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 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
October 30, 2006
10:00 a.m.
Seattle, Washington
in front of EPA Region 10 Headquarters, 1200 6th Avenue, (6th & Seneca)
The Region 10 Environmental Protection Agency is proposing to dismantle the Office of Civil Rights & Environmental Justice by moving staff to different departments. This means we will have "no" EPA office in Region 10 specifically focused on ensuring that all people have access to services regardless of race or income. This also means 1)a weaker program; 2) more pollution and health impacts to poor communities and communities of color; 3) a reversal of years of progress made by environmental justice groups in Region 10; and 4) little or no commitment to addressing disparate environmental impacts. Why you should care: We all eat, breathe, drink and live on this earth. An environmental assault to one community is a threat to all.
Contact: 206-720-0285 or justice@ccej.org
November 1, 2006
6:30 - 8:30 p.m.
Seattle, Washington
at Miller Community Center, 330 19th East
The evening features presentations on the Pollution in People body burden study, discussion and a fun dinner gathering, with Patricia Dawson, MD, study subject, breast cancer surgeon; and and WPSR Board of Sponsors member Erika Schreder, Washington Toxics Coalition staff scientist and report author. Presented by Washington Physicians for Social Responsibility. Please RSVP to the contact person below.
Contact: 206-354-2170 or nancyd@wpsr.org
November 5, 2006 (Bellevue, 2:00 - 5:00 p.m. at North Bellevue Community Center)
or November 6, 2006 (Seattle, 6:00 - 9:00 p.m. at Swedish Medical Center)
Lotion, deodorant, shampoo, makeup ... we use these products every day. But did you know that many cosmetics contain chemicals linked to cancer and birth defects? And did you know these chemicals end up in the waterways and wildlife of the Puget Sound region? Most people don't. That's why we're inviting you to a free community forum about cosmetics, your health, and the environment this November. Come find out about ingredients used in cosmetics and personal care products, their cumulative effects on our health and environment, and what consumers can do to protect themselves, their families and the environment. Refreshments will be served. And free samples from natural products companies.
Website: http://www.toxicfreelegacy.org/safecosmetics/forums_Nov06.html
Contact: Margaret Shield at 206-632-1545 x123 or fill out the web form at http://www.actionstudio.org/public/page_view_all.cfm?option=begin&pageid=7390
Abstracts: by November 6, 2006
Conference: March 29 - 31, 2007
Washington, DC
at the Howard University School of Law
It has been more than 25 years since the Warren County protest that arguably gave birth to the environmental justice movement in this country. It has been twenty years since the United Church of Christ published Toxic Waste and Race in the United States, a nationwide study that further documented the association between hazardous waste facilities and the racial composition of the communities hosting such facilities. It has been ten years since the United Church of Christ, the National Association for the Advancement of Colored People and the Center for Policy Alternatives published Toxic Waste and Race Revisited, a study that found that the associations documented in Toxic Waste and Race were just as active as they were in the original study. The National Small Town Alliance, the Howard University School of Law, and the United States Department of Energy are teaming with others to review the environmental justice movement and to determine the State of Environmental Justice in America. This effort will team with communities, scholars, researchers and others to issue a comprehensive report and conduct this conference.
Call for papers: The conference planners are inviting individuals to submit a short abstract of no more than 250 words that describes the current state of environmental justice in one of the areas listed below, preferably placing your discussion in the context of changes that have occurred in the selected area since Warren County. For a list of suggested topics, please contact ejinamerica2007@yahoo.com. Abstracts are due November 6, 2006.
Contact: Michelle Hudson, hudsonmi@saic.com
November 8 - 9, 2006
University Place, Washington
at the Pierce County Environmental Services Building
The Puget Sound Partnership meets regularly in its quest to develop an aggressive 15-year plan to solve Puget Sound's most vexing problems. The Partnership is holding a series of general public forums and specific scientific forums throughout the summer and fall.
Website: http://www.pugetsoundpartnership.org/
Contact: Martha Neuman, 206-625-0230 or mneuman@sharedsalmonstrategy.org
November 18, 2006 (Olympia) or November 19, 2006 (Seattle)
9:30 a.m. - 4:30 p.m.
Olympia and Seattle, Washington
Olympia: at the Unitarian Universalist Congregation Building, 220 E. End St. NW
Seattle: the location is TBD
This is a postelection gathering to plan for the new year and discuss common ways we will benefit from fixing our broken democracy. United on this issue, we can more easily achieve our various goals as citizens and citizen-based organizations. Those attending will discuss how we can fix democracy and speed our progress on these issues: 1) corporate power over government and corruption of democracy; 2) more effective tools for change; 3) basic assumptions and focus of activism; and 4) common bonds and strengths.
Website: http://www.SoundDemocracy.org
Contact: 360-236-9684 or JacquiAfd@comcast.net
issued by National Institutes of Health, Office of the Director, Office of Portfolio Analysis and Strategic Initiatives (OPASI)
The Request for Information (RFI) for NIH Roadmap Initiatives was released on October 20, 2006. This is an opportunity to influence the direction of trans-NIH and transdisciplinary efforts. In FY2006, Roadmap initiatives accounted for about 1.2% of the fiscal year's NIH research funding. Eventually, these initiatives are anticipated to grow to comprise up to 5% of the NIH annual funding for research. This notice requests input from a very wide audience that includes the general public as well as the scientific community, health professionals, voluntary health organizations and patient advocates. Also, NIH individual staff scientists, committees, workgroups and interest groups are able to provide input through the RFI.
Respondents are able to submit up to three ideas. Nominations must meet the set of criteria established for trans-NIH Roadmap strategic initiatives. To nominate new ideas and to comment on previously submitted ideas, please go to the following website: http://grants.nih.gov/grants/guide/rfi_files/NOT-OD-07-011_rfi_add.htm. You may be interested to know that over 100 ideas have been submitted to date. They have been sorted into broad categories (see below); they do not represent NIH priority areas, but are simply used to organize the ideas more efficiently for viewing. More information is available on the website.
