Please check the CHE-WA website to stay abreast of the latest postings, news and events: http://washington.chenw.org.
To join the Collaborative on Health and the Environment (CHE) and CHE-Washington, please complete the form at http://www.healthandenvironment.org/roles/register?&phase=registerform. Be sure to mark that you want to join the Washington State Regional Group at the bottom of the application.
October 12, 2006
7:00 p.m.
Seattle, Washington
at NW Environmental Education Council, 650 S Orcas St. Ste. 220
The current state of climate change science has been summarized by the Intergovernmental Panel on Climate Change (Third Assessment Report, 2001) and the US National Academy of Sciences (5/01). These documents present strong evidence that global climate change has already begun and is now accelerating. Predictions of global-scale climate change in this century imply major impacts on both human societies and natural ecosystems worldwide. Lecture Objectives include a basic understanding of how the earth's climate system works and the best current predictions for human-caused climate change, both globally and here in the Pacific Northwest, as well as possible responses to this threat. Dr. Richard Gammon will speak.
Website: http://www.nweec.org/ea.htm
Contact: info@nweec.org
October 13, 2006
8:30 a.m. - 6:00 p.m.
San Francisco, California
at the University of California, San Francisco Laurel Heights Auditorium
This one-day national conference is hosted by the Collaborative on Health and the Environment. This second CHE national educational meeting will provide a solid overview of current scientific knowledge regarding environmental contributors to human disease and state-of-the-art efforts to prevent, treat and otherwise improve such impacts. Researchers and health advocates will come from around the country to provide summaries of their knowledge and work. Physician and nurse continuing education credits will be available through the California Academy of Family Physicians.
Website: http://www.healthandenvironment.org/articles/che-events/702
October 16, 2006 (at the First Congregational Church, 2401 Cornwall Avenue, Bellingham, Washington)
October 17, 2006 (at the Sons of Norway, Viking Ballroom, 1018 18th Street, Bremerton, Washington)
October 24, 2006 (at the Carco Theatre, 1717 Maple Valley Highway, Renton, Washington)
6:00 - 8:00 p.m.
The Puget Sound Partnership meets regularly in its quest to develop an aggressive 15-year plan to solve Puget Sound’s most vexing problems.
Website: http://www.pugetsoundpartnership.org/psi_meetings.htm#oct16
Contact: Martha Neuman, 206-625-0230 or mneuman@sharedsalmonstrategy.org
October 16 - 18, 2006
Yakima, Washington
at the Yakima Convention Center
The conference theme is "Health Across the Generations: Demonstrating the Value of Public Health." This statewide meeting is provided by the Washington State Public Health Association, the Washington State Department of Health and the Yakima Health District.
Website: http://www.wspha.org/JCH1.html
Contact: Kathy Kondakjian, kathy@wspha.org
October 19, 2006
9:00 a.m. to 3:00 p.m.
Tacoma, Washington
This meeting is hosted by the Washington Department of Ecology, and People For Puget Sound is helping with logistics. This event will be free and open to all. The featured speakers will be Steve Weisberg from Southern California Coastal Water Research Project Authority (SCCWRP) and Jay Davis from San Francisco Estuary Institute. Steve and Jay will describe their regional monitoring programs, with a focus on lessons learned. These presentations will be followed by a group discussion about regional monitoring opportunities/challenges for WA.
Website: http://www.ecy.wa.gov/
October 19, 2006
2:00 - 3:00 p.m. EDT
This is the third of a series of four webcasts. Schools use and manage a range of hazardous and toxic chemicals and products. Classrooms, science laboratories, art studios, vocational shops, athletic fields, maintenance facilities, boiler rooms, and storage closets are just a few examples of where hazardous chemicals and products may be found. Often, existing stocks of outdated, unknown, excessive, or unnecessarily hazardous chemicals are present in schools. These chemicals can pose safety and health risks to students and staff, and a number of widely reported incidents involving such chemicals have resulted in school closures and costly clean-ups. A Schools Chemical Cleanout and Prevention program insures that excess, legacy, unused, and improperly stored chemicals are removed, and puts mechanisms in place through which chemicals are purchased wisely, stored safely, handled by trained personnel, used responsibly, and disposed of properly. In addition, pesticide use can cause possible health hazards for school occupants and contribute to environmental pollution. Integrated Pest Management (IPM) is a safer, usually less costly option for effective pest management in the school community. A school IPM program employs commonsense strategies to reduce sources of food, water, and shelter for pests in school buildings and grounds. This webcast will share two chemical management success stories -- a schools chemical cleanout campaign with the Poarch Band of Creek Indians in Alabama, and the Monroe County, Indiana IPM Program. To sign up for one of the Children's Health Month webcasts, send an email (with the date of the webcast in which you would like to participate) to ICF International at the address below.
Contact: ICF International, chm@icfi.com
October 20, 2006
2:00 p.m.- 4:00 p.m.
Seattle, Washington
at the Renaissance Seattle Hotel
The public is invited to attend a forum hosted by the newly created Governor's Interagency Council on Health Disparities. This will be an opportunity to introduce members of the council and explain what has been done to get the council up and running. The council will ask participants for suggestions about how it should go about developing a statewide plan for eliminating health disparities in Washington. The forum will be facilitated by Frankie T. Manning, MN, RN, Associate Director of Nursing Service, Department of Veterans Affairs, Puget Sound Health Care System. This is being held in conjunction with the Fifth National Conference on Quality Health Care for Culturally Diverse Populations but it is open to the public. You do not have to part of the conference to attend.
Website: http://www.diversityrx.org/CCCONF/06/TOURS_06.htm
Contact: rcchc@aol.com
October 26, 2006
1:30 - 3:00 p.m. EDT
This is the last of a series of four webcasts. EPA has developed a unique software tool to help school districts evaluate and manage their school facilities for key environmental, safety and health issues. The new Healthy School Environments Assessment Tool (HealthySEAT) is designed to be customized and used by district-level staff to conduct completely voluntary self-assessments of their school (and other) facilities and to track and manage information on environmental conditions school by school. This webcast will help acquaint states, school districts, and others with the capabilities and features of HealthySEAT. To sign up for one of the Children's Health Month webcasts, send an email (with the date of the webcast in which you would like to participate) to ICF International at the address below.
Contact: ICF International, chm@icfi.com
October 27, 2006
8:30 a.m. - 4:30 p.m.
Seattle, Washington
at Seattle University
Modern biotechnology is science-driven enterprise dedicated to help people fight serious illness, or in some cases to fight serious problems such as world hunger. However, if used unwisely, it has a potentially discriminatory and oppressive impact on indigenous peoples. How do we promote modern biotechnology's positive impact while insuring that the treatment of indigenous peoples and their environments is ethical, responsible and respectful? This day-long conference examines the impact of biotechnology on the world's indigenous peoples by bringing together life-sciences leaders, attorneys and indigenous leaders to engage in a constructive dialogue about how the biotechnology industry can seek input from and protect the interests of key stakeholders and the environment as it makes important decisions regarding research and product development.
Website: http://www.seattleu.edu/pathofthespirit/conference.html
Contact: ipc@seattleu.edu
The US Environmental Protection Agency is announcing a 60-day public comment period for the external review draft document titled Child-Specific Exposure Factors Handbook. The draft document was prepared by the National Center for Environmental Assessment within EPA's Office of Research and Development. The handbook provides a summary of statistical data on various exposure factors used in assessing children's exposures, including drinking water consumption, soil ingestion and mouthing behavior, inhalation rates, dermal factors including skin surface area and soil-adherence factors, consumption of retail and home-grown foods, breast milk intake and activity pattern data. This handbook serves as a resource for exposure assessors for calculating children's exposures. An interim final version of this handbook was published in 2002. This updated version provides analysis of exposure factors data using the age groups for children recommended in the EPA document entitled Guidance on Selecting Age Groups for Monitoring and Assessing Childhood Exposures to Environmental Contaminants (available online at http://cfpub.epa.gov/ncea/cfm/recordisplay.cfm?de id=146583.
