niobrara
Brownfield property.
EPA FRS registry ID 110071983744 (U.S. EPA Brownfields (ACRES)) Agency record
Severity 3
Niobrara Wastewater Treatment Facility, Niobrara
NPDES wastewater discharge permit.
EPA FRS registry ID 110011036066 (U.S. EPA ECHO) Agency record
Severity 2.8
Village Of Santee, Niobrara
NPDES wastewater discharge permit.
EPA FRS registry ID 110017696304 (U.S. EPA ECHO) Agency record
Severity 2.3
Verdigre Wastewater Treatment Facility, Verdigre
NPDES wastewater discharge permit.
EPA FRS registry ID 110070687026 (U.S. EPA ECHO) Agency record
Severity 2.3
Lewis & Clark Nrd - Cedar Knox Rural Water Project, Hartington
NPDES wastewater discharge permit.
EPA FRS registry ID 110006706868 (U.S. EPA ECHO) Agency record
Severity 2
Creighton Muni, Creighton
Public airport. O.
Record ID 6K3 (FAA / U.S. DOT)
Severity 2
Bloomfield Muni, Bloomfield
Public airport. O.
Record ID 84Y (FAA / U.S. DOT)
Severity 2
Wastewater Plant
Wastewater plant (mapped facility). Mapped facility presence only; no compliance or exposure measurements.
Record ID way/921082090 (OpenStreetMap contributors) Agency record
Severity 2
Wastewater Plant
Wastewater plant (mapped facility). Mapped facility presence only; no compliance or exposure measurements.
Record ID way/921082091 (OpenStreetMap contributors) Agency record
Severity 2
Creighton Wastewater Treatment Facility, Creighton
NPDES wastewater discharge permit.
EPA FRS registry ID 110006587425 (U.S. EPA ECHO) Agency record
Severity 1.5
Herzog Feedlot, Bloomfield
NPDES wastewater discharge permit.
EPA FRS registry ID 110006597030 (U.S. EPA ECHO) Agency record
Severity 1.5
Knox County Feeders Inc, Bloomfield
NPDES wastewater discharge permit.
EPA FRS registry ID 110006603041 (U.S. EPA ECHO) Agency record
Severity 1.5
Bloom-N-Egg, Bloomfield
NPDES wastewater discharge permit.
EPA FRS registry ID 110007380155 (U.S. EPA ECHO) Agency record
Severity 1.5
Jessen Feedlots, Bloomfield
NPDES wastewater discharge permit.
EPA FRS registry ID 110020503089 (U.S. EPA ECHO) Agency record
Severity 1.5
Mason Grove Land And Cattle, Bloomfield
NPDES wastewater discharge permit.
EPA FRS registry ID 110037099644 (U.S. EPA ECHO) Agency record
Severity 1.5
Mark Miller Livestock, Bloomfield
NPDES wastewater discharge permit.
EPA FRS registry ID 110040440109 (U.S. EPA ECHO) Agency record
Severity 1.5

Correctional facilities

Prisons, jails and corrections operations with an EPA facility record, and the drinking water and wastewater compliance attached to them.

No correctional facility with an EPA record is located in this county.

Discovery / public records

Records to request for Knox County

Nebraska state cancer registry
Cancer incidence counts by census tract or ZIP code, by cancer type and year (de-identified). Any cancer cluster inquiries or investigations in Knox County, and their findings.
Nebraska vital statistics office
Death certificate counts by cause of death and residence tract or ZIP code, and the years behind the mortality measures above.
Nebraska health department, environmental epidemiology
Health consultations or assessments by ATSDR or the state health department covering the county, and any exposure investigations.
Nebraska environmental agency and the U.S. EPA regional office
Compliance history, inspection reports, notices of violation, penalties and enforcement actions for each facility above, cited by EPA FRS registry ID.
Nebraska drinking water program
Violation notices, sampling results and sanitary surveys for the public water systems serving the county, including any system serving a correctional facility.
Department of corrections or county sheriff
Water testing, grievances and environmental health inspections for the correctional facilities listed above.

Each Envyrofax address report includes a printable records request worksheet with the custodian and the exact request wording per finding.

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