IMPORTANT: The list does not keep ideas from other scientific areas from being added for consideration. Additional ideas of any scientific area are welcome and encouraged!
As you can see, "prevention" is not a specific category, but taking a quick look, prevention-relevant ideas can be found within several of the categories. Additional proposals for trans-NIH prevention research ideas are strongly encouraged! The deadline for input is Friday, November 17th.
by Ian Sample, London Guardian
October 24, 2006
http://www.guardian.co.uk/medicine/story/0,,1929904,00.html
Men who use mobile phones for long periods at a time may be at risk of damaging their sperm, according to research by American scientists. Samples taken from men attending a fertility clinic revealed that their sperm declined steadily in number, quality and ability to swim as mobile phone usage increased. Where men used their mobiles for more than four hours a day, researchers found a 30% drop in sperm motility or movement and viability when compared with men who did not use a mobile phone. Scientists believe the study is too preliminary to prove an unequivocal link between mobile phones and falling sperm counts, but the work received a cautious welcome from other scientists who called for further studies to rule out other factors known to influence sperm quality, such as age, weight, smoking, stress and whether people had sedentary jobs.
Ashok Agarwal, who presented his findings at the American Society for Reproductive Medicine conference in New Orleans, stressed the study did not prove mobile phones were damaging male fertility, but urged scientists to investigate the possibility. "There was a significant decrease in the most important measures of sperm health and that should definitely be reflected in a decrease in fertility, which is seen worldwide," he said. "People use mobile phones without thinking twice what the consequences might be. It is just like using a toothbrush, but mobiles could be having a devastating effect on fertility. It still has to be proved, but it could be having a huge impact because mobiles are so much part of our lives."
Almost 1 billion people use mobile phones around the world and the number is growing in many countries at 20%-30% annually. In another five years, the number of mobile phone users is predicted to double. Dr Agarwal and colleagues at the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University in Ohio divided 361 men attending the centre for infertility tests into four groups, depending on their mobile phone usage. The groups ranged from none, less than two hours a day, two to four hours a day and more than four hours a day. Subsequent tests on the men's sperm showed significant declines in four standard measures of sperm quality, including count, viability, motility and shape, with each falling with increased phone usage. Men who used mobile phones for more than four hours a day were found to have median sperm counts of 50m per millilitre. Those using mobiles for two to four hours a day had sperm counts of 59m per ml, increasing to 69m per ml for less than two hours' usage a day and 86m per ml for men who did not use mobile phones. According to the World Health Organisation, a normal sperm count can be anything between 20m and 200m per ml.
Dr Agarwal said mobile phone radiation may harm sperm by damaging DNA, disrupting cells that produce testosterone in the testes, or shrinking the tubules where sperm are created. "It is true that all the men in the study were seeking infertility treatment, but not all these men have fertility problems themselves," he said. Allan Pacey, senior lecturer in andrology at Sheffield University, said: "This is a good quality study, but I don't think it tackles the issue. If you're using your phone for four hours a day, presumably it is out of your pocket for longer. That raises a big question: how is it that testicular damage is supposed to occur?" "If you are holding it up to your head to speak a lot, it makes no sense it is having a direct effect on your testes," he said. "Maybe people who use a phone for four hours a day spend more time sitting in cars, which could mean there is a heat issue. It could be they are more stressed, or more sedentary and sit about eating junk food getting fat. "Those seem to be better explanations than a phone causing the damage at such a great distance," he added.
Last year, scientists in Hungary claimed that men who carry mobile phones in their pockets may risk damaging their sperm count after studying mobile phone usage of 221 men, but no conclusive impact on sperm count or motility has ever been found by other scientists. Another study last year at Newcastle University in New South Wales showed that blasting mice with radiowaves similar to mobile phone radiation 12 hours a day for a week damaged the DNA in their sperm.
Alasdair Philips, director of the consumer pressure group Powerwatch, suggested men might want to hold the phone away from them before sending texts, but added that mobile phones might only affect sperm by causing heating in the groin area, especially if men were texting from their laps. "Sperm is very temperature sensitive as shown by many studies, and a short-term rise in temperature could be responsible," he said.
by Martin Mittelstaedt, Toronto Globe and Mail
October 23, 2006
http://www.theglobeandmail.com/servlet/story/LAC.20061023.CANCERGTA23/TPStory/Environment
TORONTO -- When it comes to funding cancer research, one study area almost always comes up short: finding out what might be changing in the environment that is leading more people to get the dreaded disease. While tens of millions of dollars are spent annually in Canada on finding cancer cures, better drug treatments and understanding its genetic causes, only a tiny fraction of the research money is set aside for investigating possible environmental or pollution links to the disease. To try to fill this gap, the Cancer Research Society plans to announce today in Toronto that it is setting up a new fund dedicated solely to investigating the role the environment plays in people developing the disease.
The society, a non-profit fundraising agency based in Montreal, wants to fund investigations into such factors as the contaminants seeping from waste dumps, hazardous chemicals in consumer products, and the radioactive radon gas found in many homes. It has also lined up prominent environmentalists to help it target the research priorities. While cigarette smoke and ultraviolet sunlight are well known cancer-causing agents, "there is not much known about the other killers," CRS president Mario Chevrette says. Dr. Chevrette says there are "probably links between the genome of the individual and the soup of chemicals in which he is living, or she is living," that can explain some cancers.
Among the cancers whose age-adjusted incidence rates have been increasing sharply in Canada in recent decades, and therefore might be linked to exposures to new types of environmental contaminants, are breast, testicular, prostate and thyroid, although experts caution that part of the rise in rates of some of these illnesses is due to earlier detection. The subject of whether pollution is a big cause of cancer is hotly contested, with many environmentalists and some medical researchers convinced smokestack emissions, pesticides, plastics and many chemicals used in consumer products are leaving their fingerprints all over current cancer statistics.