Direct your comments to Docket ID No. EPA-HQ-ORD-2006-0812; The 60-day public comment period begins October 6, 2006, and ends December 5, 2006. Technical comments should be in writing and must be received by EPA by December 5, 2006. For more information, please visit http://www.epa.gov/fedrgstr/EPA-RESE ARCH/2006/October/Day-06/r16573.htm.
by Roger Highfield, London Daily Telegraph
October 10, 2006
http://www.telegraph.co.uk/news/main.jhtml;jsessionid=TN4FE5TDQOSHNQFIQMGCFFOAVCBQUIV0?xml=/news/2006/10/10/nautism10.xml
Studies of girls who make an unusually large amount of male sex hormone in their bodies have backed the idea that autism is caused by an "extreme male brain". Prof Simon Baron-Cohen and Sally Wheelwright have uncovered new evidence that testosterone and other sex hormones thought to shape sex differences may cause autism by pushing brain development beyond that of a typical male.
In a study published in the journal Hormones and Behaviour, the team, with colleagues at City University, studied 34 girls with congenital adrenal hyperplasia (CAH) who, for genetic reasons, have high levels of a form of testosterone, and compared them with 24 unaffected sisters. They found that the CAH girls, who develop some male physical characteristics, have more autistic traits than typical females. Although they are not classed as having autism, which is marked by an inability to recognise and show emotions, they are closer to this end of the spectrum. "These results suggest that prenatal exposure to high levels of testosterone influences some autistic traits and that hormonal factors may be involved in vulnerability to autism", said Prof Baron-Cohen of Cambridge University, the leading proponent of the "extreme male brain" theory.
To back this work, the team is to launch a new study of the mirror image condition, called androgen insensitivity syndome (AIS). These individuals, such as Danielle Fray, 33, from Suffolk, are chromosomally male (XY) but are feminised because they have no docking sites in their bodies for testosterone. A range of ambiguous genitalia result. In extreme cases they are raised as girls, and discover they are chromosomally male at puberty, only when they fail to menstruate because they lack ovaries. "This is a very rare group, but we predict that they should have even fewer autistic traits than typical males or females," said Prof Baron-Cohen, adding that the study will also benefit those with AIS by highlighting their special needs. "We are keen to encourage people with AIS to visit our website at http://www.cambridgepsychology.com/gender to help our research," he said.
The Cambridge team has assembled a wide range of support for the theory, which says that people with autism match an extreme of the male profile, with a particularly intense drive to systemise -- find the laws that govern how a system works -- and an unusually low drive to empathise. Puberty tends to come earlier in boys with autism, supporting the idea that they have higher testosterone levels. In physical terms, children with autism tend to have masculinised brains, being larger with a thinner corpus callosum and less long-range connectivity when compared with female brains.
by Lisa STiffler, Seattle Post-Intelligencer
October 10, 2006
http://seattlepi.nwsource.com/specials/brokenpromises/288097_plastic10.asp
He loves to stroll beaches searching for the oddities that wash ashore -- the 10-foot-tall Yogi Bear, pieces of plastic from the 1940s, and bottles and caps galore. This summer on the Strait of Juan de Fuca, Ebbesmeyer found two large, weathered chunks of plastic of unknown origins measuring about 1 cubic foot. As he ran his hands along one's surface it disintegrated into a dusty powder. This, said the oceanographer, is how plastics break down and become a part of the ecosystem. The material doesn't biodegrade but rather undergoes a slow process of "photodegradation" as the sun breaks it into smaller and smaller pieces.
Pollutants -- such as PCBs and the pesticide DDT -- can be absorbed by plastics like a sponge sopping up water. The chemicals might become concentrated a millionfold compared with the surrounding water, researchers say. Plastic can also contain chemicals that mimic natural hormones, which, like birth control pills, can cause male fish and birds to exhibit female traits.
The presence of microscopic plastic "is just a new threat that has become visible and really looked at in the last five years, or 10 years," Ebbesmeyer said. "All the food out in the sea has some plastic in it, is the conjecture. And that is a horrific conjecture," Curtis Ebbesmeyer, oceanographer and marine debris expert. He's been tracking the sea's woes for much longer. Over the past four decades, Ebbesmeyer has been a consultant on major public works, including multiple sewage treatment plants. He's sat on panels advising numerous state administrations.
Recently, he's turned his focus from policy-makers to the Play-Doh set, working on a children's book about circumnavigating rubber duckies that were accidentally dumped by a cargo ship. The true-life tale emphasizes our global connections and impacts. But the ocean admittedly is a massive place, covering 71 percent of the planet. How can a 2-liter bottle here and a cigarette lighter there become such a problem?
About 300 billion pounds of plastic are produced each year, said Charles Moore, founder of the Algalita Marine Research Foundation. That's 1,000 pounds for every American. And massive amounts of it are washing into the sea. Swirling in the Pacific Ocean is an area of man-made trash the size of Texas. A few years ago Moore towed a fine mesh net like a giant cheesecloth through the area -- dubbed the "great garbage patch." The haul contained six times more plastic than plankton. "The quantities of plastics in the marine environment have gone up exponentially in the last decade," said Moore.
His group recently did a study of two Los Angeles rivers in which he collected all of the trash floating out to sea over the course of three days. They netted 6 tons of plastic. The trouble is that there's no effective way to remove the plastic pollution, whether it's in chunks or microscopic bits. Researchers say the solution is keeping it out of the water in the first place. And there's good reason to do so: It's on our dinner plates. "All the food out in the sea has some plastic in it, is the conjecture," Ebbesmeyer said. "And that is a horrific conjecture."
by Lisa Stiffler and Robert McClure, Seattle Post-Intelligencer
October 10, 2006
http://seattlepi.nwsource.com/specials/brokenpromises/288098_toxic10.asp
PORT RENFREW, Vancouver Island -- Sporting hockey helmets and knee pads, the two researchers squatting in the aluminum skiff looked ready for a roller derby. Peter Ross' voice broke the static of the marine radio. "We've got a customer," he said. "We'll be coming up alongside." On a sunny summer afternoon, the Department of Fisheries and Oceans Canada scientists zipped back to the larger Zodiak-style vessel where research gear was stored. The "customer" was a baby harbor seal swiped from a rocky, seaweed-slippery beach.
Ross opened up his medical tool kit and got to work. Shrouded in a green net, the scientists hoisted up the seal and weighed her. They stretched a measuring tape from whiskers to flippers and around her chubby, speckled belly. The surprisingly docile pup was pierced with a needle and four finger-sized vials of blood filled, plus two small plugs of blubber and fur were taken. The samples will strengthen a body of research tracking contamination in seals in Puget Sound, around Vancouver Island and along the Strait of Juan de Fuca. The scientists are looking for long-lived toxic chemicals that can sicken animals -- including orcas and people. Contamination is one of the bigger threats to local killer whale populations.
"Harbor seals give us a good snapshot, a good overview of these chemicals in our ocean food web," Ross said. The picture isn't black and white. Contamination levels have remained steady for some of the pollutants, but the amount of chemical flame retardants has skyrocketed, doubling in the Sound's harbor seals every four years dating back to 1984.
Despite years of cleanups, bans on certain chemicals and increasingly stringent regulations, pollution in Puget Sound remains pervasive. Microscopic bits of plastic are sucked up by sea life of all shapes and sizes. Humans flush their pharmaceuticals and birth control and caffeine into the ecosystem, in some cases making male fish more female. Nutrients in sewage waste are helping stoke algal blooms that then die, rot and suck oxygen from the water, making it lethal to fish, crabs and octopuses.
There are bright points. About 1 million pounds of creosote-soaked logs have been removed from Whidbey Island beaches alone. Across the Sound, efforts continue to recover abandoned fishing nets that catch and drown sea life. Two high-tech sewage treatment plants are being built and state-led plans are in place to reduce the release of dangerous chemicals, including mercury and the flame retardants.
But new man-made threats are always emerging, more waste is always being generated. All of the marine pollution causes Seattle oceanographer Curtis Ebbesmeyer to scoff at the idea of wild seafood honestly being labeled "organic." "Everything in the ocean is in a giant garbage dump," Ebbesmeyer said. "It's inescapable."
