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Coordinated nationally by the Institute for Children's Environmental Health |
To join the Partnership for Children's Health and the Environment (PCHE), please contact Elise Miller at emiller@iceh.org.
March 7 - 9, 2006
Boston, Massachusetts
at the Seaport Hotel
This conference will address our common pursuit of sustainability's best practices. A full schedule of workshops and seminars -- led by the leading practitioners in their fields -- provides professionals the means to learn what works, who is making it work, and how they can integrate these new technologies and processes into their own practice.
Website: http://buildingenergy.nesea.org/
Contact: nesea@nesea.org
March 9, 2006
Seattle, Washington
at Town Hall, 1119 Eighth Avenue (at Seneca Street)
While global warming has captured a great deal of media attention, reports have often been framed in abstract or theoretical terms that do not explain, in practical terms, its effects on human health. Jonathan Patz, MD, MPH, is associate professor of Environmental Studies and Population Health Sciences at the University of Wisconsin-Madison, where he directs a university-wide initiative on Global Environmental Health. He is also the founder of the Program on Health Effects of Global Environmental Change at Johns Hopkins University and serves as an affiliate scientist with the National Center for Atmospheric Research. Dr. Patz will lecture on the relationships between land use, climate change and infectious disease.
This lecture is part of an annual environmental health lecture series, "Our Health, Our Environment: Making the Link" sponsored by the Seattle Biotech Legacy Foundation and organized by the Institute for Children's Environmental Health (http://www.iceh.org).
Website: http://washington.chenw.org/lectures.html
March 10 - 11, 2006
9:00 a.m. to 5:00 p.m.
Seattle, Washington
at the Mountaineers Conference Center, 300 Third Avenue West
This conference is an opportunity to learn about recent developments in sustainability practices, especially those in the Pacific Northwest. Over 40 professionals and community leaders who have dedicated their lives to working for a more sustainable future will lead sessions. Speeches, workshops and films will cover topics including Simpler Living, Clean Energy, Eating for Sustainability, Waste Reduction and Green Building to name a few. The goal of the conference is to provide practical information, methods, and resources to empower attendees to live their lives and practice their work more sustainably.
Website: http://www.nweec.org/sust-400_03-06_seattle.htm
Contact: Emi Morgan, 206-762-1976 or emorgan@nweec.org
March 16 - 20, 2006
Washington, DC
Featuring 106 documentary, feature, archival, children's and animated films. Most are free and include discussion.
Website: http://www.dcenvironmentalfilmfest.org
Contact: 202-342-2564 or envirofilmfest@igc.org
April 19 - 20, 2006
Seattle, Washington
CleanMed 2006, the nation's largest environmental conference for the health-care industry, will be held April 18-20 Seattle. Leaders along the entire health-care supply chain -- including major hospital systems, top group purchasing organizations, health care providers, product manufacturers, food service professionals, architects and designers -- will be there to discuss the latest trends in safe products, green buildings, waste prevention, healthy food service and other health-care industry efforts to protect the health of patients, workers and communities. Tyrone B. Hayes, PhD, and Paul Hawken will be presenting.
Website: http://www.cleanmed.org/
The January/February issue of San Francisco Medicine, the journal of the San Francisco Medical Society, is entirely devoted to articles on environmental health. Developed with the participation of the Collaborative on Health and the Environment, it is online at http://www.sfms.org/Content/NavigationMenu/Home/SFMedicineMagazine/jan_feb_2006_sfm.pdf
by Madeline Drexler, Harvard Magazine
March-April 2006
http://www.harvardmagazine.com/on-line/030636.html
In the city of Boston -- and everywhere else -- wealth equals health. If you live in Beacon Hill's Louisburg Square, which sits in the federal census tract with the third highest median family income in Suffolk County -- $196,210 -- you're sitting pretty. Your risk of dying before the age of 65 is about 30 percent less than if you live on Pleasanton Street in Roxbury, about four miles away, where the median family income is $30,751, and where one-third of residents live (or more accurately, survive) below the poverty line. Put another way, Louisburg Square's red brick and brownstone, lovingly maintained locusts and beeches, wrought iron gates and sparkling windows with wavy glass exert a measurably salutary effect on the human body. Pleasanton Street and its environs -- home to dilapidated Victorians and untended maple trees, abandoned lots and overflowing dumpsters, shards of automobile glass and billboards that say "Looking to Re-Establish Credit? We Finance Anyone" -- in effect act like a potent risk factor for a spectrum of ills.
Two years ago the New England Journal of Medicine published a commentary titled "Class -- The Ignored Determinant of the Nation's Health." Its authors, a policy analyst and an academic physician, wrote: "[P]eople in lower classes die younger and are less healthy than people in higher classes. They behave in ways that ultimately damage their health and that take their lives prematurely (by smoking more, having poorer eating habits, and exercising less). They also have less health insurance coverage, live in worse neighborhoods, and are exposed to more environmental hazards. Beyond that, however, there is something about lower socioeconomic status itself that increases the risk of premature death."
For 20 years, that "something" about being poor and getting sick has preoccupied Nancy Krieger '80, Ph.D., professor of society, human development, and health at the Harvard School of Public Health. It has also preoccupied her older brother, James Krieger '78, M.D., chief of the epidemiology, planning, and evaluation unit at Public Health-Seattle and King County, his local public-health authority. Independent of each other, the Krieger siblings have transformed that fixation into the leading edge of public-health theory and practice. Nancy's hypotheses and methods are called, by many colleagues, the most brilliant contributions to social epidemiology in a generation. Jim's on-the-ground innovations are the envy of local health departments across the country. Sister and brother have set a standard for what public health can and should be in the United States; both are trying to steer the profession back to its roots in social justice. That few beyond their respective fields have heard of the Kriegers says as much about their modesty as about the battered profile of public health in America.
Public health is dedicated to the humble proposition that social action to promote health and prevent disease saves more lives more cheaply than does high-tech medicine. Recently, U.S. health authorities have paid some lip service to this perspective. In scientific meetings, official reports, and federal financing, the terms "health disparities" and "social determinants of health" have cropped up. In 2006, the National Institutes of Health will allot $200 million (out of a total budget of $28 billion) for its Center on Minority Health and Health Disparities. Here's the main idea behind the terms: the immediate causes of individual human affliction, parsed ad nauseam by newspaper and magazine health-advice columns -- fatty diets, tobacco smoke, sedentary ways -- are themselves caused by underlying forces: poverty, discrimination, stressful jobs, marketing by profit-driven global food companies, substandard housing, dangerous neighborhoods, and so on. Put another way, if every human being enjoyed all life's opportunities, disease patterns would look very different.
What makes the Kriegers' work unique is that they have toiled in vastly different domains but toward the same goal of understanding the social determinants of health, starting long before the phrase acquired professional cachet. They have proven that these institutional precursors are as amenable to study as any single-celled bacterium -- and not only to study, but to change.
For the complete article, please visit http://www.harvardmagazine.com/on-line/030636.html.
by Jerry Hirsch, Los Angeles Times
March 6, 2006
http://www.latimes.com/news/local/la-fi-fish6mar06,0,3536708,full.story?coll=la-home-headlines
Tuna is arguably the most popular offering at sushi bars. Many customers like slices of blood-red fish slathered in a spicy wasabi sauce. Others prefer the more simple nigiri style, which is sliced tuna over rice. But now a public health advocacy group is warning about the safety of tuna sushi and questioning the Food and Drug Administration's system of monitoring the mercury levels in fish, based on tests on a small sample of such delicacies at Los Angeles restaurants.
The group, GotMercury.org, purchased sushi from five top Zagat-rated restaurants in Southern California and from the Benihana Inc. chain in late January. Instead of eating the orders, the Forrest Knolls, Calif.-based organization took the fish for testing at CRG Marine Laboratories in Torrance. The mercury levels of the 12 tuna samples averaged about double the FDA standard, and a quarter of the orders were near or above the limit where the agency says fish should not be sold, said Eli Saddler, a public health analyst and attorney for GotMercury.org. "Eating sushi has become the new Russian roulette," Saddler said.
The advocacy group focused on sushi because the popular food has become one of the largest sources of fresh tuna consumption. Saddler believes this is the first time an independent group has attempted to monitor mercury levels in sushi. The samples came from some of Southern California's toniest restaurants -- Matsuhisa, Sushi Katsu-ya, Sushi Sasabune, HamaSaku and Sushi Nozawa. GotMercury.org also went to Benihana in Santa Monica because it's part of a large national chain where sushi is featured. "Our testing shows a pattern of mercury levels being significantly higher than what the FDA reports," Saddler said.
Mercury, which is linked to reduced brain development in fetuses and young children, is found in at least trace levels in nearly all fish. The FDA and Environmental Protection Agency have warned that women who may become pregnant and young children shouldn't eat certain high-mercury fish, including swordfish, shark, tilefish and king mackerel. They should also limit their consumption of tuna, the agencies have said.
Increasing concern about mercury in fish has pushed some in the food industry to advocate improved testing. Last week, Micro Analytical Systems Inc. of San Rafael, Calif., and Clackamas, Ore.-based wholesaler Pacific Seafood Group began a test venture to provide fish certified to be low in mercury to Holiday Quality Foods, a small grocery chain in rural Northern California. The venture uses a rapid-testing device developed by Micro Analytical that takes minutes rather than days to determine how much mercury is in a fish sample. In most instances, only fish that tests below the median mercury level in the FDA database -- for yellowfin tuna, that's 0.27 part per million -- gets the venture's Safe Harbor label, indicating that it is a low-mercury filet.
Aliso Viejo hairdresser Christopher Bliss used to eat sushi as often as twice weekly. But when his wife Valerie became pregnant two years ago, they gave it up because they were worried about the mercury content of the fish. "Now we eat it once a month. I don't think that's enough to worry about," Bliss said. Still, they have enough concern not to feed it to Ava, their 18-month-old daughter.
Susan Pasarow of Studio City likes to eat at Sushi Katsu-ya, not far from her home. "They are the best," Pasarow said. "I like to order all the yummy rolls." And she gets lots of items with tuna. Pasarow wasn't happy to learn that Katsu-ya fish had the highest mercury concentrations among the 12 samples, but said she was aware of the problems of mercury in fish. "That's why I hesitate to have sushi very often. I go maybe once a month or once every other month," Pasarow said.
The two samples from Sushi Katsu-ya in Studio City came back with mercury concentrations of 1 part per million and higher, above the FDA's threshold for mercury in any seafood species, Saddler said. One sample from Sushi Nozawa, also in Studio City, came back just shy of the limit, Saddler said. Neither restaurant responded to calls asking about the tests. Representatives of Benihana and Matsuhisa in Beverly Hills declined to comment on the findings. And HamaSaku in Los Angeles had Young Kim of Ocean Group Inc., its tuna provider, return the call. "We are just a wholesaler, we don't monitor for mercury," Kim said.
Saddler said he didn't blame the restaurants for the problem. "I know this is the way the fish comes in, but they should do a better job of warning customers," Saddler said. That's the practice of Nobi Kusuhara, chef and owner of Sushi Sasabune in West Los Angeles. He said it's well known that tuna and swordfish have high mercury levels and he regularly warns pregnant customers not to order those fish. "We would like to be able to get fish that has been tested for mercury," Kusuhara said. "That would be good for the customer and would be good for us."