But cancer organizations have traditionally played down worries about the environment, and have instead stressed the large role that lifestyle factors, such as smoking, exposure to the sun, physical inactivity and failure to eat enough fruit and vegetables, can play in driving the incidence of the disease. The Canadian Cancer Society, for instance, says it believes at least half of all cancers can be prevented through lifestyle changes, with the biggest single step being to stop smoking. In a publication on its website discussing pollution, the society says "current scientific evidence suggests that a small percentage of cancers are related to exposure to cancer-causing substances in the environment."
However, the organization is also interested in further research on the subject and this year helped back a $1-million effort to study occupational and environmental exposures to cancer-causing substances, along with lifestyle factors, to look for clues to cancer prevention. Environmental factors, including what people eat, the pollutants in the air they breathe and lifestyle factors, are "responsible for a high percentage of the cancers that we get," Dr. Chevrette says.
If pollutants are causing some cancers, it will be important to pass regulations banning or restricting the chemicals responsible, once researchers have determined what they are. There has been some research into possible environmental links that suggest they could be a major cause of some cancers. In one such recent case, researchers announced this month that women in the Windsor area who developed breast cancer were three times more likely to have worked on farms at some point, and the risk increased further if women who farmed subsequently got jobs in automobile plants. But the researcher who headed the project, Jim Brophy, an occupational disease expert, says he has found that agencies that fund cancer studies are seldom interested in looking at whether inadvertent exposures to pesticides or chemicals play a role in the development of the disease. "It's just not on the radar of cancer agencies to look at involuntary exposures," he says.
Some advocates for the eradication of cancer also want more study of the possible role environmental factors play in the disease. Barry Stein, president of the Colorectal Cancer Association of Canada, says he is "very concerned about the environmental impact on colorectal cancer," citing such possible risk factors as occupation and where a person lives. Two prominent environmentalists will also sit on the advisory board for the Cancer Research Society's new fund and help choose areas for study: Rick Smith, executive director of Environmental Defence, and Ann Rowan, a director at the David Suzuki Foundation.
by Jeremy Cox, Naples [Florida] News
October 22, 2006
http://www.naplesnews.com/news/2006/oct/22/arsenic_levels_get_herbicide_pulled/?local_news
A weed-killer that lived up to its name but contaminated countless golf courses and parks with arsenic is being pulled off the market. Arsenic levels left in MSMA's wake "raise a concern for cancer risk," U.S. Environmental Protection Agency officials said in an August statement. The agency will revoke federal approval of the herbicide's use, pending a comment period that ends Nov. 9. MSMA has been linked to high arsenic levels beneath at least a dozen golf courses in Collier County and at Veterans Community Park on Immokalee Road.
Southwest Florida's high water table and sandy soils make the area's drinking water supply particularly vulnerable to contamination, experts say. "We have many people who get their drinking water out of the shallow aquifer, and the sandy soils allow the contaminants to reach the groundwater faster than other soil types," said Doug Jones, chief of the Florida Department of Environmental Protection's bureau of waste cleanup. Jones said he was pleased with the EPA's decision to deny further use of MSMA. In a four-page letter earlier this year, he had criticized the federal agency for understating the weed-killer's cancer-causing capability.
Computer models showed that repeated application of MSMA would allow arsenic concentrations of 45 parts per million to build up in soil, Jones wrote. In Florida, officials require arsenic spills in residential areas to be cleaned up to 2.1 parts per million. At that point, the cancer risk is estimated at no more than a one-in-a-million chance. "You look around golf courses where herbicides are being legally applied and you're still seeing contamination higher than our (residential) cleanup rate," Jones said.
By any measure, arsenic is bad for your health. Studies show exposure increases the risk for heart disease, diabetes as well as liver, lung and other types of cancer. A naturally occurring element, arsenic can make you sick if you breathe it in, swallow it or touch it. MSMA has been a popular choice among cotton growers and turf managers since it appeared on shelves in the 1960s. Each year, farmers and turf managers spray 3 million pounds of MSMA or the similar DSMA nationwide, the EPA estimates.
Many golf course superintendents, including several in Lee and Collier counties, signed form letters this year, urging the EPA to spare MSMA. Locally, the EPA received opposition letters from superintendents at Tiburon Golf Club, Glen Eagle Golf and Country Club, Royal Poinciana Golf Club and Naples Grande, all of Naples; and from Shell Point Golf Club, south of Fort Myers. There are alternative weed-killers, but they cost six times as much as MSMA and might have similar environmental consequences, said Terry Stoyer, the immediate past president of the Calusa Golf Course Superintendents Association. "MSMA has been a staple in our arsenal against grassy weeds ever since I've been in the business," said Stoyer, who tends Eastwood Golf Course in Fort Myers. "I feel safe in using it. Whether there's a detriment to my health as an applicator, I have no qualms with using the product personally."
The weed-killer's manufacturers are mounting a fight against the decision. There are 90 brand-name herbicides that contain MSMA, according to EPA estimates. EPA is exaggerating the risks of MSMA by including a more toxic form of arsenic in the risk assessment, according to a research task force created by three MSMA makers. The task force disputes that the organic arsenic contained in MSMA and its cousins morphs into the more lethal inorganic arsenic as it seeps into the ground. "We disagree with the evaluations behind the agency's (assessment) and will continue our efforts to explain the science that supports our position," Michal Eldan, head of the task force, said in a statement last August.