A giant cycle
When PCBs were introduced as a fire-proof insulator and coolant in electrical items and machinery, they were hailed as safe and effective. It took severe poisonings from rice oil contaminated during manufacturing -- one incident in Japan in 1968 and another 11 years later in Taiwan -- to raise the alarm over the polychlorinated biphenyls. The United States banned PCBs in 1977 and their levels in local marine animals declined substantially until the mid-1980s. "Then we saw a much slower rate of decline," Ross said. "Almost an equilibrium." Cleanup projects were launched and completed. The PCBs wouldn't go away. Sandie O'Neill, a research scientist with the state Fish and Wildlife Department, believes the solution is tangled in the web of marine life. The chemical -- which can accumulate in animal tissues and blubber -- is traveling from the mud-dwelling creatures and tiny floating plants to salmon and orcas and back again as the creatures die and decompose. "You turn off the (PCB) tap, what's in the food web is cycling around and around and around," O'Neill said.
The geologic structure of the Sound -- a deep tub with a shallow underwater ledge at its northern end -- limits the amount of flushing from the ocean. The contamination is also found trapped in higher land elevations, carried by air and deposited in remote places. It could be unleashed as global warming melts snow packs and glaciers. "There's an awful lot of environmental contaminants that are locked up in snow packs in the Olympics and Cascades," said Steve Jeffries, a scientist with Fish and Wildlife who sometimes works with Ross. That pollution is likely to wind up in the Sound.
Now many people fear that chemical flame retardants could cause similar environmental and health woes. The retardants are called polybrominated diphenyl ethers, or PBDEs, and are a sort of chemical cousin to PCBs. The PBDEs, which are added to seat cushions, mattresses and electronic devices, among many other items, appear to be escaping into the environment as PBDE-laden foam cushions fall apart and plastics break down. The flame retardants are turning up in the dust in homes and workplaces. They're being found in human breast milk. Scientists have found that the chemicals can affect liver and thyroid function and cause behavioral and developmental problems following high exposure in the womb.
A chemical manufacturers trade group assures the public that PBDEs are safe, that they don't stick around long in animals and degrade in the environment. But O'Neill and others have researched PBDEs in the Sound and found them behaving like PCBs -- getting trapped in marine life and concentrated in the food chain. Looking 20 years into the future, Ross said, "PBDEs are likely to overtake PCBs as the No. 1 chemical in terms of concentration in killer whales."
Despite the pollution, health officials urge people to continue eating fish, noting that many varieties are still relatively safe and can be made safer by minimizing the amount of fish fat being consumed. By next summer, officials with the state Ecology Department and U.S. Environmental Protection Agency hope to have completed a rough assessment of where the Sound's pollutants are coming from. The study, which could cost about $150,000, would allow regulators to prioritize cleanup projects and pollution prevention strategies.
The state Ecology and Health departments earlier this year released a plan for reducing PBDEs in the environment. It included a recommendation that all PBDEs be banned provided an alternative product is available. An industry group strongly objected. State lawmakers failed to take action.
A tide of sewage
"Is your poop hard to get out of the water? No." Casey Plank looks out at the faces of the high school students whose good luck this day got them an all-expenses-paid visit to West Point Treatment Plant -- King County's largest sewage-treatment facility. "The poop, the solids, the foods, they're easy to get out," continues Plank, who works for the county's sewage department. "The shampoos, the medicines, all the chemicals -- they're the hardest," she says. "We're not designed to get out chemicals."
Despite big improvements in the treatment of sewage dumped into the Sound and its rivers in the past few decades, a growing tide of sewage pollution continues to pour into the Sound. And this tide carries with it chemicals that appear to affect marine creatures' reproduction, as well as nutrients that can cause unnatural explosions of oxygen-smothering algae. As the students listen, Plank explains her rule for eco-friendly shopping: Read a product's ingredients. Can you pronounce them? If so, you're probably in good shape. If not, Plank says, buy something simpler. "The safer the product is for you, the safer it is for the environment," Plank tells the class.
Medicines are a particular problem for the treatment plant. "If it dissolves, it can pass straight through," Plank says. "We can't blame industry for pills. It's households." The advice used to be to flush old, unused medicine down the toilet. Now people are advised to put the drugs in the trash. Once those chemicals get into Puget Sound, they can affect sea life. Exposure to the antidepressant Prozac can cause freshwater mussels to release larvae before they're fully developed and viable. English sole in the Sound have been found producing a female protein -- as if a male chicken started to produce egg yolk. Researchers wonder: Could hormones in women's urine or birth control pills be at work?
Virtually all of King County's sewage, some 200 million gallons on an average winter day, gets dumped at two points about five miles apart, one north of Alki Point and the other off Magnolia. More than 40 other sewage treatment plants discharge into the poorly flushed Sound or its rivers. That's got some folks concerned. Gale Cool says he's seen an explosion of the sea lettuce, or ulva, that shows up on his beach property on Bainbridge Island. He calls the waves "green tides." Cool, a former developer who now works in environmental restoration, suspects that nitrogen is to blame. It's a nutrient that's known to promote the growth of plants such as seaweed and smaller algae that eventually die and rot. Their decomposition consumes oxygen needed by marine life. "It's something we have to pay more attention to," Cool said. "We're collectively ignoring some fairly compelling anecdotal evidence, and we need better science to decide whether it's worth the money to retrofit" the sewage-treatment plants.
The state Department of Ecology, which watches over sewage plants, says it hasn't seen convincing evidence yet that nutrients are a widespread problem, except in some poorly flushed bays. Most treatment plants don't completely get rid of nitrogen. "The consensus seems to be that the nutrient problem is getting worse," said Dave Nunnalee, who recently retired as head of sewage regulation for Ecology's Northwest region. "It's on our radar. We here at Ecology don't think it's a problem here in central Puget Sound, but it is getting to be a problem in southern Puget Sound."
That's where some new technology could help. King County is building the Brightwater Treatment Plant in Snohomish County and another in Carnation. The facilities will use a treatment called "membrane bioreactor technology," a cutting-edge device that sucks water through a rubbery membrane. The membrane filters out smaller contaminants that are being flushed out to sea at older facilities. The cutting edge carries a high price. The larger Brightwater facility will cost $1.6 billion to build and will be able to handle 36 million gallons a day -- a fraction of the other county plants. And some of the drugs and hormones will still make it to the sea. "Whatever goes through your body comes out in the sewage," Plank said. "It's biology and physics -- very simple science."
by Angela Epstein, UK Daily Mail
October 10, 2006
http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=409521&in_page_id=1774
Each year more than 1,200 boys in the UK are born with a genital abnormality. Experts say the number has doubled over the past 25 years, and that 'gender-bending' chemicals are to blame. Correcting such abnormalities can be a traumatic experience for both child and parent. Here a mother whose sons were affected describes their experience. Sue Phipps gave birth to twin boys after a six-hour labour and she was thrilled when the two dark-haired bundles were placed in her arms. But euphoria quickly turned to confusion when she was told that both boys had been born with malformed penises. 'I just couldn't understand it. I'd had a straightforward pregnancy and nothing had ever shown up on any of my scans to suggest there was a problem,' says Sue, 43.
Yet what the scans were not able to show was that her sons had hypospadias. This is a condition where the opening of the urethra -- the tube that carries urine and semen out of the body -- is on the underside of the penis instead of at the end. In some cases the penis curves downwards, with the foreskin covering only the front. In severe forms of hypospadias the urethral opening is so far back it is almost in the scrotum. 'As I held my newborn children I could see that the hole through which the boys would pass urine was not at the tip of the penis but halfway down, further underneath,' says Sue. 'I realised it didn't look right, but I was so glad that my babies had been born without any life-threatening complications that my main feeling was relief. 'It was my husband who was really shocked by the boys' condition. As a father, he couldn't believe this vital part of their manhood was somehow malformed.'