Kusuhara said there was no system for regularly and rapidly checking the mercury concentrations of what's for sale at the local fish market and at Southern California wholesalers. The FDA and other health regulators should have a more rigorous testing system, he said. Saddler said the yellowfin samples culled from the Southern California restaurants had a median mercury concentration of 0.82 ppm, not far from the FDA limit. The testing methodology used by CRG is similar to what the FDA uses, said Richard Gossett, CRG's laboratory manager. "A child or a woman eating even one 2-ounce sushi order with the amounts of mercury found in some of the tuna we tested could exceed what the FDA considers safe," Saddler said. The test results might be coming in higher than expected because the fish prized for sushi are older, larger tuna that have had years of ocean hunting to build up their mercury levels, Saddler said. Younger and smaller fish probably would contain less mercury. Nonetheless, Saddler said the results highlighted flaws in the FDA's fish monitoring program. The agency does limited fish testing, and instead puts its efforts into informing the public about the hazards of high-mercury fish species.
David Acheson, the FDA's chief medical officer, said the agency hadn't advocated large-scale testing of fish because of the enormous time and expense such an endeavor would take. Moreover, current regulations don't give the FDA much leverage in trying to prevent the sale of fish containing 1 ppm or more of mercury, he said. To take action, the agency has to prove that the particular fish had too much mercury and the consumption of that fish would be harmful. Acheson said there was little chance the FDA would be able to prove in a courtroom that an individual fish was harmful.
Saddler said that now that companies such as Micro Analytical are starting to develop rapid and inexpensive testing systems, the FDA should push for increased monitoring. His organization also wants restaurants and grocery stores to stop selling the species known to be highest in mercury and that frequently exceed the FDA maximum threshold unless seafood suppliers provide proof that fish being sold don't exceed the FDA's limits.
As a branch of the Turtle Island Restoration Network, GotMercury.org previously has pushed for policy changes involving fish and mercury in California. It was one of the groups that persuaded California Atty. Gen. Bill Lockyer to sue the state's major supermarket and restaurant chains for allegedly violating California's Proposition 65 by failing to post signs warning patrons. Benihana and 10 other restaurant chains settled the suit last year and have posted warning signs. The supermarket case is pending, but many of the chains also have posted signs. "We have worked closely with them throughout this whole mercury battle," said Tom Dresslar, a spokesman for Lockyer.
Despite the test results, Saddler said he wasn't going to give up sushi. He just plans to stop ordering tuna entrees. "There's salmon, shrimp, clams and other shellfish," Saddler said. "Most of the other stuff would be OK if you are worried about mercury."
by Karoun DemirJian, contributor to the Christian Science Monitor
March 6, 2006
http://www.csmonitor.com/2006/0306/p13s02-sten.html
Look around you. What do you see? A computer screen, the print on this page, a pen, your shirt. Chances are there's petroleum in all of it. Petroleum-based substances are in everything from lipstick to laundry detergents, clothes to computers to chocolate bars -- even fertilizers and pharmaceuticals. Petroleum for nonfuel use made up just over 5 percent of total oil consumption in the United States last year, according to the Department of Energy. Five percent may not seem like a lot, but it's still 1 million barrels a day, more or less. That's enough to demand the attention of a new generation of industry and academic scientists who are working to find natural, nontoxic alternatives to petroleum for consumer products. They have dubbed their field "green chemistry."
"The way we've always dealt with environmental issues in the past is that we take products and processes, and if there's problems, then we try to clean it up afterwards," says Paul Anastas, a former EPA executive and director of the Green Chemistry Institute in Washington, D.C. "Green chemistry tries to do it from the design stage." Those designs try to replace oil-derived ingredients with substitutes made from plant material such as corn, potatoes, biomass, or flower and vegetable oils. "The industry wants drop-in technologies," says John Warner, director of America's only doctoral program in green chemistry at the University of Massachusetts at Lowell. "The product has to be something that in every way looks and feels the same -- so that's the challenge."
The size of that challenge depends on the petroleum-related product to be duplicated. In the case of paints, detergents, and personal care products like lotion and shampoo, the inspiration for green science has been around for a while. "Many years ago, paints were produced from vegetable and mineral resources," says Scott Egide, General Manager for AURO USA, which makes paints using linseed and flaxseed oils. Oil-based chemicals began to appear in household cleaning products around World War II, says Martin Wolf, director of product and environmental technology for Seventh Generation, which makes petroleum-free detergents. "Animal fats and plant oils were the basis of soaps through the first part of the 20th century," he says. "Surfactants [soaps and detergents] made from petroleum later were just designed to mimic nature."
Substituting for the petroleum used in plastics, however, is a relatively new science. To make conventional plastics, oil must be broken down into constituent monomers, which are then reconstituted into polymer chains (plastics). Scientists have now mimicked this process with corn starches, creating a new polymer called polylactic acid (PLA).
Adding pineapple reinforcers
While the idea of plant-based polymers goes all the way back to the 1930s and '40s, significant steps toward the development and production of PLA did not occur until the 1990s. "This is the product of literally decades of research," says Mr. Anastas. Research continues to make natural plastic more durable and impermeable -- necessary to make it competitive.
At Cornell University in Ithaca, N.Y., chemistry professor Geoffrey Coates and researchers from the school's Consortium on Green Polymers combine soybean-based proteins with natural fibers, like those found in pineapple, to make the plastics stronger. In Professor Warner's lab in Lowell, Mass., researchers treat corn-based polymers with ultraviolet light. That twists and contorts the polymers, making them stronger and more durable. The natural plastic can be intentionally broken down with the help of bacteria that turn the complex polymers back into plant material -- which can then be reconstituted into natural plastic again.
Purifying and breaking down used petroleum-based plastics is costly. Instead, plastic recycling usually consists of taking a high-end product and producing a low-end one. "I want to be able to take a laptop computer and make another laptop computer, not a speed bump," Warner says. "The dream with our technology is to be able, at low cost, to recover the polymer in its originally useful form." Optimal use of energy is a paramount concern.
Energy-efficiency is key
"You have to look at the energy balance," Professor Coates says. "It's not just 'Did the stuff come from nature?' It's 'Well, if it came from nature, is it worth it?' If it takes a lot of energy, you might be better off just converting your fossil fuels" into plastic. Energy efficiency also keeps costs low. "Folks in industry like green chemistry, because it helps them meet profit goals and economic competitiveness goals," Anastas says. "Nonhazardous nontoxic chemicals are going to be cheaper to manufacture, and add value to the industry."
Large-scale production of biorenewable plastics is already under way. NatureWorks LLC, a subsidiary of food and agriculture giant Cargill, sells corn-based plastic to manufacturers of plastic containers, cutlery, and packaging. Chemical company Dupont's biorenewable Sorona plastic can substitute for polyester and other synthetic fabrics. And last year, Wal-Mart announced its intention to use only biorenewable materials for its plastic packaging. "To replace a commodity material, you have to get those economies of scale," says Ann Tucker of NatureWorks. Her company has been able to lower the price of its biorenewable packaging plastic from more than $1 a pound to about 63 cents. While the price of the equivalent petroleum-based plastic packaging currently can cost as little as 40 cents per pound, NatureWork's pricing is extremely competitive, says Frank Esposito of PlasticsNews. That's because petroleum-based plastics bear the cost of rising oil prices. Large orders, like those anticipated from Wal-Mart, should lower the cost of biorenewable plastic still further, he says.
Support crosses party lines
Support is also trickling in from the political sector, as various state governors (including those of Maine, just last week, and New York earlier this year) mandate the development and use of nontoxic chemicals. Interest in Washington cuts across party lines. "The first perception is always that green chemists are tree-hugging hippies, until they realize that this is hard core beakers-and-flasks chemistry," Anastas says.
The last significant challenge, perhaps, is acceptance by an increasingly oil-conscious America. "Using petroleum in materials is not as bad as burning it," Anastas says. "But we never want to use a finite resource at a greater pace than we can replace it."
Clothing: Synthetic clothes are essentially plastic, which, like soda bottles and storage bins, are made from petroleum-based polymers. That includes such fibers as polyester and nylons, synthetic substitutes for shoe leather, hard plastic buttons, and plastic zippers. Most clothing dyes are oil-based as well.
Detergents: The surfactants that enable many modern soaps and detergents to break up greasy stains are derived from petrochemicals.
Chocolate: Many chocolates maintain their appetizing look with the help of paraffin, an oil-based wax also used in candles. The paraffin helps molded chocolate hold its shape, and makes it look shiny. Food-grade paraffin is harmless, but nondigestible.
Soda bottles and other plastics: The polymers that form the building blocks of plastics are made from reconstituted monomers, traditionally derived from petroleum and natural-gas liquids.
by Susan Allan, the Ottawa Citizen
March 5, 2006
http://www.canada.com/ottawacitizen/news/story.html?id=1a0ccc38-194a-4f28-8e96-3e62a625b13e
Davis Baltz is a toxic waste site, according to a 2003 investigation that unearthed 15 dioxins and furans, 41 PCBs, four organochlorine pesticides, 33 volatile and semi-volatile organic compounds, lead, mercury and phthalates. Problem is Davis Baltz is not a place, he is a person. "As alarming as those figures were to me, the reality is that everyone in the world, no matter where they live, is going to have somewhat similar profiles," says Mr. Baltz, an environmental researcher in Bolinas, California. "Everyone on Earth is exposed. There's no place to hide."
Mr. Baltz was one of nine participants in an Environmental Working Group study led by the Mount Sinai School of Medicine in New York. Thirteen vials of blood were drawn from each volunteer, who also provided urine samples throughout a 24-hour period. Doctors and researchers screened the samples and discovered in each, on average, 91 industrial compounds, pollutants and other contaminants, including PCBs, which have been banned in the United States since the 1970s. They also found phthalates, a plasticizer chemical used in many everyday products, including perfumes and nail polish. "Scientists have been studying pollutants in air, water and on land for decades," the Washington-based research group explained. "Now, they're studying pollution in people."
The EWG and other advocacy groups believe the findings from this and similar studies highlight the failure of current chemical regulations and reveal disturbing truths about the way our bodies metabolize manmade toxins. They argue that low-dose exposures to hundreds of chemicals -- including those found in shampoos, lotions and perfumes -- can have wide-ranging and serious health effects. The chemical industry argues that proof of exposure is not proof of harm.
In a speech to investors in October 2003, the president of the American Chemistry Council predicted that "professional health activists" and "other traditional detractors" would become increasingly vocal in their demands "to bring about compound substitution, product de-selection and additional and costly regulatory burdens." The trade group represents 135 leading manufacturers in the chemical industry, a $450-billion enterprise in the United States. Greg Lebedev, then president of the ACC, told a New York audience that phrases like "chemical trespass" were coined by activists with "very little, if any, knowledge" in order to inspire negative response. "These antagonists, of course, ignore the differences between acceptable risk and legitimate hazard, and turn away from common sense that tells us, for example, the chemical properties in penicillin can save your life, but if taken in excess can harm you ... as most things done in excess."
The chemical industry is a powerful opponent, Mr. Baltz observes. "Sometimes, on my optimistic days, I think we're actually doing quite a lot considering how outgunned we are. Our strength is in our argument: We're saying that chemicals that are potentially harmful don't belong in people."
Across the Atlantic, Karl Wagner leads DetoX, a World Wildlife Fund campaign demanding European leaders take swift action to ban certain industrial chemicals. Last June, the environmental group enlisted politicians to their cause, drawing the blood of 14 government ministers from 13 countries of the European Union. Tests revealed 55 chemicals in the ministers' blood -- "a ubiquitous contamination by a cocktail of hazardous chemicals." The chemical found in the highest concentration and the highest median concentration was diethylhexyl phthalate, a synthetic chemical that is used in a wide range of consumer products, including cosmetics and perfume.