High concentrations of arsenic beneath several golf courses in Collier County prompted a coalition of state and local officials to convene periodically over the past few years to monitor the problem. A North Naples golf course had to devise a plan to clean up an arsenic plume near a maintenance shed. Earlier this year, Collier County commissioners approved a proposal to dig up 2,300 tons of arsenic-laced soil at LaPlaya Golf Club and reuse it beneath a new maintenance building. The work hasn't started yet because the permits haven't been approved, said Katie Sproul, vice president of real estate for Barron Collier Cos. Workers stopped using MSMA voluntarily at the course after the company learned of the contamination four years ago, Sproul said. "There are other products out there now that achieve the same goal," she said. "We didn't feel that given the concerns about that product we would continue to use it.... We didn't want to make anything worse."
by Jon Brodkin, MetroWest [Massachusetts] News
October 22, 2006
http://www.metrowestdailynews.com/localRegional/view.bg?articleid=143482
It's no surprise a severe asthma attack can force someone to go to the hospital. It might surprise some to learn chemicals and substances commonly found inside hospitals can cause asthma or trigger asthma attacks. Cleaning products, latex gloves, pesticides, dust, mold and even some medications can cause or exacerbate asthma, according to a report issued Wednesday by Health Care Without Harm, an international coalition of 450 groups trying to make the health care industry safer. "Ironically, many products that are used in hospitals to keep patients, visitors and personnel safe from pathogens represent some of the very same products that have some potential to cause or exacerbate asthma in susceptible individuals," the report states.
Low doses of certain chemicals can trigger attacks in asthma patients, said Polly Hoppin, a report co-author who directs the Environmental Health Initiative at UMass-Lowell. Janitors, nurses and laboratory technicians are also exposed to harmful chemicals, she said. Hospital officials have long been aware that cleaning chemicals and other substances may pose harm, even if they have not thought about the potential link to asthma, said Susan Macdonald, infection control practitioner at Newton-Wellesley Hospital. Newton-Wellesley officials have replaced many chemicals with safer alternatives. The challenge is finding replacements that are cost-effective and perform their tasks well, whether it be cleaning, disinfecting, sterilizing or killing bugs. "That's always the trick for hospitals," Macdonald said. "You're trying to balance the risk of the product and the chemical in question with its overall efficiency."
Newton-Wellesley stopped using most latex products and latex gloves years ago, except for certain products that are made only with latex and in surgeries where latex gloves are more effective than substitutes, Macdonald said. Medical products are not the only concern. MetroWest Medical Center in Framingham and Natick does not allow visitors to bring in latex balloons, said Beth Donnelly, hospital spokeswoman. Doctors and nurses at the hospital do use latex gloves, unless a patient is allergic to them, she said. "Doctors prefer to use the latex gloves. They have a better feel," Donnelly said.
Newton-Wellesley has stopped most usage of the disinfectant glutaraldehyde, and stopped all use of ethylene oxide, a sterilizer, Macdonald said. Getting rid of bleach, a known irritant, has been more difficult, she said. "It's the most effective environmental cleaner in certain situations," Macdonald said. "We've not been able to completely eliminate it. We've tried to be judicious in its use." MetroWest Medical Center no longer uses bleach, ammonia or formaldehyde in any cleaning products, said Linda Campbell, director of quality, risk management and safety. The hospital's use of chemicals is limited by its membership in the Massachusetts Water Resources Authority, which does not allow certain substances to be discharged into the waste stream, Campbell said.
Health Care Without Harm's report, which is 94 pages long, urges hospitals to analyze chemical usage and adopt safe alternatives when feasible. "It's really a serious issue. Asthma prevalence has increased, not only in workers ... but in children as well," said Thomas Fuller, a report co-author who works at a Boston hospital and runs a private consulting firm in Charlestown that assesses worker exposure to chemicals. Asthma prevalence in children has risen at least 25 percent per decade since 1960, according to Health Care Without Harm. A 2003 U.S. government survey found 9.5 percent of adults in Massachusetts have asthma, the highest rate in the nation.
Fuller, who also works with the Massachusetts Nurses Association, a union, on the issue of chemical use, said hospitals have been responsive to the concerns "to a great extent." But he said there is more work to do. "Part of the problem with introducing a new way of thinking about things, is they're often entrenched in the old school," Fuller said. "People think you need to use these chemicals to make something clean, make something shinier.... Sometimes you have to accept the less shiny floor."
Safer replacements are often available, but not always. Formaldehyde, for example, is used in hospital laboratories to preserve tissue despite harmful fumes given off by the substance. "There really is no substitute for formaldehyde that I'm aware of," Macdonald said. Newton-Wellesley Hospital recycles formaldehyde to reduce the amount it uses. It also performs regular air quality testing to make sure vapor levels remain below safety limits set by the federal government, she said.
Even certain drugs are known to cause or exacerbate asthma, according to Health Care Without Harm. These drugs include penicillin and tetracycline, both of which treat bacterial infections. Whenever prescribing medication, doctors must take into consideration illnesses a patient has that might be worsened by a drug, Campbell said.
Another problem highlighted by Health Care Without Harm is biologic allergens, including cockroaches, dust mites, indoor pollen, fungus and mold. "Cockroaches are one of the primary sources of allergens that people think are contributing to high asthma rates," Hoppin said. Many patients are at high risk of complications related to mold and other spore-forming organisms, Macdonald said. Newton-Wellesley Hospital is building a new emergency room and must regularly change air filters and prevent contamination of ventilation systems that could spread harmful compounds to patient areas, she said.