Mr and Mrs Phipps were told that while the immediate physical problem could be corrected with surgery, the condition was also linked to low sperm count and a higher risk of developing testicular cancer. Hypospadias can be triggered by a random genetic fault -- and initially the doctors suggested this as the cause of their sons' problem. However the Phipps have no family history of the condition, and they -- and their specialist -- are convinced environmental factors are to blame. There is increasing evidence to show that male reproductive abnormalities such as this are linked to exposure to 'gender-bending' chemicals found in everyday products such as shampoo and carpets.
These chemicals are known as hormone disruptors or EDCs -- endocrine disrupting chemicals. They include phthalates, a group of chemical liquids which are used to give many ordinary products a flexible texture. Phthalates are found in plastic, carpets, fabric, make-up, perfume, cosmetics, milk, vegetables and pesticides. In a two-year experiment by the Medical Research Council's Human and Reproductive Sciences Unit in Edinburgh, rats exposed to high levels of phthalates had double the rate of genital defects and low sperm counts. More crucially, in the first human study, researchers from the University of Rochester in New York have now linked exposure to phthalates to a higher risk of genital abnormalities in baby boys.
The researchers, who examined 134 boys, found women with higher levels of phthalate-related chemicals in their blood were more likely to give birth to babies with undescended, or small testicles and small penises. Professor Richard Sharpe of the MRC's Human Reproductive Sciences Unit believes that all these male reproductive abnormalities are interrelated and that the increase is linked to environmental and lifestyle factors. 'The problem is that we don't know the exact cause. But the fact is that phthalates are the most ubiquitous of environmental chemicals. They contaminate house dust, even rain water. There is no definitive proof yet that they are linked to male birth abnormalities. But they are a strong candidate.'
Aivar Bracka, a consultant genito-urethral surgeon who specialises in hypospadias, is convinced that environmental factors are to blame. 'All the solid evidence points to a strong link between the rise of male reproductive abnormalities and something in our environment.' Hereditary factors can only partly explain hypospadias, he says. 'For example I have seen twins where one has the condition and one hasn't even though the children are genetically identical. 'That situation can only arise from an external factor affecting foetal development. Otherwise both twins would be affected.' The theory is that phthalates interfere with the manufacture of the male sex hormone, testosterone at a critical stage in foetal development -- the first three or four months of pregnancy. It is testosterone which gives a foetus its male characteristics.
There is no doubt that women in particular are vulnerable to chemical exposure. According to Julia Mitchell, spokeswoman for environmental website http://www.chemicalsafeskincare.co.uk, the average woman will use 12 different cosmetic products a day -- unwittingly applying 175 different chemicals to her body. And in recent tests carried out by WWF, formerly the World Wide Fund for Nature, man-made pollutants and chemicals were found in every one of 27 food products tested, including bread and eggs. The amount of contaminants was well within legal limits, but the worry is that the chemicals may represent a serious risk when they mix together in the body.
At the moment it seems that only baby boys are at risk of reproductive abnormalities. (Indeed Sue Phipps and her husband Peter, 52, a retired businessman, have a 14-year-old daughter, Harriet, who has not suffered any problems.) However, as Professor Sharpe explains, 'just because the studies have not yet been carried out doesn't mean that females are not also vulnerable'. Changes in women would be more subtle, and not visible. 'However there is potential for any organ of the body to be affected by exposure to chemicals.'
Sue, who gave birth to the twins at Warwick Hospital in April 1995, was told that her sons' condition was 'mild to moderate'. And while there was no rush for surgery, it was clear the condition could not be left untreated: the children would have been unable to pass water standing up, since the urine would have been impossible to direct. 'We also knew they could face psychological problems of having a penis that looked different. And, though it seemed ridiculous to think of it when they were so young, hypospadias could also compromise their ability to have intercourse. 'It seemed right to correct the problem while none of these things were an issue.'
In every other way the children were normal healthy boys. They were referred to a consultant plastic surgeon at their local hospital who assessed the boys every year until they were four. The operation was finally scheduled for July 2000 -- by then they were considered old enough to cope with surgery and the timing meant they could start school in September without appearing 'different'. The surgery involved extending the existing urethra. This was done by creating an artificial urethra using a tube of skin taken from the foreskin and then stitching it to the end of the existing urethra. Grafting on this new piece of urethra would close the existing hole and the plastic surgeon then guided the artificial urethra to the end of the penis. 'It's awful watching not one, but two, of your children going down to surgery,' says Sue. 'Henry went first for the 90-minute operation. And as he came back from theatre, Charlie, who was already sedated, was wheeled down.'
In order to allow the stitches to heal, urine was not initially allowed to pass down the new urethra. Instead the boys were fitted with a stent which diverted urine from the bladder into a catheter bag. However shortly after the boys were brought back from theatre it was clear something was wrong. Within 20 minutes they were both writhing in agony. 'It was terrifying to watch,' says Sue. The problems seemed to be caused by a blockage in the stent. During the children's week-long stay in hospital, doctors had to reposition the catheter four times as on each occasion their pain only intensified.
The boys were not allowed to leave hospital until they could pass water without the catheter. But when they tried urinating naturally their parents were shocked by what she saw. 'When Charlie tried, the urine came out of five tiny holes near the end of his penis. When Henry did the same it came out of three holes. It sounds crude but it was like looking at a hosepipe with tiny puncture marks in it. 'Though we were assured these would heal naturally we were horrified. Their penises looked grotesque too. From thinking that this was just a routine operation I wondered if they would ever function normally.'
Hypospadias is technically difficult to correct and the Phipps sought a second opinion. They consulted Aivar Bracka, a consultant genito-urethral surgeon who specialises in hypospadias, at Wordsley Hospital in Stowbridge. He suggested a six-week wait to allow the children to recover from their trauma before carrying out corrective surgery -- one-third of his caseload comprises similar repair work. The 'salvage' operation took an hour. 'This time, thankfully, there were no tears or pain,' says Sue. 'Within a week their catheters were taken out and the boys healed quickly and were back at school within three weeks. 'The boys now have a check-up every two years and will do so until the age of 18.'
Although the boys have put the surgery behind them, Sue cannot but be concerned about what might lie ahead. Studies have shown that boys with the condition tend to have a slightly lower sperm count which could lead to problems conceiving. There is also an increased risk of testicular cancer. 'They haven't been offered any fertility tests and to be honest don't intend to pursue this unless it becomes an issue,' says Sue. 'Of course it is at the back of my mind, but I don't dwell on it.'
So what can be done to protect future children from such abnormalities. Later this month the EU parliament will vote on replacing hazardous chemicals in everyday products with safer alternatives. In the meantime, Prof Sharpe suggests that pregnant women try to minimise chemical exposure where they can. 'One new study has shown how rapidly the skin absorbs phthalates because it has such a large surface area. So it is best for pregnant women to try to avoid applying body creams and cosmetics.' For Sue the message is clear. 'I would urge all women who are thinking of having babies to be aware of the chemicals in everyday life. We need to raise awareness about the potential dangers.'
by Ricardo Alonso-Zaldivar, Los Angeles Times
October 7, 2006
http://www.latimes.com/news/printedition/front/la-na-fda7oct07,1,7169046.story
WASHINGTON -- When scientific advisors urged the Food and Drug Administration in February to put a strong warning about suspected cardiovascular risks on attention-deficit drugs taken by millions of children and adults, agency officials said more clinical evidence was needed. Now, the FDA-funded study meant to authoritatively answer questions about the drugs for attention-deficit hyperactivity disorder may be halted in midstream. The reason: The agency doesn't have the money to finish it.
The threat to the study, as revealed in documents and interviews, stems from chronic shortchanging of the nation's drug safety program. It is one symptom of a federal agency increasingly constrained by a budget that has failed to keep up with costs. This crunch is even more dire in the food division, which tries to keep tainted foodstuffs from supermarket shelves. Even as concerns grow, the agency has budgeted only $1.6 million for such safety studies of medications already on the market, and that number is scheduled to drop to $900,000 in the coming year. Outside experts estimate that the agency needs $20 million to $100 million a year to conduct such studies.