The WWF, like Mr. Baltz, argues that it is possible to infer that everyone in the world is similarly contaminated and offers the investigation as proof that chemicals the industry insists are safe are, in fact, accumulating in human bodies. "The findings call into question the claims that chemicals are under 'adequate control,' a claim made despite the fact that the vast majority of chemicals have no publicly available safety data."
Chemical manufacturers dismiss the "alarmist tone" of the campaign, and the producers of bromine flame retardants, in particular, condemn the WWF for "creating public anxiety." Mr. Wagner himself was tested and expressed shock when the Bad Blood report was released last October. "In my blood, there are at least 43 artificial, manmade chemicals. Chemicals used to make fire-resistant sofas, non-stick pans, grease-proof pizza boxes, baby bottles, the lining of tin cans and even pesticides banned decades ago," he said. "I did not have a choice, I was not informed, there was no way I could have prevented this contamination."
It's a dirty secret that toxins are building up in people and in wildlife, says Mr. Wagner, or at least it was before the start of his campaign. "If scientists cannot tell me the effects of individual chemicals, what about the cocktail of chemicals streaming around my body?" The question preoccupies Davis Baltz. At the Commonweal nonprofit health and research institute on the coast of the Pacific, Mr. Baltz is helping to establish a biomonitoring resource centre. "The chemical industry will say biomonitoring is a useful tool but that it doesn't prove anything -- it doesn't tell you how you've been exposed, that there's no evidence of harm," he said in an interview. "But what they will never tell you is that these chemicals don't belong in our bodies and they're getting there without our permission."
Commonweal argues that "body burden" measurements -- testing for chemical compounds in blood and urine or breast milk, for starters -- demonstrate that North Americans must change how we manage risk. "We assume chemicals are innocent until proven guilty beyond a reasonable doubt," says Mr. Baltz. "The chemical industry puts the onus on the public to prove harm."
All of this is changing in the European Union where complex regulations have been proposed that would overhaul the chemical industry and force manufacturers to prove their products are safe. Companies that produce more than a tonne of a substance annually will have to register the chemical and disclose its properties, uses and hazards. Ultimately, chemicals found to be carcinogenic will be phased out over a 10-year period. "If you don't set certain objectives, you will never trigger the research or the political initiatives to make it work," explains Robert Donkers, co-author of the EU draft legislation.
Beauty-care substances would be covered indirectly by REACH proposals, which apply to their chemical ingredients. Personal-care products have been regulated since 1976 by the European Cosmetics Directive, which is intended to safeguard the safety of makeup products sold in European markets. It is no coincidence that the WWF DetoX campaign is in high gear as politicians in Europe debate REACH -- Registration, Evaluation and Authorization of Chemicals. "We are making politicians very much aware that chemicals are a serious health problem and that they need to act," Karl Wagner said in an interview from his home near Vienna.
While the debate in Brussels is being watched closely by the U.S. chemical industry, Mr. Donkers observes that those who wish to remain competitive have no choice but to adopt a precautionary approach to chemical safety. "I hope industry will be more proactive," he said from his office in Washington, D.C. "If they want to do business in Europe, they have to adapt because we are now 450 million customers -- that's not Mickey Mouse." The U.S. State Department is openly lobbying against REACH, arguing that it is costly and unworkable. However, Mr. Donkers says there are a few states studying the proposal. "Washington state, the New England states and also California have a different view," he notes. "They are pushing for an overhaul at the federal level. If that's not possible, they'd certainly like to do it at the state level. But that is not for tomorrow, I'm afraid."
In California, state senator Deborah Ortiz recently introduced Bill SB1168 in the legislature. The proposed law would create a statewide biomonitoring program to test Californians for chemical exposure. New Hampshire and Washington have also introduced similar bills on bioaccumulative toxins, pollutants that persist in the food chain. In cases such as mercury, the substances occur naturally. In others, like DDT and PCBs, the chemicals are manmade. The U.S. Environmental Protection Agency links Persistant Bioaccumulative and Toxic pollutants (PBTs) to a wide range of health problems, including cancer. "Most of these chemicals are not tested to determine whether or not they cause diseases in humans," Senator Ortiz said in a statement about the 85,000 synthetic chemicals registered in the United States. "This bill will enable us to know just which toxic pollutants are in our bodies and move accordingly to improve everyone's health and safety."
It is the second time the Healthy Californians Biomonitoring Program has been introduced. In June 2004, the bill failed by one vote and was criticized in part for fuelling panic about exposure to low doses of chemicals. The American Chemistry Council opposes the bill as does the California Chamber of Commerce. Steve Milloy, a vocal critic associated with the Cato Institute, a libertarian think-tank in Washington, D.C., has argued in the media and on his website JunkScience.com that there is no basis for assuming chemicals play a role in the onset of chronic disease. "We know trace levels of many chemicals and other substances can be detected in the body," he writes. "But so what? While all substances may be toxic, they're only toxic when exposures to them are sufficiently high."
Ms. Ortiz likens the debate to past discussions about lead. For most of the 20th century, scientists and public-health officials downplayed the health hazards of the heavy metal. But as science improved, the dangers became obvious and today no level of exposure is considered safe. Industry objected to a ban on leaded gasoline, but after it was outlawed, levels of the contaminant in blood went down. "It may take years to get this bill through, but we decided let's keep pushing," says Sharyle Patton, who along with Davis Baltz worked behind the scenes on the bill at Commonweal. "We are used to the chemical industry saying, 'We all have chemicals in our body and we're all living longer.' The problem, of course, is that there is an increase in brain tumours in children and an increasing risk of testicular cancer, there's no doubt. Other diseases, it's not so clear -- but how clear does it have to be?"
Testing air, water and soil is well and good, says Ms. Patton, "but when you test a human being, it's ultimate proof of exposure." Ms. Patton learned this lesson first-hand when her own results arrived from the EWG body burden study. "I just thought I'd have a few chemicals. I don't live next door to a refinery. I don't live next door to a highway. I don't live in a big city. I grew up in the Rocky Mountains." In fact, the environmentalist's blood and urine revealed 105 contaminants, including 46 different compounds of PCBs and six furans. The tests also revealed phthalates. "It speaks to the fact we're facing global contamination," Ms. Patton said from her office in California. "We're all walking around with DDT, we're all walking around with PCBs."
And yet, she says, there is reason for optimism if governments can be convinced to ban or restrict certain toxins. "There's a rich arena for productive action. Even though we have these chemicals in our bodies now, it's really possible that within a generation we won't. There's reason for hope."
Much as the WWF recruited politicians for bloodwork, Commonweal is collecting a cohort of California "luminaries" whose blood and urine will be screened for such chemicals as phthalates, polytetrafluoroethylene (Teflon) and flame retardants. "We are hopeful the tests will create a swell of interest at the same time this bill is going through the legislature," Davis Baltz explains. If and when governments start to generate exposure data, it seems a given that policy changes will follow. Sweden, for example, has been monitoring the breast milk of first-time mothers for more than three decades. Milk samples have been gathered annually from cohorts ranging in size from 20 to 116. Six years ago, studies found that milk was highly contaminated with fire retardants -- PBDEs -- and that levels were doubling every two to five years. The response was a ban on the bioaccumulative compound that is found in hundreds of everyday products. While PBDEs are being phased out in Europe, they are still used in Canada and the United States.
Since the ban in Sweden, Mr. Baltz notes, the corresponding curve of concentration in breast milk has gone down. "There is a clear relationship between banning a chemical and seeing the body burden go down." Breast-milk monitoring is not without controversy. Some women's groups suggest that informing mothers that they are passing polybrominated flame retardants, dioxin and even DDT to their babies might discourage breastfeeding. Commonweal's Sharyle Patton, who was worked extensively on the issue, insists that human milk is still the best choice for a baby. The information is obviously alarming, but she argues it is always better to know. Lactation proponents may object to the second point, Ms. Patton observes, but they share the same goal -- "we want to protect babies" -- and agree the answer is to stop pollution, not nursing mothers.
Although no one knows if environmental toxins are harming our children, in time biomonitoring may offer clues. Researchers in the United States are in the organizing stages of an ambitious project that will follow 100,000 children from birth to age 21. The National Children's Study will examine many issues, including how low-dose exposures to synthetic chemicals affect the health of developing babies, growing children and maturing adolescents. Canadian researchers lobbied the federal government unsuccessfully to create a piggyback study that would follow some 10,000 children.
Also in the U.S., the Centers for Disease Control and Prevention runs a national biomonitoring program that every two years assesses the exposure of the general American population to environmental chemicals. The studies are dedicated to answering three questions:
In the most recent report, released in January 2003, the CDC warned that just because an environmental toxin is found in someone's blood or urine does not mean the chemical causes harm. Dr. Daniel Krewski of the University of Ottawa agrees. "It is important to know what chemicals are there, but it is even more important to know at what concentration," says the head of the McLaughlin Centre for Population Health Risk. "You can detect a number of trace chemicals in body tissue, but that's just an observation that there's something there, it doesn't really address the level of risk -- if those contaminant levels are really low, the risk is going to be really low as well."
Dr. Krewski leads a committee at the U.S. National Research Council that is studying how scientists can best use emerging science to assess the toxicity of environmental contaminants. Biomonitoring is one tool that will be explored by the scientists, who will produce two reports during the next three years. At Statistics Canada, scientists are preparing the framework for a national survey of the general population that will collect lifestyle information and measure environmental exposures in approximately 5,000 randomly selected Canadians. Unlike the National Children's Study or the CDC Reports, this will be a one-time survey to establish a national baseline of health measurements.
Dr. Mark Tremblay, who leads the Canadian Health Measures Survey, says ideally this would only be the beginning -- especially since much of the cost of such research is incurred at the front end. Results of the survey are expected in 2008. On the California coast, Commonweal is working to change the way people think. Chemical contamination is not just about smokestacks or toxic spills, they say, "it's about exposures to complex mixtures of chemicals, even at low levels of exposure."
Commonweal director Charlotte Brody has spent much of her career trying to change minds. In 1996, the former nurse created Health Care Without Harm, now an international coalition that encourages hospitals to consider the environment in all areas of health-care decisions. Ms. Brody also works on the Campaign for Safe Cosmetics, which has successfully lobbied U.S. cosmetic firms to remove dibutyl-phthalate from their products. It's all related, she says. "We want to work for the government that most of us think should already be there. It's not asking for Nirvana to think that government should be working with us to protect the rights of babies to be born toxin-free," says Ms. Brody. "Corporations can make money -- godspeed -- but when they mess with my breast milk, they've gone too far."
Like others at Commonweal, Ms. Brody participated in body-burden testing. Because she was an expert on the issues, she anticipated the results -- 85 contaminants, including 45 carcinogens. Yet despite everything she knew, she says, "it suddenly moved from the academic to the personal in a fundamental way." As outrageous as it sounds, Ms. Brody says, the bioaccumulation studies are an inspiration. "There are no personal solutions," she observes. "This is about a society protecting the health of the next generation, which is what community and government should really be about. "It's not out of reach to start moving in the right direction."
Davis Baltz
Tested for 210 chemicals, 106 found. Among the contaminants in his blood: 15 dioxins and furans, 41 PCBs, four organochlorine pesticides, 33 volatile and semi-volatile organic compounds, lead, mercury, five phthalates.