Macdonald said she expects industry will make significant advances in the production of safer cleaning agents. But one reason the task is challenging in hospitals is they have to meet federal regulations governing the types of cleaning products used to kill viruses and bacteria, she said. "It's been harder to find suitable replacements in some of those areas," she said. "That's probably the last big bastion of areas where over the next few years I'm guessing there will be more products available."
by Pam Belluck, New York Times
October 22, 2006
excerpts from http://www.nytimes.com/2006/10/22/health/22kids.html?_r=1&oref=slogin
PLYMOUTH, Mass. -- When Haley Abaspour started seeing things that were not there -- bugs and mice crawling on her parents' bed, imaginary friends sitting next to her on the couch, dead people at a church that housed her preschool -- her parents were unsure what to think. After all, she was a little girl. "I thought for a long time, 'She's just gifted,' " said her father, Bejan Abaspour. "'This is good. Don't worry about it.'" But as Haley got older, things got worse. She developed tics -- dolphin squeaks, throat-clearing, clenching her face and body as if moving her bowels. She heard voices, banging, cymbals in her head. She became anxiety-ridden over run-of-the-mill things: ambulance sirens, train rides. Her mood switched suddenly from excitedly chatty to inconsolably distraught. "It's like watching 'The Sound of Music' and 'The Exorcist' all at the same time," Mr. Abaspour said.
For her family, life with Haley, now 10, has been a turbulent stream of symptoms, diagnoses, medications, unrealized expectations. Diagnosed as a combination of bipolar disorder with psychotic features, obsessive-compulsive disorder, generalized anxiety disorder and Tourette's syndrome, her illness dominates every moment, every relationship, every decision. Haley's fears, moods and obsessions seep into her family's most pedestrian routines -- dinnertime, bedtime, getting ready for school. Excruciating worries permeate her parents' sleep; unanswerable questions end in frustrated hopes. "The first time we took Haley to the hospital, I guess I expected that they would put it all back together," said her mother, Christine Abaspour. "But it's never all back together."
At least six million American children have difficulties that are diagnosed as serious mental disorders, according to government surveys -- a number that has tripled since the early 1990's. Most are treated with psychiatric medications and therapy. The children sometimes attend special schools. But while these measures can help, they often do not help enough, and the families of such children are left on their own to sort through a cacophony of conflicting advice. The illness, and sometimes the treatment, can strain marriages, jobs, finances. Parents must monitor medications, navigate therapy sessions, arrange special school services. Some families must switch neighborhoods or schools to escape unhealthy situations or to find support and services. Some keep friends and relatives away. Parents can feel guilt, anger, helplessness. Siblings can feel neglected, resentful or pressure to be problem-free themselves. "It kind of ricochets to other family members," said Dr. Robert L. Hendren, president-elect of the American Academy of Child and Adolescent Psychiatry. "I see so many parents who just hurt badly for their children and then, in a sense, start hurting for themselves."
While increasing awareness of childhood mental illness has helped many children and families, it can also create a misimpression that everything can be treated, said Dr. Glen R. Elliott, chief psychiatrist at the Children's Health Council, a community mental health service in Palo Alto, Calif., and the author of "Medicating Young Minds: How to Know if Psychiatric Drugs Will Help or Hurt Your Child." That can make families with complex cases feel "either genuine confusion or pretend certainty," Dr. Elliott said.
The Abaspours decided to speak with a reporter about Haley's illness and its impact on their family because they hoped it would help other families and make society more hospitable for children like their daughter. Talking about it was sometimes emotional, especially for Mr. Abaspour, whose eyes often clouded with tears. But they also said they found it useful to articulate their feelings. When she was almost 8, Haley visited Dr. Jackson at his office at the Cambridge Health Alliance. He was struck by the results of a screening: Haley met full criteria for virtually every mental disorder listed. "Her symptoms," he said, "suggested anxiety, morbid thoughts, obsessions possibly of a sexual nature, frequent fluctuations in mood, periods of euphoria, giddiness, irritability, rapid speech, auditory and visual hallucinations, thought disorganization, vocal tics, distractibility, poor socialization in school, sensory integration issues, attention impulse disorder, manic behavior, sleep disturbance." Dr. Jackson wondered if the voices and the friends, which Haley told him were "nowhere but everywhere," were schizophrenic-like hallucinations or milder thought distortions. He also saw Haley's mood swing from anxiety about a "disturbing dream in which her mother was killed" to euphoria, as she gleefully drew a large, brightly colored butterfly and a self-portrait with a too-big smile and a skirt that ballooned as if she were floating. The pictures, he said, "scream" manic sensibility, suggesting bipolar disorder.
Dr. Jackson prescribed an antipsychotic, Risperdal, one of a dozen drugs Haley would try. Some helped initially, but the voices returned or side effects developed. Huge pills or bad-tasting liquid made Haley gag or throw fits. "It was horrible, horrible, horrible," her mother said, "and she'd pull us into it because we had to make her take it." Lithium caused weight gain: clothes that fit her one day no longer did the next. When Haley was 8 1/2, Mr. Abaspour said, "Let's drop all of these medications and see what happens." He said, "I wanted to see her true self." The results chastened them. "You see her fine one day," Mr. Abaspour said. "The second day comes and she's fine and you say, 'You see, honey, there's nothing wrong with her.' Then it's the third day and she goes crazy and you feel like an idiot."
Haley resumed taking Risperdal. Then, abruptly, her condition worsened. "She couldn't function, she couldn't go to school," said Ms. Abaspour, who took Haley to a hospital; she had to handle the crisis with her husband away in London. In the emergency room, Haley was manic and hyperarticulate, Ms. Abaspour recalled. "I was a basket case." When Mr. Abaspour returned and saw Haley "like a zombie" in a hospital full of out-of-control children, his first reaction was, "She can't be in here." But the eight-day hospital stay made him grasp the severity of her illness.
Ms. Abaspour said that she had no regrets, and that Haley "was given to us for some reason, and I keep waiting for the day when I realize why." Still, the experience has tested her stamina, and she avoids capitulating to Haley's whims and outbursts by imposing structure, consistency, even distance. "I'm her mother," Ms. Abaspour said. "I try to make it a better world for her, a more comfortable world. I stay very strong for her and very encouraging for her. If she comes out of a meltdown, I'll say, 'I knew that you could.' I don't make her feel totally hopeless. It doesn't give me any satisfaction, though, because I still feel helpless. Unfortunately it just bites you in the face all day long."