Recently, three former secretaries of Health and Human Services sounded a public alarm about what they saw as a dangerous squeeze on the overall FDA budget. Tommy G. Thompson, who served in President Bush's first term; Donna Shalala, who served under President Clinton; and Louis W. Sullivan, who served under President George H.W. Bush, joined consumer and industry groups in calling on the administration to substantially boost -- perhaps double -- the agency's $1.5-billion annual budget, which has increased only modestly in recent years.
FDA officials declined to discuss problems with funding for drug safety, saying the issue was under internal review. In a statement, the agency acknowledged that more money was needed for safety and noted that funding to complete the ADHD study had "not yet been identified." A special fact-finding panel of the Institute of Medicine recently put the troubles in blunt terms in a report that called for significant FDA changes. Funding for drug safety is "especially inadequate [and] resource limitations have hobbled the agency's ability to improve and expand this essential component of its mission," the panel concluded.
FDA officials estimate the study of ADHD medications, including such well-known brands as Ritalin and Adderall, will cost $2 million to $3 million. About $1 million has been committed. By analyzing the records of thousands of individuals, outside medical researchers have been trying to determine whether the medications predispose patients to heart attacks and sudden death. Most ADHD drugs are derived from powerful stimulants. They help patients concentrate, but they also raise blood pressure, a major risk factor for heart disease and stroke. The medications, once given primarily to children, are increasingly prescribed for adults -- a population more susceptible to heart problems. About 2.5 million children and 1.5 million adults now take such medications. "If the FDA lacks the resources to complete the study of cardiovascular risks of ADHD drugs, the consequences can have a profound adverse impact on public health," said Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic. "The makers of these agents have no incentive to study the hazards of their own drugs. Therefore, the FDA will likely represent the only entity capable of objectively assessing the safety of the ADHD drugs."
The ADHD study is not the only example of a patchwork system. The FDA bought -- at a cost of $500,000 a year -- a British database that is considered a state-of-the-art tool for drug safety research. The General Practice Research Database contains complete medical records on 4 million patients that can be mined for information on reactions to drugs. But the FDA has acknowledged that its drug safety office doesn't have enough professionals -- epidemiologists, biostatisticians and computer programmers -- to take full advantage of the database.
Meanwhile, the 90-person drug safety office is reeling from a surge in reports on medication side effects. The number of such "adverse event" reports jumped from about 250,000 in 2000 to more than 450,000 in 2005. The trend reflects greater use of prescription drugs, growing awareness of their risks and improvements in the reporting system. "We have to do difficult triage about which ones we are going to follow up on," said an FDA official closely involved with the agency's budget who asked not to be identified because of the sensitivity of discussions within the Bush administration. "Our funding is just not robust enough for scientific research." Fully funding the ADHD risk study would mean "we wouldn't be able to do too many other studies," the official added.
The FDA's budget crunch has also hurt its ability to safeguard fresh produce, some critics say. That has become an issue in the aftermath of the E. coli outbreak traced to California spinach. The number of inspectors and field office staffers has been cut from 2,217 in 2003 to about 1,960. "The agency is like a fire department running around with a little fire extinguisher," said Michael Jacobson, director of the Center for Science in the Public Interest, a nutrition advocacy group. "The money situation for foods is probably worse than it's ever been."
Earlier this year, the FDA's food division announced that budget pressures had forced cuts in its headquarters workforce from 950 in 2003 to fewer than 850, with further reductions expected. The FDA has "been presented with unique challenges, and we will not be able to take on the same large number of objectives we have identified in previous years," Robert E. Brackett, director of the food division, wrote in an unusually candid letter to consumer and industry groups. "The challenges are likely to continue [in 2007] and beyond for domestic agencies in the federal government."
The agency's budget challenge has three facets, outside experts and agency officials say. First, modest annual increases for the FDA have not kept up with escalating salaries for its doctors, pharmacologists, epidemiologists and other professionals. For example, experts in the FDA's Center for Drug Evaluation and Research made an average of $70,000 in 1997, but now command salaries of $140,000 to keep up with industry. A recent internal FDA analysis estimated that the 2006 budget would have needed to be $2.2 billion -- not $1.5 billion -- just to keep pace with increases in personnel costs.
Second, the post-market drug safety program -- with a few exceptions -- is not allowed to tap into user fees that pharmaceutical companies pay the agency for the review of proposed new drugs. The user fees add about $400 million a year to the FDA's $1.5-billion budget.
Finally, compared with funding for the National Institutes of Health, which sponsors cutting-edge medical research, securing more money for the FDA has been a low priority for the administration and Congress. The NIH budget has increased from $20.5 billion in 2001 to $28.6 billion. "There has been a dramatic increase in the attention focused on NIH, and we believe similar attention needs to be given to the FDA," said Sheila Burke, chairwoman of the Institute of Medicine panel that recently reported on drug safety. "The center of that effort has to be an increase in resources. There is no question that it needs to be done."
Meanwhile, despite the uncertainty over funding for the ADHD study, researchers are continuing work on it. They plan to use several medical databases to try to address three key issues: whether there is a link between ADHD drugs and higher rates of heart attack and sudden death in children; whether such a risk exists for adults; and whether there is a link between ADHD drugs and heart-rhythm abnormalities in children. They have designed the study, but without more money won't be able to determine whether these popular drugs can lead to heart attacks. "That's a very important question," said Laurel Habel, an epidemiologist at the Kaiser Foundation Research Institute in Oakland, which is participating in the study. "These drugs are being prescribed for a large and growing number of children, and they are also being prescribed to a growing number of adults. And, in general, they are medications that are taken for the long term."
by Marian Burros, New York Times
October 7, 2006
http://www.nytimes.com/2006/10/07/education/07snack.html?_r=1&adxnnl=1&oref=slogin&adxnnlx=1160367540-y48Kec5qGZbpZHt+jOgA8Q
In an effort to fight the rise in childhood obesity, five of the country's largest snack food producers said yesterday they would start providing more nutritious foods to schools, replacing sugary, fat-laden products in vending machines and cafeterias. French fries, ice cream, candy, cupcakes and potato chips from the machines, lunch lines, school stores and even school fund-raising events could disappear under a voluntary agreement between the companies and the Alliance for a Healthier Generation. The plan, which may take effect at the beginning of the next school year, is the first nationwide effort to set strict nutrition guidelines for school vending machines.
Because the guidelines are voluntary, critics say they will not be effective. Both the Center for Science in the Public Interest, a frequent critic of the food industry, and the School Nutrition Association want government regulation instead. "Our organization feels pretty strongly that we need some kind of nutrition guidance from the Department of Agriculture," said Janey Thornton, president of the nutrition association.
Dr. Carlos Camargo, an associate professor of epidemiology at the Harvard School of Public Health was more positive. "I think it's helpful for groups that have traditionally denied any connection between snack foods and obesity or health to be acknowledging now that there are links, and that moves the agenda forward," Dr. Camargo said. A bill introduced in the Senate this year would require the Agriculture Department to set standards for snack foods based on those that the Institute of Medicine is expected to issue by the end of the year. The agreement will be more difficult to implement than those announced in May between the three largest soft drink companies and the alliance, which is a partnership of the William J. Clinton Foundation and the American Heart Association, in which companies agreed to replace sugary soft drinks with more healthful beverages.
The soft drink companies account for 90 percent of soft drinks in schools, which are sold through the company distributors. But there are about 70 snack food companies that supply schools, and those products are sold through independent vendors who are not in the agreement. That means yesterday's initiative will require the companies to educate vendors on the need for more healthful snacks. At the news conference announcing the new initiative, former President Bill Clinton said: "The companies are going to work to convince distributors and even their competitors to follow suit. I think after today, their competitors are going to have a very difficult time explaining why they won't." Several company officials agreed. "The power of this alliance is to get others to join it," said Charles Nicholas, a spokesman for Frito-Lay.
Under the guidelines, products could contain no more than 35 percent sugar by weight and have no more than 230 milligrams of sodium. No trans fats would be allowed. No product could get more than 35 percent of its calories from fat. The guidelines would also set calorie limits for each serving based on age: 150 calories for elementary school children, 180 calories for middle school children and 200 calories for high school students.