'As alarming as those figures were to me, the reality is everyone in the world, no matter where they live, is going to have somewhat similar profiles.'
Karl Wagner
Tested for 103 chemicals, 43 found: Tests found high values for DHEP (a phthalate, 1.5 times the average) and a high concentration of Deca PBDE (flame retardant, 45 times the average). 'In my blood there are at least 43 artificial, manmade chemicals. Chemicals used to make fire-resistant sofas, non-stick pans, grease-proof pizza boxes, baby bottles, the lining of tin cans and even pesticides banned decades ago.'
Sharyle Patton
Tested for 210 chemicals, 105 found. Among the contaminants in her blood: 13 dioxins and furans, 46 PCBs, five organochlorine pesticides, 33 volatile and semi-volatile organic compounds, lead, mercury and four phthalates. 'I don't live next door to a refinery. I don't live in a city. It speaks to the fact we're facing global contamination. We're all walking around with DDT, we're all walking around with PCBs.'
Charlotte Brody
Tested for 210 chemicals, 85 found. Among the contaminants in her blood: 14 dioxins and furans, 28 PCBs, two organocholorine pesticides, 32 semi-volatile organic compounds, lead, mercury, three phthalates. 'Corporations can make money -- godspeed -- but when they mess with my breast milk, they've gone too far.'
by Shelley Page and Susan Allan, the Ottawa Citizen
March 5, 2006
http://www.canada.com/ottawacitizen/news/story.html?id=3e55f9fb-a950-4dc0-bc3f-a0e0f83d4f5e&rfp=dta&p=2
Age-old wisdom dictates that mothers know best, but in a complex and chemical world it turns out mothers know less and less. Consider the staples of a baby's world: diapers, wipes, washes, lotions. We know very little about products and chemicals we use a lot -- every day, many times a day. Take a top-selling bottle of gentle, soothing baby wash: tear-free, dye-free, "clinically proven." You couldn't ask for more in a baby product but chances are you might if you knew the brand-name suds contain allergens, impurities linked to cancer and ingredients that have not undergone a public safety review.
Baby washes were among 7,500 personal-care products analysed last year in a safety study by the Washington-based Environmental Working Group, which concluded that almost all products on the market -- including those intended for babies and children -- contain one or more ingredients that have not been publicly assessed for safety. The EWG petitioned the U.S. Food and Drug Administration last June and on Feb. 3, 2005, the FDA issued an unprecedented warning. Manufacturers using untested ingredients may soon be forced to tell consumers with product labels that say, "Warning: The safety of this product has not been determined."Dr. Samuel Epstein has long lobbied the FDA on safety issues in his role as head of the non-profit Cancer Prevention Coalition in the United States. "It's unthinkable that women would knowingly inflict such exposures on their infants and children, let alone themselves, if products routinely used were labelled with explicit warnings," he says.
While the U.S. government is taking a closer look at what labels reveal about ingredients, here in Canada, labels need not list ingredients at all. Some companies provide the information; others won't until November 2006 when government legislation forces them to do so. Perhaps then parents will read the small print on shampoo bottles for questionable ingredients, just as many currently scan cracker-box labels for traces of trans fats. "Right now, it's hit-and-miss," says Kathleen Cooper, senior researcher at the Canadian Environmental Law Association. "It's hard to advise parents to read the labels (on toiletries). Maybe the ingredients are there, maybe they're not. You want to avoid phthalates, for example -- if you can find them on the label."
Of course, even when we learn what's in the bathwater with the baby there will be no guarantees it has been tested for safety by an independent regulatory panel. What's more, Dr. Phil Landrigan, an expert in child health and the environment, has suggested that of the few chemicals that have been tested, fewer still have been examined for their effects on children's health. There are more unknowns than knowns, it seems.
Ottawa's Donald Wigle is the author of Child Health and the Environment, considered the first textbook on the subject when it was released by Oxford in 2003. Dr. Wigle says public-health policy must work harder to protect children who, while vulnerable to environmental toxins, have no control over exposures. "The link between environmental and health outcomes can be quite subtle but very real," Dr. Wigle said in an interview. "Lead toxicity is a classic example where for most of the 20th century the health hazards of lead, especially the effects on the brains of children, were consistently downplayed by scientists and public-health officials. As the science got better, the effects on the brain at ever lower blood-lead levels became clear." Today no level of exposure is considered safe.
Dr. Wigle warns at the start of his book that prenatal and early childhood exposures to environmental toxicants can disrupt development, "causing structural and functional abnormalities that range from subtle to obvious, immediate to delayed, and transient to permanent." If you were to judge only by their gear, you would assume babies have never been safer. New parents will purchase almost anything to protect their kids. Nursery-surveillance monitors are standard issue, along with motion detectors, tub thermometers and remote fever detectors that promise 24-hour protection. Better safe thansorry. In a market that exploits infinitesimal odds and irrational fears, someone's come up with a disposable polypropylene shield to protect toddlers from grocery-cart bacteria.
But while children have never been better protected in some ways, mounting evidence suggests they have never been more vulnerable to things we have always considered safe: air, water, bubble bath.
No one knows why, though many suspect the widespread and increasing use of synthetic chemicals is to blame. "There are major gaps in understanding the relationships between prenatal and childhood environmental exposures and health outcomes," Dr. Wigle writes. Personal-care products are but a small part of a very large picture, but they are under increasing scrutiny because they play an intimate role in our daily routines. We lather, slather and apply liberally, even though most of us, especially babies and children, could go without the daily use of shampoos and moisturizers.
Washington's Environmental Working Group is one of many voices asking why certain chemicals are in toiletries in the first place. And while bathwater obviously poses a lesser risk than pesticides, second-hand smoke or vehicle exhaust -- exposures that we cannot always avoid -- it's a chemical world and, if nothing else, we do have say over what products we use in the tub.
Exposure to toxins begins in the womb, a vulnerable and critical time in development. Breast milk then delivers a cocktail that may include polybrominated flame retardants, dioxin, heptachlor, chlordane, mirex, benzene, perchloroethylene and even DDT -- chemicals that can accumulate over a lifetime in the fatty tissues of a woman's breasts. Although doctors insist breast is still best, some are starting to wonder. The rough-and-tumble exposes developing kids to countless chemicals; the routines of day to day to countless more. The Center for Children's Health and the Environment in the U.S. explained why children need protection in a series of provocative ads that ran in the New York Times in late 2002. "Pound for pound, kids are exposed to more toxic chemicals in food, air and water than adults," the scientists explained, "children breathe twice as much air, eat three or four times more food and drink as much as two to seven times more water."
Nothing is known for sure about the long-term effects of these chronic and multiple low-dose exposures. One U.S. study blames environmental contaminants for 100 per cent of lead poisoning, 30 per cent of asthma, 10 per cent of neurobehaviour disorders and five per cent of cancer. Studies are piling up, but proof is elusive. "The thing is, there are many more unknowns than knowns," says Dr. Vyvyan Howard, a toxicologist from the University of Liverpool who devotes much time to studying the effects of chemicals on the fetus and infants. "We can observe that there are a number of changes taking place in the frequency of certain conditions including cancer, allergies and auto-immune disease. And we can agree that those are undesirable and have our suspicions about what may be contributing." But there will never be absolute proof, he says.
"We are exposed to a very complicated mixture, hundreds of groups of chemicals which, if you break them down to their individual constituencies, become tens of thousands of different variants. We don't have the toxicological tools to sort that out." In some countries, politicians and governments are starting to acknowledge the intricacies of these exposures. "They're beginning to say this is an extremely complex thing, we can't hope to unravel it, the weight of the evidence is such that we must take action."
Robert Donkers is the co-author of REACH proposals that will overhaul chemical regulations in the European Union and force manufacturers to prove their products are safe. In part, he says the Registration, Evaluation and Authorization of Chemicals report was motivated by surprises that fuelled consumer anxiety. "We found carcinogens in diapers, PVC softeners (phthalates) were leaking from baby toys when babies sucked on them, we found chemicals in T-shirts that shouldn't be there." The REACH legislation, which is not expected to receive a final vote until 2006, would apply to chemicals that go into personal-care products, but not the finished goods, which are regulated by a separate cosmetics directive that states that manufacturers have a legal obligation to provide only products that are safe. "Sometimes, you need to set your objectives a little bit farther than your horizons," says Mr. Donkers. "You may miss by a few years, but if you don't set a target, industry will never work to it."
Precaution is the only option, says Dr. Howard. "Decision-makers in Europe are beginning to act that way. There isn't any other way forward." Better safe than sorry, especially when nothing about the bathwater is clear.
Environmental studies in Europe and the United States have revealed lists of potentially troublesome chemicals. Here is what is known -- and not known -- about five common ingredients:
Phthalates
Found in nail polish, hair spray and in the "fragrances" of some scented products. Dibutyl phthalate (DBP) is used to make nail polish last longer and reduce chipping. Diethyl phthalate (DEP) and dimethyl phthalate (DMP) make scents last longer. Chemical manufacturers insist exposure to phthalates in personal-care products is extremely low. Still, Kathleen Cooper of the Canadian Environmental Law Association cautions, "in my opinion, little girls should not be using nail polish or nail-polish remover."
Phthalates are suspected hormone disrupters, chemicals that can mimic estrogen and interfere with systems in the body that regulate sexual development, sperm counts and fertility. The Mount Sinai School of Medicine in New York concludes that although links are tenuous, evidence is mounting that "endocrine disrupters play a significant role in reproductive problems." Although phthalates are classified by the Environmental Protection Agency as a "probable human carcinogen," the industry-financed U.S. Cosmetic Ingredient Review panel maintains the chemicals used in personal-care products are safe. Health Canada agrees, but is monitoring concerns about phthalates. The EU, meanwhile, has banned phthalates from cosmetics, citing their reproductive toxicity. In response, some U.S. cosmetics firms -- including L'Oreal and Revlon -- have started to formulate phthalate-free products.
Parabens
A group of compounds -- methylparaben, propylparaben, ethylparaben, butylparaben, among others -- used as preservatives in shampoos, bubble baths, diaper-rash ointment, baby wipes, lotions and toothpaste. Parabens are also suspected hormone disrupters. Early studies have linked the ingredient to breast cancer and a reduction in sperm count. "From what I've read in the literature, I would choose not to expose any child or baby of mine to parabens unnecessarily," says toxicologist Dr. Vyvyan Howard. "I don't know that we have enough information. So, therefore, on a precautionary basis, my personal choice would be to avoid them. The products are not essential."
Sodium Lauryl Sulfate
Foaming and surface-cleansing agents, sodium lauryl sulfate (SLS) and sodium laureth sulfate (SLES) are common ingredients that create bubbles in shampoos, bath products, toothpastes and mouth rinses. Enter sodium lauryl sulfate or SLS into an Internet search engine and you will find pages linking it to cancer. It has also been associated with eczema and with skin and eye irritation. Such is the concern that marketers are starting to tout such products as Doctor Burt's Cinna Mint Toothpaste that are "SLS Free!"
The Cosmetic Ingredient Review committee in the U.S. says the ingredient is safe. Health Canada concurs. The American Cancer Society even issued a statement in 1998 titled "Debunking the Myth" denouncing the accusations "flying through cyberspace" that SLS causes cancer. Still, safety remains a Frequently Asked Question, one to which Johnson and Johnson responds on its U.S. website: "Anyone anywhere can publish or send anything on the Internet regardless of validity," the company writes. "We assure you this ingredient (SLES) is safe and approved for use by the Food and Drug Administration. No body of scientific evidence links this ingredient to cancer." The Environmental Working Group has another concern about SLES, which it says works as a "penetration enhancer," allowing potentially dangerous chemicals to penetrate deeper into the skin.