Ms. Abaspour's stoic approach, which her husband appreciates but cannot always emulate, is "a good coping skill for parents," Dr. Elliott, of the Children's Health Council, said. "It's what happens to a family system when you've got a source of chaos in the middle of it." After getting Haley ready for school, Ms. Abaspour feels she has already lived an entire day. In the afternoon, "Haley walks in the door and I just want to hold her and give her a big kiss like most kids," Ms. Abaspour said. "Instead I get a frown and tears and 'Ooh, I had such a stressful day.'"
She said that every evening, a distraught Haley will "say to me her same 12 questions: 'What's going to happen when I need to go to school and I can't leave the classroom?' or 'What do I have to look forward to today?'" By bedtime, Ms. Abaspour said, "your heart's just breaking."
To slake Haley's thirst for "something to do," Ms. Abaspour keeps her involved in activities outside of school. Otherwise, the family ends up stopping for ice cream or concocting other outings, because unstructured time allows Haley to focus on the voices and anxiety. "Staying home is not an option," Ms. Abaspour said. "Honestly I could not keep her busy. Sometimes being around here on a Saturday or Sunday, it's almost toxic. She has multiple episodes -- it's like living hell."
Ms. Abaspour was recently laid off from a medical assistant's job. Her former co-workers understood her need to interrupt work to deal with Haley's needs, she said, and "didn't look at me and say, 'Her child's crazy.'" Now she fears she will not find an employer who is as tolerant, though the family needs the income. Haley's illness, the Abaspours were dismayed to discover, does not qualify for disability assistance.
Families once kept illnesses like Haley's quiet, afraid of being shunned or disparaged. Public acceptance has grown, but some misperceptions and prejudice remain, and families feel conflicted: they want people to understand so the child can get appropriate help, but they also fear that Haley will be mocked or ostracized. "If they keep it a secret then they're bad parents," Dr. Elliott said. "If they start spewing diagnoses, they're subject to criticism because they're not taking responsibility, just laying it on the illness. Or they're social pariahs because there are some people who think that mental illness is contagious."
Like other families, the Abaspours sometimes hesitate to publicly label their daughter mentally ill. But they also want people to know, and they get frustrated if people do not fully accept or understand it, or see her symptoms "as a manipulative thing, or they feel like they can fix it themselves, maybe by distracting her," Ms. Abaspour said. Some day, the Abaspours hope, Haley will have more effective drugs and better coping skills, and society will be more tolerant, so she can lead an independent life. But they have no illusions. "This is not going away," Ms. Abaspour said. Not for Haley or her family. "The overflow of what Haley has is what has made all of us what we are today."
by Laura Ungar, Louisville Courier-Journal
October 22, 2006
http://www.courier-journal.com/apps/pbcs.dll/article?AID=/20061022/NEWS01/610220423/1008/NEWS01
During a routine visit, Audrey Campbell's doctor noticed something that shouldn't have been there -- budding breasts on the 2½-year old. She was hitting puberty much too early. And if left untreated, her mother was told, she might have started menstruating as a preschooler. So she was given treatments of a drug that stops the body's production of certain hormones at adult levels. "I shuddered to imagine what would go through her head," said Ann Campbell of Louisville, whose daughter is now 11. "She was in day care at the time."
Local doctors say they are seeing more children developing sexual characteristics like budding breasts or underarm hair at too young an age -- younger than 8 in girls and younger than 9 in boys. University of Louisville physicians spoke about the condition, known as "precocious puberty," during an educational session for local doctors earlier this month. "It's a topical subject," said Dr. Michael Foster, Audrey's endocrinologist and acting head of U of L's division of pediatric endocrinology. "There is no question that (it) is increasing." Such observations follow national trends on the condition, which is six times more common in girls than boys.
A landmark study of 17,077 girls, published in the journal, Pediatrics, in 1997, showed that 27 percent of African-American girls and 7 percent of white girls had breast or pubic hair development at age 7. At 8, nearly half of black girls and 15 percent of white girls had begun to develop. Medical experts aren't sure why this is happening or why it's more prevalent among African Americans. A leading theory links the condition to childhood obesity, but researchers also tie it to exposure to certain chemicals, such as plastics byproducts called phthalates.
U of L and the University of Kentucky are preparing to study phthalic acid levels in the urine of girls with early breast development. In Audrey's case, doctors suspect an unknown environmental cause. Doctors and parents worry about the social and physical fallout, such as growing up too short or getting unwanted attention from the opposite sex. Dr. Aaron Davis, a clinician in U of L's endocrinology department, said just because a girl hits puberty early doesn't mean she's any more emotionally mature than any other girl her age. "She's still very much a 5- or 6-year-old little girl," he said.
Defining puberty
As doctors see more cases of precocious puberty, they're also seeing something else -- the age of puberty going down in general. And that has led them to question the definition of the disorder. "There's a huge debate in the literature: What is precocious?" said Dr. Margaret Blythe, professor of pediatrics at Indiana University Medical School in Indianapolis. Currently, breast development averages about 9 years old for black girls and 10 years old for white girls. Doctors agree this is lower than in the past. Those who start developing much earlier than that don't necessarily develop as fast as those who hit puberty at a normal age. Some girls with precocious puberty don't get their periods until up to five years later, Blythe said, about twice as long as the usual span of time between the early signs of puberty and menstruation. The average age girls start menstruating is between 12 and 13, although Blythe recalls one girl who began her periods at 8½.
Blythe is among those who believe obesity plays a major part in the trend toward earlier puberty, especially fat tissue around the body's mid-section. Dr. Paige Hertweck, chief of gynecology at Kosair Children's Hospital, said it's one of many problems related to today's sedentary lifestyles and bigger food portions. Last year, 16 percent of high school students across the state were overweight, the highest proportion among 39 states included in a federal survey. "There's so many more heavy kids than there used to be," she said. "It's an epidemic."