The five food manufacturers -- Dannon, Kraft Foods, Mars, PepsiCo and the Campbell Soup Company -- agreed to make specific changes in what they sell to schools. They are the following:
Some states and school districts already have strict limits on food sold outside the government-regulated school lunch and breakfast programs. But the Center for Science in the Public Interest in a survey of states found that two-thirds of them had either extremely weak policies on snack foods or no policy at all.
Dr. Thomas Robinson, associate professor of pediatrics at the Stanford School of Medicine and director of the Center for Healthy Weight at the Lucile Packard Children's Hospital, takes the long view: "This problem is similar to what happened to tobacco over the last several decades; things happened incrementally," Dr. Robinson said. Mr. Clinton reminded his audience that problems of this magnitude aren't solved in a day. "We didn't get in this fix overnight, and we won't get out of it overnight," he said.
by Janet Wilson, Los Angeles Times
October 7, 2006
http://www.latimes.com/news/science/environment/la-me-soot7oct07,1,5967636.story
As many as 24,000 lives -- a large number of them Californians' -- could have been saved each year if the head of the Environmental Protection Agency had tightened soot standards by one microgram per cubic meter annually, according to an analysis released Friday. The cost-benefit analysis also shows that although the tab for power plants, refineries, auto manufacturers and other industry for such a change would be about $1.9 billion a year -- or about $15 per household -- the savings in healthcare costs, work and school attendance and other benefits would be between $4.3 billion and $51 billion.
Exposure to soot, or fine particulate matter, has been repeatedly linked to respiratory and cardiac illness and premature death. Southern California and the San Joaquin Valley have the worst fine particulate pollution in the nation, largely because of diesel-powered vehicles. The estimates found as many as 6,400 lives would be saved annually in California. By law, the EPA is not allowed to consider the costs of a new regulation. But it, along with all other federal agencies, is required to calculate them. The agency is required to consider health benefits.
EPA administrator Stephen Johnson has been harshly criticized by medical groups, environmentalists and his own science advisors for his Sept. 21 decision to retain a standard allowing annual exposure of 15 micrograms per cubic meter, rather than tightening it to 14 micrograms or fewer. The American Medical Assn., the American Lung Assn., pediatric and environmental groups and scores of doctors and academics who specialize in heart and lung disease had asked Johnson to set a standard of between 12 and 14 micrograms per cubic meter of air for fine particulates, saying that study after study had shown a correlation between increased exposure to soot and higher numbers of illnesses and deaths.
Friday's online posting unleashed a new round of criticism. "It's pretty sobering and shocking stuff to realize the agency concluded the human cost of refusing to strengthen these air quality protections was going to be [thousands of lives] lost each year," said attorney John Walke, the clean air director for the Natural Resources Defense Council. Walke said that although the cost to industry "is not insignificant ... it pales in comparison to the $50 billion annually that they project will be incurred in healthcare costs as a result of the failure to upgrade the standards." "It's pretty darned obvious that better standards would mean fewer premature deaths," said Frank O'Donnell of Clean Air Watch. Industry representatives could not be reached for comment late Friday.
Johnson did significantly tighten daily exposure amounts to soot, cutting the allowable level from 65 to 35 micrograms, which electric industry representatives in particular had criticized as being of unproven need and costly. The same analysis released Friday shows as many as 13,000 lives will be saved as a result of that change, at a cost of $5 billion annually, with $9 billion to $76 billion in social benefits. Johnson was not available for comment Friday. He said at the time of his decision that "reasonable minds can disagree" and that there was disagreement among scientists on the evidence concerning annual particulate exposure.
But the analysis released Friday shows that every member of a 12-member panel of scientists convened at the request of the White House Office of Management and Budget and National Academy of Sciences found that thousands of additional lives could be saved if the tougher annual standard were adopted. The panel was made up of authors of the studies that Johnson used and specialists picked by their peers as the leading experts in particulate pollution. All reviewed the available literature on soot illness and death and primarily relied on the same two studies that Johnson did in making their estimates.
"I feel that he didn't really take into account the best available science, which is now saying very clearly that there are very significant health effects related to this longer-term exposure," said Dr. Bart Ostro, one of the 12 panelists and chief of the air pollution epidemiology section for the California EPA. Ostro said the science panel had set risk percentages of increased illness and mortality, which the EPA then converted into possible deaths based on U.S. population and total death rates. Under a limit of 14 micrograms, those estimates found a range of lives saved from 2,200 to 24,000, or an average 13,000 annually. In all cases, the highest number of deaths avoided would be in California.
Ostro said that because California has the most fine particulate pollution and a large population, "we would see a large chunk of the benefits" if the standard were set at 14 micrograms. "We're talking about ... hospitalization and emergency room visits, asthma attacks and work loss as well as mortality," he said.
Acting assistant EPA administrator William Wehrum, who worked with Johnson on the new rules, said Friday that the new analysis was not ready when Johnson made his decision, so it was not included as part of that process. But it would be helpful in future regulations, he said, adding that Johnson and agency staff "absolutely considered impacts to human health."
by Diedtra Henderson, Boston Globe
October 7, 2006
http://www.boston.com/business/globe/articles/2006/10/07/will_lipstick_be_safe/
WASHINGTON -- From sunscreens to drugs that ease nausea to the promise of a lipstick that changes color, consumers can expect to see more products based on technology that harnesses the tiniest specks of material. Nanotechnology is poised to become a revolutionary force in manufacturing -- including pharmaceuticals and medical devices -- according to a Washington, D.C., project that aims to increase public understanding of the technology while reducing its risks.
But the promise of such innovations runs smack against a chronically underfunded Food and Drug Administration that is ill-equipped to guarantee the new products' safety, the Project on Emerging Nanotechnologies said in a report released this week. To ensure the safety of nanotechnological creations, the FDA would need more legal powers and funding -- perhaps tens of millions of dollars, said Michael R. Taylor, a former deputy FDA commissioner who wrote the report.
Nanosizing materials can make them small enough to fit a million particles onto the head of a pin. That creates "fantastic" materials with strength of steel and the flexibility of rubber, at one-quarter the weight, said Julia A. Moore , deputy director of the project, which is funded by the Woodrow Wilson International Center for Scholars and the Pew Charitable Trusts. Nanotechnology also refers to techniques used to build material atom by atom or molecule by molecule. "It is going to affect the food you eat. It's going to affect the medicines that treat your cancer and Alzheimer's disease," Moore said.
According to Lux Research Inc., manufacturers sold more than $32 billion in nanotechnology products worldwide last year. By 2014, manufactured goods worth about $2.6 trillion will incorporate nanotechnology, the firm estimates. But safety advocates say the FDA will be overwhelmed because the agency lacks enough money to oversee safety of products already on the market. And Congress has not given it authority to police the safety of conventional products already using some nanomaterials.
The agency does not share those concerns. Both camps point to cosmetics to bolster their arguments. The cosmetics industry is self-regulated and fills store shelves with products it says use nanoparticles. That includes sunscreens that are transparent, creams said to tone skin, and shampoos said to make hair glow. Working voluntarily with the FDA, the cosmetics industry conducts its own safety studies. It is under no obligation, however, to share safety data with the FDA.
Taylor said the FDA, at a minimum, should get access to the safety studies. It should also track safety of cosmetics through such tools as a database of side effects attributed to cosmetics use, he said. "If you believe people's confidence in your product is going to be undermined because they are not sure about safety, then you have some incentive to get some basis for FDA to vouch for its safety," Taylor said.
To argue against significant congressional action, the FDA points to a history of voluntary compliance by the cosmetics industry and the low number of safety problems caused by cosmetics. Also, the nanotechnology movement is only in its infancy, giving the FDA time to prepare for the new regulatory challenge. The FDA, which is already identifying regulatory gaps in nanoproduct oversight, along with potential fixes, is scheduled to discuss nanotechnology in a public meeting on Tuesday. "There is no question when the industry nanosizes the material -- whether it's [material] we've looked at before or one we've never looked at -- that material has different properties," said Norris Alderson, FDA associate commissioner for science.