Petrolatum
Petroleum jelly is listed as a probable human carcinogen on the European Union's Dangerous Substances Directive and is banned from cosmetics in Europe unless manufacturing is proven to meet purity standards. The concern is not with the petrolatum, but rather with production procedures that may expose the jelly to polycyclic aromatic hydrocarbons, common contaminants known as PAHs, which have been linked to breast cancer. Paula Begoun, author of Don't Go to the Cosmetics Counter Without Me, says petrolatum does not deserve the rap. "Topical application of petrolatum can help the skin's outer layer recover from damage, reduce inflammation, and generally heal the skin," she notes. The Environmental Working Group estimates there is petrolatum in one of every 14 products on the market including 40 per cent of all baby lotions and oils.
Talc
The Cancer Prevention Coalition in the United States does not waste words on the main ingredient in baby powder. "Talc is toxic," states Dr. Samuel Epstein, citing a 1993 National Toxicology Program study that linked cosmetic grade talc to tumours in laboratory animals. "Clearly, dusting with talcum powder endangers an infant's lungs at the prospect of inhalation. Exposing children to this carcinogen is unnecessary and dangerous." Even without conclusive studies, many doctors discourage the use of baby powder for fear children will inhale dust-sized particles that can cause breathing problems or lung damage.
No one knows the long-term effects of using these chemicals day in and day out, one on top of the other, but it is something that will soon be considered in a massive longitudinal study in the United States. Researchers are in the initial stages of an ambitious project designed to determine how the environment -- including these low-dose and multiple exposures -- affects the health of children. The National Children's Study will follow the development of 100,000 children in 96 centres across the U.S. from before birth to age 21. Dr. Irena Buka, who runs Canada's only environmental health clinic at Misericordia Community Hospital in Edmonton, had hoped Canada would piggyback on the U.S. study but was unable to persuade the government to fund such a project. There is very little in the way of environmental health research in this country, says Dr. Buka. "There isn't even an institute that looks at environmental health. We're in the very early stages of even considering it to be an issue in Canada."
Dr. Donald Wigle worked at Health Canada when the National Children's Study was discussed. "It was a missed opportunity," he said in an interview. "My observation going back many years is that child health gets a lot of lip service by senior people in government, but when it comes time to actually allocate the money, it doesn't happen." Dr. Wigle is now an affiliate scientist with the McLaughlin Centre for Population Health Risk Assessment at the University of Ottawa where he synthesizes the latest studies on children's health. "There is an urgent need for countries and international agencies to invest in population and laboratory research on the role of environmental hazards in fetal and child health and development," he writes in his book, Child Health and the Environment.
Scientists and doctors may agree there should be more research into the influence of environmental toxins on the fetus, yet significant funding is lacking. At the Ottawa Health Research Institute, Dr. Mark Walker heads a study that hopes to follow 8,000 pairs of mothers and babies to determine how time spent in the womb affects an individual's health over a lifetime. "In utero, you start as one cell and end up with umpteen billion cells, all of your organs are formed and all your physiology is programmed," he explains. "If that's where 99 per cent of your development is occurring, it makes perfect sense that anything affecting that would have profound downstream implications." So far the research team has stored the blood of 3,000 mothers for future analysis. That, of course, will depend on securing more research money. "Right now, we only have funding to follow them until birth," he says. "In the States, they'll provide hundreds of millions of dollars to do a study, here we have to go one kilometre of the road at a time."
Despite his commitment to the research, he says the lack of support is frustrating. "There's only so many times you can get hit on the head by grant rejections until you say, 'You know what, I'm going to change my focus. They want more heart-disease research, I'm going to do it.'" Dr. Walker would like funding to study the concentration of phthalates in amniotic fluid and umbilical cord blood. "It may be that exposure levels are so low that it's not a problem," he says. "Unfortunately, when we make the discoveries, it's going to be another 10 or 15 years of exposure before we are able to implement policy changes."
Until we know more we should aim to use less, says Kathleen Cooper of the Canadian Environmental Law Association. She recommends reaching for the most natural ingredients while cutting back on personal-care products in the first place. "Childproofing covers more than you think," she observes, "and it lasts longer than you think." And until science confirms or invalidates suspicions about long-term exposures to synthetic chemicals, Dr. Howard says consumers have alternatives to explore and choices to make. Instead of baby wipes, for example, try using soapy water and a wash cloth or tissue for diaper changes at home. If you choose disposable over cloth diapers, consider using unbleached, chlorine-free disposables and diaper wipes. If you can't do without talcum powder, try corn starch. "I tend to avoid unnecessary exposure in my own life," Dr. Howard says, "but acknowledge that I may be taking unnecessary steps." Better safe than sorry.
All in a Day
Here are some of the ingredients found in baby products used in an average day:
Baby Wash
Typical ingredients: Water, Cocamidopropyl Betaine, Glycerin, PEG-80, Sorbitan Laurate, Sodium Laureth Sulfate, Sodium Lauroamphoacetate, PEG-150 Distearate, Glycol Distearate, Phenoxyethanol, Polyquaternium-7, Sodium Hydroxide, Fragrance, Polypropylene Terephtalate, Acrylates/C10-30 Alkyl Acrylate Crosspolymer, Tetrasoidum EDTA, Methylparaben, PEG-14M, Mineral Oil, Propylparaben, Butylparaben Suggested alternatives: Fragrance-free products generally contain fewer chemicals than scented ones. If you want fewer still, choose an organic product. The top-rated baby wash on the Environmental Working Group's safety survey was Aveeno Soothing Baby Bath Treatment, Single Use Packets. Burt's Bees Baby Bee, Pint-Sized Buttermilk Bath Soak was also near the top of the list. Consider bathing your baby a little less often and using soap only when truly required.
Baby Lotion
Typical ingredients: Purified Water, Propylene Glycol, Glyceryl Stearate, Myristyl Myristate, Stearyl Alcohol, Isopropyl Palmitate, Cetyl Alcohol, Dimethicone, Aloe Barbadensis (Aloe Vera Gel), Chamomilla Recutita Matricaria (Chamomile Extract), Lavandula Angustifolia (Lavender Extract), Hydrolyzed Silk Protein, Panthenol, Tocopheryl Acetate, Synthetic Beeswax, Retinyl Palmitate, Fragrance, Stearic Acid, Methylparaben, Tetrasodium EDTA, Sorbitan Stearate, Propylparaben, Butylparaben, Benzyl Alcohol, BHT, Polysorbate 60, Sodium Hydroxide, Carbomer, Oleic Acid, Cholecalciferol Suggested alternatives: Few babies actually need baby lotion. In fact, in some cases dry skin may be the result of soapy baths that rob the skin of essential oils. Organic products are one option. For suggested alternatives, see www.lesstoxicguide.ca, a consumer's guide written by the Environmental Health Association of Noval Scotia.
Disposable Diapers
Typical ingredients: Wood cellulose fibre and polyacylate absorbents. Diaper liner includes: Petrolatum, Ethylene/VA Copolymer, C26-34 Olefin (and) Polyethylene Suggested alternatives: There's always cloth, obviously, though even those are exposed to some chemicals since cotton diapers have usually been bleached with chlorine and will be treated with cleaning products on a regular basis. If you use disposables, author Beth Ann Petro Roybal suggests choosing unbleached diapers that do not contain water-absorbing gels. The author of 101 Simple Ways to Make Your Home & Family Safe in a Toxic World says regular disposables should be changed often; "avoid scents, colours and patterns, which are likely to contain toxic inks and other chemicals."
Fragrance-Free Baby Wipes
Typical ingredients: Water, Potassium Laureth Phosphate, Glycerin, Polysorbate 20, Tetrasodium EDTA, DMDM Hydantoin, Methylparaben, Malic Acid, Aloe Barbadensis, Tocopheryl Acetate (Vitamin E) Suggested alternatives: The Environmental Health Association of Nova Scotia recommends using a spray bottle of soapy water and a washcloth or tissue for changes at home. There are baby-care companies that sell non-chorine bleached, unscented and alcohol-free wipes.
Diaper Rash Ointment
Typical ingredients: Zinc Oxide, BHA, Cod Liver Oil, Fragrance, Lanolin, Methylparaben, Petrolatum, Talc, Water Suggested alternatives: The Guide to Less Toxic Products recommends treating a rash with corn starch, though be sure to apply it carefully and sparingly. The guide also recommends such natural brands as Aubrey Organics, Burt's Bees and Druide.
The Edmonton Journal
by Chris Cobb, CanWest News Service
March 5, 2006
http://www.canada.com/edmontonjournal/news/story.html?id=82b58c13-0bc7-4b05-8211-46e742226e9b&k=91736
OTTAWA -- Wendy Mesley had a rough idea what the results would be when her blood was tested for cancer-causing toxins, but that didn't lessen her dismay when she read the list. She was tested for 57 carcinogens, 45 were found. But this, she says, is the point: The cocktail of cancer-causing poisons in her body is about the North American average. "Cancer is multiple exposures to multiple risk factors over a period of time," says Mesley. "I'm contaminated and I'm sure everyone else who grew up in North America is, too. I was probably born with a fairly clean slate in the late 1950s, but our own kids are starting out contaminated. That's the really depressing thing."
Mesley had the blood test as part of Chasing the Cancer Answer, her 30-minute documentary that broadcasts this Sunday evening on the CBC-TV consumer series Marketplace. She reads the blood results for the first time on camera. There is no shortage of shocking detail in Chasing the Cancer Answer, but essentially Mesley's message is this: Through a combination of ignorance, benign neglect, misplaced trust and corporate cynicism, we are allowing ourselves to be poisoned into cancer by commonly used, legal carcinogens and, worse, condemning an alarming number of children and young adults to the same fate.
Doctors diagnosed Mesley with breast cancer in 2004. She had two growths removed and underwent chemotherapy and radiation. Her outlook is now good, but she is in the throes of a year-long treatment with the new drug Herceptin. "Every three weeks, I go and sit in the chemo ward," she says. "Last time I was there, there was a young woman with a one-month-old baby on her lap. The woman was about 21 years old and starting chemo. The chemo wards are full of young people."
The greatest cause of rising cancer rates is not genetic but environmental, says Mae Burrows, a Canadian environmentalist pushing for legislation that will force companies to declare all carcinogens on consumer product labels. "There is lots of stuff we should be avoiding," she says during an interview on the show. "But there is absolutely no requirement to label a product if it has a carcinogenic in it. I'd like to see laundry detergents labelled, I'd like to see pet supplies labelled and I'd like to see personal care products labelled. What we're saying to industry is that we know you can reformulate these products without carcinogens. Do it. Make changes and you can still make a buck."
Mesley says it's almost impossible for most consumers to decode or investigate chemicals listed on products. "I've had cancer and I've spent the last year thinking about this story," she says, "and I haven't memorized all the chemicals I have to look for. "People are busy with jobs and families and they assume the Canadian Cancer Society and Health Canada are looking after them -- if there is something on the shelves that is harming them, it will be taken care of. But it's not that simple. We've got to start looking after ourselves and getting people in positions of responsibility to get this stuff off the shelves. Don't assume that anyone is looking after you."