Foster agreed that obesity might play a role in early puberty, but said environmental causes like phthalates are probably even bigger factors. Often called plasticizers, this group of chemicals is used in hundreds of products such as vinyl flooring, adhesives, detergents, soap, shampoo and nail polish -- and before 1999, in items such as pacifiers and teethers. According to the U.S. Centers for Disease Control and Prevention in Atlanta, animal studies have shown adverse effects on the male and female reproductive systems and other health effects from phthalates. Other chemicals also have been tied to the condition, including some pesticides and herbicides and accidental exposures to hormonal drugs, experts said. And in rare cases, tumors or growths on the ovaries, adrenal glands, pituitary gland or brain cause children to develop too soon.
Social problems
The social ramifications of early puberty are often the most troubling for children. Students who develop early may be treated differently by peers or teachers because they look older, Blythe said. In addition, they are usually much taller than others their age, and may be teased by classmates or seen as more mature by students of the opposite sex. Blythe said a fourth-grade girl who gets romantic attention from eighth-grade boys may not know how to handle it. The physical effects of early puberty are also a concern. For girls who start menstruating, pregnancy is a possibility, and boys with the condition may produce sperm. An 1834 case described in Pediatrics involved a Butler County, Ky., girl who began menstruating at a year old and gave birth to a healthy baby girl at age 10.
Also, children who start puberty early risk not reaching their full adult height because the normal growth spurt associated with puberty happens too early. Young children also might experience the hormonal mood swings typically associated with the teen years. There's also a concern that some girls with precocious puberty may face a greater risk of breast cancer because they are exposed to estrogen for longer periods during their lives.
Aside from maintaining a healthy weight and trying to reduce potentially-harmful environmental exposures, doctors say there's no way to prevent precocious puberty. But for those diagnosed with the condition, doctors often recommend medication, especially for the youngest patients. For Audrey, puberty was stalled by injections of a drug called Lupron, which she received monthly for seven years. Now 11, she doesn't remember starting the shots, but recalls wondering why she was getting them as she got older. Her mother read her a children's book about precocious puberty and tried to explain it to her on her level. "I just told her she was growing up too quickly and we needed to slow it down," Ann Campbell said. Because they held puberty at bay, Audrey said she never felt or looked different than classmates. She has now stopped the injections and is developing normally -- plus getting As and Bs in school, playing basketball and volleyball and participating in Girl Scouts. "I feel really good," Audrey said. "I don't think about it a lot anymore."
by Jeff Nesmith, Austin American-Statesman
October 21, 2006
http://www.statesman.com/news/content/news/stories/nation/10/21/21disrupters.html
WASHINGTON -- Ten years after Congress ordered the Environmental Protection Agency to develop tests to see if pesticides could be disrupting human hormone functions, no chemical has been tested under the program. The EPA has not even decided which pesticides will be tested first.
The recent discovery of egg-forming tissue in the testicles of male bass in the Potomac River has raised new fears that manufactured chemicals known as endocrine disrupters, or hormone disrupters, are becoming more common in the environment. It's not clear whether the "intersexed" nature of the fish had any effect on their reproductive or other functions. However, the fact that they even exist has caused environmentalists to repeat warnings that tiny, but possibly potent, levels of endocrine disrupters are showing up in nature. Scientists fear that by mimicking, blocking or otherwise altering the activity of natural hormones such as estrogen and testosterone, pesticides and other substances may pose subtle threats not only to animals but to humans as well. Earlier discoveries have linked the presence of endocrine disrupters to genital deformities in alligators and endangered panthers in Florida, polar bears in Alaska, river otters in Oregon, barn swallows in Louisiana, loons in Maine and other creatures.
The 1996 Food Quality Protection Act set a 1999 deadline for EPA to develop a battery of animal experiments with which pesticide manufacturers would be required to screen their products as possible endocrine disrupters. Similar tests already are required to determine whether the chemicals cause cancer, birth defects, genetic mutations or other problems. The EPA has repeatedly pushed back the deadline. The agency now says it will be 2008 before it finalizes a set of tests. But President Bush has proposed cutting the agency's budget for the endocrine disrupter program, leading to questions about whether even that deadline can be met. "This has been a fairly Herculean effort," said Lawrence Reiter, director of the EPA National Exposure Research Laboratory. He and other EPA officials said the tests ordered by Congress had to be developed from scratch, a project the agency has found challenging.
Frustrated environmental activists say there is no excuse for the delay. "It is inexcusable that the EPA has not yet gotten this basic screening program into place 10 years after it was mandated by Congress," Erik Olson, a lawyer with the Natural Resources Defense Council, told a House committee this month at a hearing on the Potomac River intersexed bass. Although the 1996 law specifically directed the EPA to establish the screening tests for pesticides, some scientists say thousands of other chemicals may be causing subtle endocrine effects as well. They include pharmaceuticals and over-the-counter drugs. Sometimes called feral pharmaceuticals, these drugs can find their way into water supplies through human and animal waste. Nothing is known about possible effects of the vast majority of these chemicals, scientists say.