That does not necessarily mean there is a significant difference in product safety, he said. "It's too early to jump to a solution via changing the law," Alderson said. "The science is just not there yet to lead us to that conclusion."
But Kirsty Mills, a University of New Mexico researcher who teaches a course on the social and ethical implications of nanotechnology, worries about some of the new materials. A French manufacturer, for instance, is working on an experimental lipstick that looks transparent. The lipstick uses layers of nanoparticles to create the illusion that the lipstick changes colors when lighting changes, according to media and analyst reports. And new sunscreens achieve translucence by miniaturizing and encapsulating titanium dioxide particles. "There is a debate going on about, is that safe or not," said Mills, associate director of the university's Center for High Technology Materials. "Does that go through your skin? They're small enough; it's possible that they penetrate. What happens when they penetrate?"
by Cheryl Hogue, Chemical & Engineering News
October 5, 2006
http://pubs.acs.org/cen/news/84/i41/8441EPA.html
Three members of a panel that advises EPA on the management of commercial chemicals resigned as a bloc effective Oct. 4. The National Pollution Prevention & Toxics Advisory Committee "has been unable or unwilling to consider systematic, structural problems" with EPA's assessment and management of chemicals under the Toxic Substances Control Act, they said in an Oct. 2 resignation letter to the agency. Leaving the 15-member panel are Richard A. Denison, senior scientist for Environmental Defense; Joseph H. Guth, executive director of the California League for Environmental Enforcement Now; and Joel Tickner, assistant professor in the Department of Community Health & Sustainability at the University of Massachusetts, Lowell.
The three said EPA has been reluctant to acknowledge and confront limitations in its approaches for assessing and managing chemicals. Also, the agency has "repeatedly cited EPA's budgetary constraint as a barrier even to considering changes." In addition, the advisory panel is "numerically weighted excessively toward industry," they said. This has allowed some industry members to put off the panel's discussion of broader issues and limit its agenda to "narrow, short-term issues" that do not warrant the time and expense to EPA of having the advisory committee, the three wrote.
Industry members include representatives of the American Chemistry Council, the Synthetic Organic Chemical Manufacturers Association, the American Petroleum Institute, Dow Chemical, Procter & Gamble, and GE Advanced Materials. Chairing the committee is Harry Gregori Jr., the vice president of Environmental Solutions, an environmental consulting firm. Other members of the panel are a retired executive director of the Risk Science Institute at the International Life Sciences Institute, a representative of the National Center for Healthy Housing, and officials from two state agencies and one from a Native American tribe.
The committee was scheduled to meet in a public session on Oct. 4-5, but EPA abruptly cancelled the meeting on Oct. 2, providing no explanation. Calls from C&EN to EPA on the issue were not returned by deadline.
by Marla Cone, Los Angeles Times
October 5, 2006
http://www.latimes.com/news/printedition/asection/la-me-perchlorate5oct05,1,7438204.story
Many women exposed to perchlorate, the rocket fuel chemical that has contaminated hundreds of Southern California water wells, have suppressed thyroid function, which can lead to health problems in them and abnormal brain development in their offspring, according to a study by the Centers for Disease Control and Prevention published Wednesday. The study is the first research that links reduced thyroid hormones in people with the low amounts of perchlorate routinely found in the bodies of Americans nationwide. Women with low iodine levels -- more than one-third of U.S. women -- were most at risk from the chemical, according to the report.
Perchlorate is particularly a pervasive threat in California, where more than 450 wells and other water sources operated by more than 100 agencies are contaminated, primarily in Los Angeles, Orange, Riverside, San Bernardino and Sacramento counties, according to the state health department. The chemical also is found in milk, cheese, lettuce and other food, as well as human breast milk and baby formula. Much of the contamination comes from military bases and aerospace plants, where perchlorate was used as the explosive component of solid rocket fuels.
The findings could provide major evidence for the U.S. Environmental Protection Agency, which for years has been reviewing whether it should set a national standard for perchlorate in drinking water. The CDC team analyzed thyroid hormones and perchlorate levels of 1,111 women and found a relationship between them, particularly in those with low iodine levels. Women with moderate to high perchlorate exposure had fewer T4, or thyroxine, hormones -- on average, a reduction equivalent to 8% to 33% of the normal range for the hormone. "For women overall, perchlorate was a significant predictor" of two important thyroid hormones, T4 and TSH, or thyroid-stimulating hormone, according to the study, published Wednesday in the online version of the journal Environmental Health Perspectives. The research was led by Benjamin C. Blount of the CDC's National Center for Environmental Health in Atlanta.
Prolonged reductions in thyroid hormones, often caused by insufficient iodine intake, can lead to hypothyroidism, a metabolic disorder, in adults, and mental impairment in fetuses and infants. The most pronounced reductions in the thyroid hormones were in women with iodine levels of less than 100 micrograms per liter, the minimum level suggested by the World Health Organization. No drops in the hormones were seen in men, possibly because women are more at risk due to the thyroid effects of estrogen and pregnancy.
Last year, a panel of the National Academy of Sciences concluded that perchlorate can affect the thyroid's ability to absorb iodine and suppress its hormones. But it also determined, based on the science at the time, that effects would occur at high levels of exposure. In the new study, the reductions in thyroid hormones were seen "at perchlorate exposure levels unanticipated based on previous studies." Based on the average perchlorate levels in their urine -- 2.9 parts per billion -- the women were ingesting almost 10 times less than the dose the EPA has considered safe based on the national academy panel's recommendations.
In a report accompanying the new study, Environmental Health Perspectives called the reductions in thyroid hormones "significant" and said they "indicate that even small increases in perchlorate exposure may inhibit the thyroid's ability to absorb iodine." The CDC researchers reported that nearly all of the previous studies that found no thyroid effects analyzed men, not women. Only two previous studies included women, and they had normal iodine levels so they were less vulnerable to effects. "Our study is the first to target and separately analyze results for women with lower levels of urinary iodine, a potentially susceptible population," they said.
While the EPA reviews whether to impose a drinking water standard, it has set an interim goal -- not an enforceable limit -- for industrial cleanups. The Pentagon and its contractors, including Aerojet and Lockheed Martin, have been lobbying against a stringent drinking water standard, saying there are no proven health effects and that cleaning up perchlorate could cost billions of dollars.
In August, California proposed its own drinking water standard of 6 parts per billion. The state health agency will hold a hearing on its proposed regulation Oct. 30 in Sacramento. Comments from the public will be accepted until Nov. 3. Massachusetts is the only state with a mandatory limit in place: 2 parts per billion. Perchlorate has been detected in the public drinking water supplies of more than 11 million people in 26 states at concentrations of at least 4 ppb, according to the 2005 National Academies of Science report.
by Laura Landro, Wall Street Journal
October 4, 2006
http://online.wsj.com/article/SB115991894763881827.html?
Hospitals play a pivotal role in protecting America's health. But they may also have a surprising unhealthy side -- inadvertently contributing to illness and pollution by exposing patients and staff to a witch's brew of toxins from building materials, medical waste, hospital supplies and cleaning products. Environmental health experts warn that materials that cover floors, walls and ceilings release hundreds of chemicals into hospital air, and chemicals used to clean and maintain hospitals add more. Volatile organic compounds such as formaldehyde, acetaldehyde, naphthalene and toluene are released into the air from particle board, carpets and other finish materials and are inhaled by patients and staff. Polyvinyl chloride (PVC), which releases the carcinogen dioxin during its manufacture, is widely used in the production of IV and blood bags, plastic tubing and other hospital products, as well as carpets. In addition, inadequate ventilation and generally high energy consumption have contributed to poor air quality and pollution, studies show, with effects ranging from longer patient recovery times to more sick days for staff.
Now, as the industry embarks on a $200 billion construction program over the next decade to replace or rebuild decaying facilities and meet growing demand from aging baby boomers, that is starting to change. Under pressure from local and state governments, as well as health-care architects and designers and their own environmentally conscious donors, hospitals are building more efficient, eco-friendly facilities with "sustainable" design features that conserve energy, use natural light and materials and reduce potentially dangerous emissions.