The documentary features an interview with Dr. Sam Epstein, a cancer expert at the University of Chicago. Epstein says Canada is in a cancer epidemic and the real reasons are being trivialized or ignored by governments and such groups as the Canadian Cancer Society. "They have told people that if you get cancer, it's your own fault -- it's the lack of a healthy lifestyle," he says. "But there has been almost no movement in prevention. We're spending the money on screening and diagnosis -- damage control. Wait for people to get cancer and then try and treat it. And the more drugs being bought, the greater the profit."
Mesley, mother of a seven-year-old daughter, has been exploring the world of environmental toxins since her own doctors told her about the dramatic rise in cancer -- from roughly one in five Canadians during their lifetime in the 1970s to almost one in two today. "As a journalist," she says, "it completely blew me away that there is all of this reputable scientific literature available from the most conservative of organizations and we're not told about it. The case against environmental toxins as a leading cause of the increase in cancers is overwhelming. It's not good enough just to tell us to stop smoking or keep out of the sun. We are passing this on to our children."
She was shocked to find that research linking environmental toxins to cancer isn't all new. "I found this quote from a senior scientist at the National Cancer Institute in the United States," she says. "In 1964, he warned that cancer was an epidemic in slow motion and we are surrounded by carcinogens and other chemicals in what we eat, breathe and touch and if we don't take some action we are going to contaminate ourselves. What are we waiting for? For 100 per cent of people to get cancer?"
by Joshua Boak, Toledo Blade
March 5, 2006
http://toledoblade.com/apps/pbcs.dll/article?AID=/20060305/BUSINESS05/603050303
It was just a house, not something Lorie Nicholson thought would harm her children. The former Maumee resident leased a house from the Westhaven Group in 2002. Three years later, she sued the Toledo real estate company. She blamed the toxic paint chipping off her house's window sills and garage door for her three daughters' poor health, which has caused them to miss school repeatedly. "To me, it's no different than giving someone arsenic just a little bit at a time," Ms. Nicholson said The U.S. Environmental Protection Agency began to investigate the Westhaven Group in the summer for not disclosing that high levels of lead-based paint covered its houses after learning of Ms. Nicholson's problems. The investigation is another wound for the real estate company, which the Ohio Department of Commerce shut down in December for securities fraud. In an audiotape called Thriving Not Just Surviving, Westhaven founder John Ulmer bragged that he attempted to "skirt around" the requirements of the 1992 Residential Lead-Based Paint Hazard Reduction Act. "We'd probably be able to negotiate the price lower because [a house] has that in there," he said.
Each offense of failing to disclose lead-based paint is punishable by a $10,000 fine, which is almost the average price Mr. Ulmer paid for a blighted house to later rehabilitate and resell. Jerry Phillips, an attorney for Mr. Ulmer, was unaware of the investigation and declined to comment.
The EPA investigation stemmed from a 2003 complaint by Ms. Nicholson, who leased a Westhaven house at 621 River Rd. in Maumee. An EPA official in Chicago said her case was sent to the agency's criminal investigation division in Cleveland. Gerry Kowalski, who manages Westhaven as a court-appointed receiver, does not yet have a "feeling" regarding the merits or severity of Ms. Nicholson's claims. "We are reviewing the lawsuit presently and will be handling it in the course of the litigation," Mr. Kowalski said.
Although Brighton Analytical, a laboratory, measured significant amounts of lead in paint samples from Ms. Nicholson's home, the lead content in her daughters' blood was not high enough to trigger a mandatory cleanup of the house by Lucas County.
Most houses built before 1978 contain lead-based paint, according to the EPA. The lead helped the paint dry and gave it a fine gloss. As the paint peels, it releases an invisible dust that can blanket floors, toys, or backyards. Ingesting that dust can cause lead poisoning, which harms a child's brain development.
A Sept. 19, 2002, inspection of Ms. Nicholson's residence by Maumee Fire Chief Patrick Wambo found additional issues, such as an open circuit breaker panel box and loose electrical wires. Midwest Environmental Control, a private consultant hired by Ms. Nicholson, removed traces of lead-based paint from her belongings. The firm also found that a sample of pipe insulation from the house had an asbestos content of 65 percent, according to a 2003 letter from the consultant.
Ms. Nicholson said she never received a government-approved pamphlet about lead-based paint's dangers from Westhaven, a violation of federal standards. Nor does the lease agreement contain any disclosure information. In the contract signed by Ms. Nicholson, Westhaven excused itself from any responsibility, stating that it makes "no warranties or representations whatsoever regarding the condition of the premises."
Ms. Nicholson said she met during the summer with Thomas Kohl, a special agent for the EPA's criminal investigation division, and his Ohio EPA counterpart at a diner in Delta, Ohio. Ms. Nicholson said they talked for two hours, her hands shaking as they reviewed Westhaven's business practices. "They asked me if I knew what racketeering was," Ms. Nicholson said. Unable to discuss ongoing investigations, the EPA refused to confirm that the meeting happened. It referred all questions about Westhaven to the U.S. Department of Justice, which declined to comment.
Just as Mr. Ulmer's business uncomfortably straddled the boundaries of state securities laws, he knew that laws regarding lead-based paint posed a similar obstacle for Westhaven. "For 10 years, lead-based paint has been an issue," he said on the audiotape. "And I would imagine all of us have skirted around it somehow. We try to disclose that we have no knowledge of lead-based paint in our disclosure form." Mr. Ulmer later explained that there are no tests to "check" the lead content of house paint. This is false. A receipt shows Ms. Nicholson tested three paint chips from her house for a total of $30. In fact, under the 1992 law Mr. Ulmer skirted, "Sellers must provide homebuyers a 10-day period to conduct a paint inspection or risk assessment."
"How can someone who's done this for 20 years not know that a house had lead paint?" Ms. Nicholson said. Tears slid down her face as she recounted the problems with her Westhaven house. What shocked her was Mr. Ulmer's purported sense of altruism as conveyed by his company's motto: "Good people helping good people."
"Whether I get anything or not, he'll get what he deserves when he goes to heaven," she said. "That will be his judgment day."
The San Francisco Chronicle
by John Heilprin, Associated Press Writer
March 4, 2006
http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2006/03/03/national/w084512S33.DTL
Most of the nation's rivers and streams -- and the fish in them -- are contaminated with pesticides linked to cancer, birth defects and neurological disorders, but not at levels that can harm humans. Pesticides were found in almost all U.S. rivers and streams between 1992 and 2001, says a study released Friday by the U.S. Geological Survey, although most drinking water supplies haven't been affected. "While the use of pesticides has resulted in a wide range of benefits to control weeds, insects and other pests, including increased food production and reduction of insect-borne disease, their use also raises questions about possible effects on the environment, including water quality," said Robert Hirsch, the USGS associate director for water.
Pesticides were seldom found at concentrations likely to affect people, and they were less common in groundwater. But they were found in most fish. Most frequently detected in agricultural streams were three herbicides used mainly on farms: atrazine, metolachlor and cyanazine. Just last week, the Environmental Protection Agency settled a 2003 lawsuit brought by the Natural Resources Defense Council, forcing the government to assess whether atrazine threatens the survival of endangered Chesapeake Bay sea turtles, endangered Texas salamanders and 16 other aquatic species. Three other herbicides used commonly in cities -- simazine, prometon and tebuthiuron -- showed up more often in urban streams.
The USGS looked for 100 pesticides, and found 40 of them had a widespread presence in streams and sediment in both urban and agricultural areas, at concentrations that could affect aquatic life or fish-eating wildlife. The pesticides showed up more than 90 percent of the time in the fish tissue found in agricultural, urban and mixed land-use areas. In each of the streams the USGS studied, at least one pesticide was detected. In about 19 of every 20 streams with agricultural, urban or mixed land-use watersheds, pesticide compounds were found at nearly all times of the year. The most frequent occurrence was in shallow groundwater beneath agricultural and urban areas, where more than half the wells contained one or more pesticide compounds.
Jay Feldman, executive director of Beyond Pesticides, a national research and advocacy group, said the data surrounding the nation's reliance on about 1 billion pounds of pesticides a year "shows an urgent need to strengthen policies at all levels of government and curtail pesticide use." The USGS report is based on an analysis of data from 51 major river basins and aquifer systems nationally, and a study of an aquifer system that runs through eight states from South Dakota to Texas, east of the Rocky Mountains.It found that concentrations of individual pesticides nearly always complied with the EPA's drinking-water standards, though no water samples from streams were taken at drinking-water intakes. The EPA also is responsible for reviewing pesticides, based on pesticide-makers' tests that can cost tens of millions of dollars. It typically takes up to a decade to study each one before it can reach the marketplace, according to industry figures.
But simply detecting the presence of a pesticide does not always mean there is reason for concern, said Jay Vroom, president of CropLife America, which represents pesticide developers and manufacturers. He emphasized that the use of pesticides by farmers, ranchers and others is strictly regulated by federal and state laws. "Water quality is of paramount importance to us," he said. "And the USGS report correctly recognizes that the large majority of pesticide detections in streams and groundwater were trace amounts, far below scientifically based minimum levels set for protecting human health and the environment."
by Jane Kay, San Francisco Chronicle
March 3, 2006
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/03/03/BAGVGHHV1H1.DTL
The regulation of pesticides might not be strict enough to protect newborns and infants, a study published Thursday by UC Berkeley researchers suggests. The study of 130 mothers and their children in California's Central Valley revealed that a natural enzyme in the human body that breaks down toxicants, including commonly used pesticides, varies to such a degree that some of the population's youngest members may be virtually defenseless against some chemicals.
For the first time, researchers believe they can predict people's vulnerability to certain pesticides based on their enzyme levels, their age and their genetics. "People have this remarkable difference in enzymes that defend their health from pesticide exposure," said Nina Holland, a UC Berkeley adjunct professor and molecular epidemiologist in children's environmental health. "In developing regulatory standards for safe levels of exposure, we need to protect the most sensitive in a population, particularly because children and unborn fetuses are involved," said Holland, an author of the study published in the journal Pharmacogenetics.
The human body contains dozens to hundreds of important enzymes that control metabolism. Other studies already have shown that this particular enzyme, PON-1, is linked to protection against neurodegenerative or cardiovascular diseases. The study was designed to examine the protective levels of the enzyme against a class of chemicals called organophosphates, which were developed in the 1940s as warfare agents. In pesticides, they attack the nervous systems of insects.
Two common organophosphate pesticides, diazinon and chlorpyrifos, were widely used before they were restricted for most household uses by the state and the U.S. Environmental Protection Agency by 2002. Chlorpyrifos was a key ingredient in the popular Raid spray pesticide before the restriction took effect.
By analyzing the enzyme in newborns, the researchers found that some newborns may be 26 times more susceptible to diazinon exposure than newborns with the highest level of the enzyme, and 65 times more susceptible than adults with the highest enzyme levels. With chlorpyrifos, some of the newborns may be 50 times more susceptible than newborns with high enzyme levels and 130 to 164 times more susceptible than some of the adults. The enzyme typically reaches adult levels by the time children reach 2 years old.
The two pesticides are still used on cropland, where the brand names for chlorpyrifos are Dursban and Lorsban. "Chlorpyrifos was banned in households largely because of its hazards to children," said Margaret Reeves, senior scientist at Pesticide Action Network of North America in San Francisco. "But it's still widely in farm applications, putting at risk the health and well-being of farmworkers, farm families and rural-urban interface areas."
The EPA reported that about 20 percent of all foods for sale in 2001 had residues of one or more organophosphate pesticides, according to the group. An author of the new study, Brenda Eskenazi, UC Berkeley professor of epidemiology and director of the school's Center for Children's Environmental Health Research, coordinated the research through the school's Salinas-based Center for the Health Assessment of Mothers and Children. In addition to the study, the researchers have collected samples from 470 other mothers and their children, which they will continue to follow along with the original 130.
Press Release
March 3, 2006
Contact State Representative Elaine Nekritz, 217-558-1004 or Max Muller, Illinois PIRG, 312-364-0096 x211 Cell: 503-706-4738
Today, Governor Rod Blagojevich directed Illinois EPA to research the availability of safer alternatives to a chemical flame retardant known as "DecaBDE," which is widely used in household products such as television sets and sofas. In addition, Governor Blagojevich directed the agency to initiate regulatory proceedings to require the use of safer alternative flame retardants where they are available and affordable. The directives, contained in a letter to the agency director, came in response to a newly-released Illinois EPA study, which concluded that DecaBDE is building up in our bodies, homes and environment, and is in widespread use despite considerable uncertainty about its safety.
"This report has given us an opportunity to take action and provide Illinois consumers with products that do not harm our health," said State Representative Elaine Nekritz, the author of legislation passed last year which initiated IEPA's research. "I'm heartened that the Governor is committing to protect Illinoisans' health."
Polybrominated diphenyl ethers (PBDEs) are added to consumer products like computers, televisions, curtains, furniture, and carpet, as flame retardants. PBDEs leach out of these products and into our environment, where they are accumulating in our bodies, food, homes, office, water and land. "The problem is that we are exposed to these chemicals daily and tests have shown them to cause thyroid dysfunction, neurodevelopment delays, and birth defects in animals," said Nekritz.
Last year, Illinois joined six other states in passing legislation banning products containing two kinds of PBDEs known as PentaBDE and OctaBDE, and now these two chemicals are off the market. However, a third kind of PBDE known as Deca is still in widespread use. In fact, an estimated 54 million pounds of DecaBDE are sold every year in the U.S. and it is the most prevalent of the PBDEs in house dust.
"We shouldn't be used as human guinea pigs. The safety of chemicals should be studied and established before they are put into widespread use in our homes and offices," said Max Muller, Environmental Advocate for Illinois Public Interest Research Group, which has spearheaded a campaign to phase out PBDEs. "Wednesday's report shows that in the case of DecaBDE, we are being exposed to constant barrage of a chemical that hasn't been proven safe." Last year's legislation required the Illinois EPA to study the latest scientific research on DecaBDE.
That report was completed and transmitted to the legislature and Governor Blagojevich Wednesday. "There is a growing consensus that the continued use of DecaBDE will result in the build up of toxins in our homes and environment. We thank the Governor for his appropriate response to IEPA's findings," said Muller.
Major findings of Wednesday's IEPA report:
Wednesday's IEPA's report on DecaBDE is available at http://www.illinoispirg.org/PDFs/IEPADecaBDEStudy.pdf.
Today's letter from Governor Blagojevich to IEPA is available at http://www.illinoispirg.org/PDFs/GovDecaBDELetter.pdf.
Bangor Daily News
March 1, 2006
http://pqasb.pqarchiver.com/bangor/995366461.html?did=995366461&FMT=ABS&FMTS=FT&date=Mar+1%2C+2006&author=&pub=Bangor+Daily+News&desc=POTATO+PLASTIC
Maine took a small but important step in reducing the prevalence of toxic chemicals in everyday items Wednesday when the governor signed an order changing state purchasing policies to prefer safer alternatives. The order also boosts research and development into safer chemicals and bio-based products.
Most people don't realize that chemicals linked to cancer, learning disabilities and illnesses are used in common household items. Brominated flame retardants, for example, are used to treat upholstery cushions, mattresses and the plastic casings around electronic components to make them flame resistant. The chemicals have been found in human breast milk and are known to harm brain development in laboratory animals. Repeat expose to airborne perchloroethylene, a chemical used in dry cleaning, may cause cancer, according to the Environmental Protection Agency.
To reduce the amount of such chemicals in Maine, the executive order requires state agencies to avoid products and services that use or release carcinogens when safer alternatives are available, effective and affordable. For example, the order calls for the use of non-lead wheel weights on state vehicles and the purchase of state uniforms that don't require drycleaning with perchloroethylene.
As for affordability, plastics for electronics made without brominated flame retardants cost about twice as much. But, because the plastic is a small part of the overall production cost, using the alternative would add only about $7 to the cost of a $300 television set, according to a study by the University of Massachusetts at Lowell. Other changes required by the executive order would save money. It requires the state to use an integrated pest management (IPM) approach at all its facilities. Schools already use this approach, which calls for the least toxic means of pest control. Some state facilities are now routinely sprayed, whether insects or weeds are present or not. Spraying only when necessary would save money and lessen exposure to toxins.
At the same time, the order creates a 12-member task force to develop policies for encouraging safer chemical alternatives for Maine consumers and for expanding research and development of such chemicals and products. Interface Fabrics in Guilford already uses corn-based fabric for some of its products. Corn-based plastic is better for the environment because it is a renewable resource, which oil, the standard basis for plastic, is not. Also, corn-based plastic can be composted like other vegetable waste. It would like to buy similar material from Maine and it is working with researchers at the University of Maine to develop bio-products made from waste potatoes.
Expanding this research could help Aroostook County by creating a new market for potatoes. It could also lead to Maine-based companies to make and market bio-based products. Corn-based plastic is used in packaging for companies as diverse as eco-friendly grocer Wild Oats and retail giant Wal-Mart. Encouraging safer chemicals and building green chemistry expertise in Maine will help the environment and the economy.
Environmental Health Perspectives, March 2006
by C. Bradley Kramer, Alison C. Cullen and Elaine M. Faustman
http://www.ehponline.org/members/2005/8299/8299.html
Introduction
Since 1990, the Human Genome Project and subsequent technologic advances have made generating genetic information cheaper, easier, and more reliable, thus changing the face of science (Decaprio 1997). Recently developed technologies have enabled scientists to identify mutations that define human variability, determine the prevalence of identified genetic mutations in the population, and interpret the function and role of specific genes in disease. In May 2002, the U.S. Environmental Protection Agency's (EPA) Science Policy Council released an Interim Policy on Genomics (U.S. EPA 2002c). The U.S. EPA continued to explore the application of genomic information in a second document, Potential Implications for Genomics for Regulatory and Risk Assessment Applications at EPA (U.S. EPA 2004b). The interim policy heralds the potential of genomic information "to enhance its assessments and better inform the decision-making process." Genomic information has the potential to improve the U.S. EPA's regulatory process in a key context--the setting of health-based standards directed at protecting susceptible subpopulations. The interim policy concludes that as the U.S. EPA "gains experience in applying genomics information . . . it will develop guidance to explain how genomics data can be better used in decision making, and related ethical, legal, and social implications" (U.S. EPA 2002c).
In this commentary we examine opportunities within current policy for the inclusion of genetic information in regulation of air pollutants, with particular attention to particulate matter (PM). We focus on key polymorphisms that identify asthmatics, an established sensitive subpopulation that stands to benefit from the inclusion of genetic information in air quality regulation (U.S. Senate 1970). In a subsequent analysis (Cullen AC, Kramer CB, Faustman E, unpublished data) we extend the integration of genomic science and regulatory policy using a decision analytic framework. An additional manuscript (Bradley A, Cullen A, Burke W, Faustman E, unpublished data) addresses both the importance and the challenge of incorporating genetic information in other statutory contexts, such as food safety and pesticides.
The U.S. Clean Air Act (CAA) requires that the EPA set National Ambient Air Quality Standards (NAAQS) for six criteria pollutants: carbon monoxide, lead, nitrogen dioxide, ozone, sulfur oxides, and PM. These standards are set at levels "requisite to protect public health" with "an adequate margin of safety" [U.S. Clean Air Act Amendments (CAAA) 1990 §109(b)(1)]. The CAA further requires the U.S. EPA to consider sensitive subpopulations and the increased risk they bear as a result of exposure to criteria air pollutants [U.S. Clean Air Act Amendments 1990 §108(f)(1)(C)]. Asthmatics represent a significant and increasing subpopulation in the United States (U.S. EPA 2003). Since the Centers for Disease Control and Prevention (CDC) began reporting on the occurrence of asthma in 1980, the number of asthmatics in the United States has been steadily rising. In 2002, the CDC reported that 30.8 million people were clinically diagnosed with asthma at some point over their lifetime (CDC 2005).
Asthma is a complex disease with environmental and genetic contributions to both disease susceptibility and progression. Genomic information can increase our understanding of asthma etiology as well as individual and population predisposition to developing asthma. Exposure to airborne PM exacerbates the physiologic responses leading to asthma, such as airway inflammation, and may also increase sensitization to allergens resulting in atopy, a risk factor associated with asthma (Dockery et al. 1993; Pope et al. 1995). In an effort to improve scientific understanding of the mechanisms governing the relationship between asthma and PM exposure, government agencies have developed targeted research strategies [National Research Council (NRC) 1998, 1999, 2001, 2004; U.S. Department of Health and Human Services (DHHS) 2000; U.S. EPA 2002a] and directed substantial funding to this goal. By measuring the prevalence of genetic biomarkers, scientists can quantify the health risks borne by the most susceptible subpopulations among asthmatics, as a result of exposure to specific concentrations of PM. These data can inform the air-quality standard-setting process to protect even the most sensitive individuals from adverse health effects with an adequate margin of safety.
Through a review of these government documents we find opportunities for the inclusion of genetic information in the regulation of air pollutants. In addition, we identify sources of information in recent scientific research on asthma genetics relevant to regulatory standard setting. We conclude with recommendations about integrating laboratory-based science, in the form of genetic information, into the risk management process to improve regulatory decision making.
To read the full commentary, please visit http://www.ehponline.org/members/2005/8299/8299.html.
by Tara Parker-Pope, the Wall Street Journal
February 28, 2006
http://online.wsj.com/article_email/SB114109831946985052-lMyQjAxMDE2NDAxMTAwOTE4Wj.html#
When Bernadine Healy announced plans for the Women's Health Initiative in 1991, the then-director of the National Institutes of Health promised it would be one of the most definitive studies of women's health ever undertaken. Fifteen years and $725 million later, the project has upended the thinking on important health issues many experts thought were settled. The NIH has announced findings that menopause hormones are risky and don't protect the heart, that low-fat diets don't fight breast cancer or heart disease, and that taking calcium and vitamin D doesn't protect bones or prevent colorectal cancer.
The conclusions of this high-profile study have drawn enormous publicity and had wide impact. The hormone result, for instance, so swayed the thinking of women and doctors that use of menopausal hormones has plunged by half. But a close look at the Women's Health Initiative raises questions about its central conclusions. Design problems in all of the trials mean the results don't really answer the questions they were supposed to address. And a flawed communications effort led to widespread misinterpretation of results by the news media and public.
Even critics of the project agree it generated a wealth of valuable data, and this week the NIH is asking academic researchers around the country for proposals on how best to continue mining the information. Of particular interest are hundreds of freezers in Rockwell, Md., filled with tens of thousands of blood, urine and other samples taken from the 161,000 women studied. Officials at the NIH reject criticism that they mishandled the study, saying people are upset only because it took on controversial topics and upset accepted notions. "The strength of the reaction has been commensurate with the strength of the dogma it overturned," says Jacques Rossouw, WHI project officer for the NIH.