About a dozen pioneering groups, including Kaiser Permanente and Dartmouth-Hitchcock Medical Center in Lebanon, N.H., began the move to "green" hospital construction several years ago, and others are now following suit. According to the nonprofit Center for Health Design, which co-sponsored a conference in New Jersey last week to promote green design, more than 180 health-care facilities have been built or are being designed and constructed to standards such as those set by the Green Guide for Health Care (GGHC.org), modeled on a certification system developed by the U.S. Green Building Council, a coalition of builders, architects, government agencies and nonprofit groups.
When Kaiser Permanente's new medical center in Modesto, Calif., is completed in 2008, solar panels will cut energy costs, permeable pavement material will filter chemicals from rainwater runoff, floors will be covered with natural rubber, carpets will be backed with recycled safety glass -- even toilets will be fitted with special fixtures to conserve water. The new center is part of a $20 billion-plus facilities program at the Oakland, Calif.-based health-care giant that includes building or replacing 27 hospitals over the next nine years.
To be sure, there is conflicting evidence about the harm caused by chemicals in hospitals, and some manufacturers say there is no direct evidence that PVC, for example, is harmful to humans. But the nonprofit advocacy group Healthcare Without Harm says hospitals have a responsibility to choose the safest course when evidence suggests harmful effects. The group cites studies that show hazardous additives in PVC are toxic to both the reproductive and neurological systems -- a particular concern for neonatal-intensive-care patients. The American Hospital Association signed a memorandum of understanding with the Environmental Protection Agency several years ago to phase out the use of mercury, which can affect the human nervous system, in things like thermometers and blood-pressure cuffs. At the same time, studies show that environmental improvements associated with sustainable buildings, such as bringing in more natural daylight, meditation areas and "healing gardens," can shorten patients' length of stay, reduce reliance on medication, and lessen mental and physical stress.
As hospitals move to make such changes, the challenge now is not only to build hospitals to rigid environmental standards, but also to operate them with the same principles in mind. "You can't build a green hospital and still have Styrofoam cups in the cafeteria," says health-care architect Robin Guenther, a co-coordinator of the Green Guide for Healthcare. Stiffer federal regulations governing emissions of chemicals and heavy metals like dioxin and mercury have driven some changes, in particular regarding incinerators used to dispose of medical waste. Since the mid 1990s, when regulators found that hospital incinerators were a major contributor to mercury and dioxin emissions, more than 5,000 medical-waste incinerators have closed, and hospitals have adopted safer waste-disposal and treatment technologies. "Hospitals didn't think of themselves as polluters, with spewing smokestacks and waste going out the back door," says Laura Brannen, executive director of the nonprofit Hospitals for a Healthy Environment (h2e-online.org), which helps hospitals devise improved environmental programs that also shave costs. Among them: separating hazardous waste, infectious waste and solid waste, which must be treated and disposed of differently, and recycling or reclaiming chemicals for medical use.
But Ms. Brannen cautions that many hospitals still send their waste to municipal incinerators that contribute to health threats. Wastewater from hospitals, she adds, still contains toxic lab and cleaning chemicals and pharmaceutical compounds, many of which aren't broken down in sewage-treatment plants. Hospitals are also scrambling to find substitutes for building and interior finish materials. And companies that supply the industry are under growing pressure to come up with green products, including latex-free examination gloves, greener cleaners without harsh chemicals and recyclable solvents. "In an era of rising construction costs, you don't have to pay extra money and use precious health-care dollars just to be green," says Christine Malcolm, Kaiser senior vice president of national facilities and hospitals. With the industry's purchasing power, "we can force suppliers to generate environmentally sensitive products."
Kaiser, for example, pressured carpet manufacturers to come up with a PVC-free product, which it will use in all its new facilities. Kaiser is also installing "dual-flush" toilets, which use more water for flushing solid waste and less for liquid, saving half a gallon of water for the latter. In the past five years the company says it has eliminated the purchase and disposal of 40 tons of hazardous chemicals, chosen "ecologically sustainable" materials for 30 million square feet in new construction, and saved more than $10 million a year through energy-conservation strategies. While many of the innovations cost more up front, they can actually reduce operating costs over time, says Gary Cohen, executive director of the Environmental Health Fund, a nonprofit group that works on chemical-safety issues. Rubber flooring is more expensive to install than PVC, for example, "but the hospital will save much more during the lifetime of the flooring due to the fact that you don't need to constantly strip the floor with toxic chemicals and rewax it," Mr. Cohen says.
Still, going green can be challenging for hospitals that have to rebuild or retrofit older facilities. To build the new Lacks Cancer Center, St. Mary's Health in Grand Rapids, Mich., had to tear down old buildings, remove asbestos from pipes, tear out linoleum tiles, and separate metals like steel and copper. But it recycled more than 90% of the materials, recrushing brick and cement for the new facility, and installed energy-saving devices like windows with self-cleaning coatings. "It may have cost us a few dollars more, but in the long run it will pay dividends," says St. Mary's President and Chief Executive Philip H. McCorkle Jr. Another incentive: A local benefactor made a major gift to the hospital contingent on sustainable design. The hospital also prepares food to order, which Mr. McCorkle says uses less energy, wastes less food, and makes patients happier than the traditional cafeteria model.
The University of Pittsburgh Medical Center, which is building a new children's hospital due for completion in 2009, is paying special attention to issues such as materials used to cover and clean floors, since its small patients "are closer to the floors and the source of chemicals," says President and CEO Roger Oxendale. But the hospital is also teaching medical interns about environmental health and reaching out to underserved populations to educate them about issues such as how second-hand smoke can harm their children.
by David Sampson, American Cancer Society
October 3, 2006
http://www.cancer.org/docroot/MED/content/MED_2_1x_Study_Calls_Reductions_in_Smoking_Major_Contributor_to_Drop_in_Cancer_Mortality.asp?sitearea=MED
Atlanta -- A new report from the American Cancer Society -- the first to systematically addresses the dramatic success of tobacco control efforts -- finds even the most conservative estimate shows that reductions in tobacco smoking account for about 40 percent of the decrease in cancer death rates among men between 1991 and 2003. Researchers say those efforts have prevented at least 146,000 cancer deaths in men during that time. Writing in the October issue of Tobacco Control, American Cancer Society vice president of epidemiology and surveillance research, Michael J. Thun, M.D., and Ahmedin Jemal, Ph.D. say their findings suggest that without reductions in smoking, recent reductions in overall cancer mortality in men and women would have been virtually erased. They add that the lifesaving results of tobacco cessation initiatives are only just beginning.
In 1991, the age-adjusted overall cancer death rate in the U.S. peaked. Between 1991 and 2003, it dropped by 16.1 percent in men and by 8.4 percent in women. The decrease in lung cancer and overall cancer mortality among men began approximately thirty years after the downturn in their smoking rates. No decrease in lung cancer mortality has yet occurred among U.S. women, who took up regular smoking 20 to 30 years after men and have been slower in giving it up.
The authors of the report used two approaches to estimate the impact of reductions in smoking on cancer death rates and number of cancer deaths. First, they projected the increase in lung cancer death rates in men and women that would have occurred had they continued to rise at their previous rates. From this, they conclude that without the drop in smoking that began in the 1960s, there would be essentially no decrease in cancer death rates occurring today. In a second, more conservative approach, the authors applied the 1991 lung cancer death rate in men to the U.S. male population in each year from 1991 to 2003. From this they estimate that about 146,000 lung cancer deaths were prevented or postponed by the drop in lung cancer death rates in men during this interval. They say while the second approach likely underestimates the full benefit of reductions in smoking on cancer mortality, it illustrates that a very large number of deaths from lung cancer were avoided because of reductions in cigarette smoking resulting from anti-smoking messages and other tobacco control measures implemented since the 1950s.
The authors say as dramatic as those gains have been, the payoff from past investments in tobacco control has only just begun. Lower smoking initiation rates today and the anticipated future decrease in lung cancer mortality in women have the potential to drive cancer death rates down even further. "The bottom line," they say, "is that sustained progress in tobacco control is essential if we are to continue to make progress against cancer."