Many doctors believe the public-health messages that have come out of the WHI in the past four years are simply a wrong interpretation of the data. The nutrition study didn't reveal the full effect of a low-fat diet, they say, in part because most of the women didn't stick to one. The bid to measure the effect of taking calcium and vitamin D suffered because a majority of test subjects, including those given a placebo, were allowed to take calcium supplements on the side. And the hormone study was heavily weighted to older women long past menopause, giving the findings little meaning for the typical user of hormone drugs. In many cases, the WHI data paint a very different picture from the widespread public perceptions of the study. The data strongly suggest that women who stick to an eating plan that cuts dietary fat and who increase calcium intake probably do boost their health. They also suggest that the benefits of menopause hormones probably outweigh the risks for the vast majority of women who use them -- women in their late 40s and early 50s who take them to treat hot flashes and other menopause symptoms.
Even some of the staunchest supporters of the WHI are disappointed that both the findings and the limitations of the trials haven't been better communicated. "Unfortunately, science never works in sound bites," says Marcia Stefanick, a Stanford University School of Medicine professor who heads the WHI steering committee. Elizabeth G. Nabel, who has just become director of the National Heart, Lung, and Blood Institute, which oversees the WHI, says, "I'm not convinced anything really went terribly wrong here. I think this was a complex study with findings that did not turn out as many people hoped or expected, but when you drill down to the details the findings are very consistent with current health guidelines. I may be accused of being overly simplistic, but that's how I see it."
The WHI story began in 1991, when Dr. Healy took over NIH as its first female chief. A sharp critic of the level of funding for research on women's health, she quickly announced plans for a huge research project: three major clinical trials looking at hormones taken for menopause, at low-fat diets and at calcium and vitamin D supplements, as well as a major "observational" study that would collect data on tens of thousands more women.
In the diet study, one problem was that women recruited had lower-fat diets to begin with than the investigators had planned for. The design assumed they would be getting about 38% of calories from fat. It was actually about 35%. It may seem like a small matter, but in the tricky world of statistics, it had ramifications. The study was meant primarily to test whether cutting fat from a woman's diet helps protect her from breast cancer. Women in one group were told about basic dietary guidelines but left to eat whatever they wanted. The others got intensive nutrition counseling in an effort to cut fat calories to 20% of the total eaten. Researchers knew many women would have a tough time sticking to that, and many did. By the sixth year of the study, only 14% were meeting the goal.
What mattered most was the difference in fat content of the two groups' diets. Investigators assumed they could keep the study group eating a diet with at least 11 percentage points less fat than the others. The gap needed to be that big to maintain statistical power. To achieve that difference, when the starting point was about 35% fat, the dieters would have to hold fat to about 24% of calories. They did so at first but by the sixth year, they were getting 29% of their calories from fat. Besides not being a particularly low-fat diet, this meant that by the end of the study there was a difference of only a bit more than eight percentage points, not 11, in the fat content of their diet and the control group's. Once the gap narrowed, differences that emerged between the two groups weren't considered statistically valid.
Yet even with the smaller gap, some striking differences appeared. The dieting group had a 9% lower risk of breast cancer -- a finding that missed the statistical-significance threshold by just a hair. If more women had been studied or the study had gone on just a little longer, the data very likely would have been statistically meaningful and announced as such, says Ross Prentice, a biostatistician at Fred Hutchinson Cancer Research Center in Seattle who helped develop the WHI trials. Women who made the greatest changes -- those who began with the highest-fat diets and cut fat calories by about 12 percentage points -- saw their breast-cancer risk fall 22%. That finding did meet the statistical-significance test. Yet it was given little attention by the NIH, which made only a general reference to it near the end of a two-page news release. The NIH says it didn't stress the finding because it was among a subgroup of women and thus wasn't as relevant. Some WHI investigators don't agree. "It's the strongest data in the paper," Dr. Prentice says. "I guess it's our failure that it hasn't come through clearly."
The study's failure to show any difference in heart-disease risk also reflected design decisions. The study didn't distinguish saturated fats and trans fats, which are linked to heart disease, from mono- and poly-unsaturated fats, which can actually benefit heart health. Part of the problem of the WHI design is that it reflected the thinking of 15 years ago, and much has changed in medical knowledge since then. For instance, the researchers had long debates about this fat issue, say the study's investigators. They ultimately decided to target total fat, rather than types, because previous breast-cancer research was based on that and breast cancer was the study's primary focus.
Ambitious Scope
The WHI's ambitious scope complicated matters. If its three clinical trials -- of hormones, diet and calcium -- were done alone, they would require enrolling 112,400 test subjects, a huge undertaking. Instead, the NIH recruited many women to take part in more than one trial at a time. There was so much overlap that only 68,132 women were involved in the clinical trials. More than half took part in at least two of them, and more than 5,000 were in all three trials.
Among problems this posed was simple burnout. Clinical-trial participation entails lots of office visits, lab tests and paperwork. The diet trial was especially time-consuming, requiring women to keep track of what they ate and to attend 18 lengthy nutrition counseling sessions the first year and quarterly sessions after that. Height, weight and other data were collected every six months. "Being in a trial can be work," says John Baron, a researcher at Dartmouth Medical School who wasn't involved in the WHI. "You fill out stupid forms, people are calling you to do this and do that. It's a burden to do this. Maybe participating in two trials is just too much to ask." The hassles of being in multiple trials may have contributed to compliance problems that plagued all three and hurt the reliability of their results. By the end of the two hormone studies, nearly half of women had stopped taking their pills. In the fat study, 70% weren't able to stick to the difficult eating plan. In the trial of calcium and vitamin D, 41% didn't take the pills consistently.
The trial of calcium and vitamin D sought to test the theory that regular use boosts bone density and lowers risk of fractures and colorectal cancer. However, the WHI let women in the placebo group -- those not given supplements -- take calcium and vitamin supplements on their own. At the end of the study, 69% of trial subjects were taking calcium on the side. The result: Even among those in the placebo group, calcium intake averaged about 1,100 milligrams a day from a combination of supplements and diet. Normally, such a study would discourage participants from taking calcium on their own. But all 36,282 women in the calcium study were also taking part in other WHI trials. Investigators say they let subjects take supplements out of concern that some might drop out of one or all of the trials if told they couldn't take calcium. They also say it would have been unethical to tell women they couldn't take a supplement that the government already recommended. (Its guideline is about 1,200 mg a day.)
The NIH said this month the trial had shown that taking calcium and vitamin D had no effect on hip fractures, bone density or colorectal cancer. Some scientists say flaws in the trial make it difficult to draw such a definitive conclusion. Instead of comparing effects of taking or not taking calcium, they say, it was essentially a study of consuming around 1,000 mg a day vs. about 2,000 mg. While the overall calcium trial, like the diet trial, didn't show statistically meaningful differences among all of the women studied, certain groups did benefit. Women over 60 had a 21% reduction in risk for hip fracture. Women who consistently took their full dose of calcium had a 29% decrease in risk. As a result, the NIH has said that current calcium guidelines should remain in place and women over 60 especially should consider the supplements for bone health.
"We really did have to accurately report that over the entire cohort of women that these interventions, whether it be diet or calcium, didn't have significant effects on the primary outcome," Dr. Nabel says. "But if you get down to the next layer of the press release, we tried to talk about trends. We tried to provide an interpretation for the public and a positive health message."
A Major Worry
The goal of the hormone trials was to study the risks and benefits of menopause hormones, especially whether they helped protect women's hearts, as many people long believed. A major worry was how to keep the study "blinded" so that women (as well as researchers) didn't know whether participants were getting hormones or a placebo. The problem was that women with symptoms such as hot flashes and night sweats would quickly realize they were in the placebo group if these continued and might drop out. Yet researchers needed to keep the trial going for years to get enough data on cancer and heart disease to be meaningful. The WHI's solution was to recruit older women, long past menopause. They would be less likely to get hot flashes, and they would be more likely to face the heart attacks and other health problems the study hoped to measure. The striking result was that the biggest study ever done of menopause hormones didn't study many women who were suffering menopausal symptoms. The average age of women in the hormone study was 63. Of the more than 27,000 women in the study, only 3,400 were below age 55.
Researchers had expected a positive finding: The strong thinking at the time was that hormones could help menopausal or postmenopausal women of any age to ward off heart disease. So recruiting predominantly older women didn't seem like a design problem at the time. Age breakdowns of the data by WHI investigators in months following the study's 2002 release show that younger women had a far different response to the hormones than older women. Because the study had so few women who still were young enough to have menopausal symptoms, no reliable conclusions about the risks and benefits of menopause hormones for those typical users can be drawn.
The hormone study was in two parts. The first looked at the standard combination of estrogen and progestin. The second, involving women who had had hysterectomies, studied estrogen only. Women without a uterus aren't given progestin. The NIH halted the first part in 2002, about four years earlier than planned, saying women given the combined hormones showed an increased risk of both heart attack and breast cancer. It has become apparent since then that those risks probably apply only to older women many years past menopause. Subsequent analyses have shown that heart risk, in particular, is probably much lower or nonexistent for younger, menopausal women. Such data weren't yet obvious at the time of the news conference.
Dr. Rossouw says he wanted to have "maximum effect" on doctors and women to stop the practice of prescribing hormones to protect women's hearts. He says the intention was never to stop women from using hormones for menopause symptoms. Sales plummeted anyway, and many women remain fearful about using the drugs for any reason. Dr. Rossouw now says that more recent analyses of the WHI data should reassure women who want to use the drugs to treat symptoms. When the study was curtailed, "we said the absolute risks are very low, and we had some reassuring messages," he says. "Was that the message that was picked up? Or was the message that hormones are risky picked up? It was the latter, obviously."
When officials stopped the first part of the study because of increased cancer and heart-disease risk, the women in the second part -- testing estrogen only -- were doing fine. Nonetheless, NIH officials who controlled the study began mulling whether to stop this part as well. The study's Data Safety Monitoring Board didn't ask that the estrogen-only study be halted. And some study investigators says they argued against stopping it. Nonetheless, in February 2004 NIH director Elias Zerhouni and Barbara Alving, who was acting director of the National Heart, Lung, and Blood Institute, stopped the estrogen-only study 13 months early.
Dr. Alving says they had all the information needed from the WHI hormone studies. She also notes that some members of the safety board were concerned about a stroke trend. "There was data showing the trend toward increases in stroke and since this was a prevention study, adverse events of this nature were to be taken seriously," she says, something the investigators didn't know. "I have no second thoughts," says Dr. Alving, now acting director of the NIH's National Center for Research Resources.
Striking Data
The agency didn't factor into the decision some of the most striking data emerging from the study. The research had begun to suggest that use of estrogen alone might actually lower breast-cancer risk, provide some protection against heart disease and lessen the risk of hip fractures, according to a report published in the Journal of the American Medical Association. No definitive conclusions could be drawn because the data suggesting such benefits hadn't reached statistical significance. Had the study been allowed to continue, statisticians and researchers say, much of these data likely would have crossed the statistical threshold.
Dr. Healy, the former NIH head who launched the WHI, acknowledges that news reports on it have been confusing for many women. She says she thinks the hormone results have been widely misinterpreted and calls the finding that calcium protects women over 60 from hip fracture particularly surprising. "I find the criticism amusing and fulfilling," Dr. Healy says. "We're not getting pat answers, and that's been one of the problems in the past -- we've been given pat answers, and they're generally wrong."