Although the EPA's slow progress in establishing the screening program has frustrated environmental activists, another federal agency, the U.S. Geological Survey, has moved aggressively in a nationwide effort to identify potential endocrine disrupters in water supplies and wildlife. It was the Geological Survey that found the intersexed bass in the Potomac, some of them within a mile of EPA's national headquarters. Also, a 2003 survey in Palm Beach County, Fla., that found hermaphrodites among giant toads was carried out by Geological Survey endocrinologist Timothy Gross and Krista McCoy, a University of Florida graduate student. McCoy collected male toads in sugar cane fields near the Everglades and compared them with toads caught on the University of Miami campus. From 25 percent to 39 percent of the toads collected in the cane-growing area were hermaphrodites. None of the Miami toads was abnormal. Gross and McCoy emphasized that their findings were preliminary and required further study. Their survey was funded by Syngenta, a Swiss-based company that manufactures atrazine, a herbicide previously implicated in endocrine-disrupting effects. Although it has been banned by the European Union, atrazine is the most widely used weed killer in America.
by Lidia Wasowicz, United Press International
October 19, 2006
http://www.upi.com/ConsumerHealthDaily/view.php?StoryID=20061019-023841-3973r
submitted to this bulletin by Chemical Sensitivity Network
SAN FRANCISCO -- Many are counting on the numbers keepers to provide critical clues to some fundamental questions about the rising rates of autism diagnoses in America's children. In particular, those who hold the mercury-based vaccine preservative thimerosal responsible for the increase have been eagerly awaiting a verdict on their prediction that as children's exposure to the compound decreases, so, too, will their autism rates. Phased out of most childhood shots around the turn of the century, thimerosal remains in some booster and flu vaccines recommended for pregnant women and babies. With the release of California's special-education statistics in the summer of 2005, the thimerosal skeptics gleaned a glimmer of substantiation of their suspicions.
In a trend they had anticipated, a decade-long climb of newly identified autism cases indeed appeared to be turning around at the critical juncture. The data were compiled by the state Department of Developmental Services. They showed the sum total of autistic children in the system continues to grow -- by now topping 28,000. However, the rate of increase peaked in 2002 -- the year the government says the last of the thimerosal-containing childhood vaccines expired -- then started to take a slight dip.
The telling parallels were highlighted in a 2006 study by geneticists Dr. Mark Geier and David Geier, a father-son research team often cited by mercury-in-medicine opponents. They picked up signs of a downward drift in neurodevelopmental disorder cases from mid-2002 through 2005 in both the figures released by the California agency, widely regarded as the most accurate barometer of full-syndrome, professionally diagnosed cases, and the much less reliable federal Vaccine Adverse Events Reporting System. The latter is a depository of voluntarily submitted, unsubstantiated claims of ill effects thought to be related to immunization. While acknowledging the loosely structured program is short on consistency and credibility, the Geiers included it as an informal confirmation of the California counts.
In addition, they cited provisional national education department data showing a concurrent decrease of 529 in the number of new autism diagnoses recorded among children ages 3 to 5 after years of annual increases. There were 1,451 new cases in 2001-2002; 1,981 in 2002-2003; 3,707 in 2003-2004; and 3,178 in 2004-2005. The Geiers attributed the rise and fall of autism diagnoses to the corresponding trends in the use of thimerosal-containing vaccines.
Those who disagree point to a new set of figures released last month by California's DDS, which show a recent upturn in the state's caseload of autistic children 3 to 5 years old -- from a total of 6,083 reported at the end of the second quarter, in June, to 6,188 as of the end of the third quarter, in September. If thimerosal is to blame, why are the numbers going up, they ask?
However, others think the removal of the compound from childhood vaccines has been offset by its continued presence in flu shots administered to infants and pregnant women whose developing fetuses are more vulnerable to the effects of mercury than are children already born. Others read far less into the numbers. Even setting aside the inherent imprecision of using raw counts -- which any number of fluctuating factors such as falling birth rates can affect -- as a measure of trends in prevalence, there are other confounding elements to consider.
The California DDS itself prefaced its reports with a cautionary note, stating, "(I)t is inaccurate to represent the change in the numbers reported from one quarter to the next as 'new intakes.'" The caveat: A recorded hike from one period to the next does not necessarily represent new arrivals. The reasons for this disappointingly confounding revelation include the sometimes years-long delay in the filing of an evaluation. The newly recorded may indeed be those coming into the system for the first time, but they could also be old-timers whose paperwork hadn't caught up with them. Similarly, a gap may exist between those said to depart the programs and those who actually do.
Even if the waning caseload numbers in the earlier California report represented a true downward trend in actual autism rates, there remain other uncertainties that could stand in the way of connecting the dots directly to vaccines. Take a March 2006 study showing newborns may be 65 to 130 times more sensitive than adults -- and even 26 to 50 times more vulnerable than fellow infants -- to certain pesticides. This variability is far greater than anyone had predicted. Based on previous presumptions -- which the findings take to task, at least for the chemicals in question -- Environmental Protection Agency standards require that in cases where individual susceptibilities are not well known, levels of exposure considered safe for adults should be multiplied by a factor of 10 as an extra precaution to protect the more vulnerable younger populations. The new study -- which suggests that factor should be six to 13 times greater -- raises questions about whether children are sufficiently safeguarded under the current safety criteria for pesticide exposure. At the very least, more research is needed to find out whether that's the case, the authors say.
What makes the findings potentially relevant to the autism debate is that the chemicals under study, so-called organophosphate compounds like diazinon and chlorpyrifos, have been shown, in high doses, to have profound effects on the central nervous system. Growing evidence from animal and human studies also suggests chronic low-level exposure may affect neurodevelopment. What makes the tale even more intriguing is that to guard children's health, the pesticides were banned from home use in 2001 -- about the time the last of the thimerosal-containing childhood vaccines were reaching the end of their run. And just as with the mercury-based preservative, which remains in some flu and booster shots, so too the chemicals are still permitted for agricultural and certain structural purposes, such as treatment of house foundations.
Of course, the compounds may have nothing to do with autism, but the parallels are suggestive, and the findings illustrate how both sides of the thimerosal issue can rightly claim to be making certain valid points. They lend support to those who insist vaccine trends are not the only ones that can explain the perceived patterns of harm as well as to those who question the establishment's capability to safeguard children from it. In fact, researchers probing the mercurial chemical that has escaped much scientific scrutiny for over 60 years have dug up evidence that indicates the nation's leading health authorities examined the wrong compound and failed to look far enough when they were assessing the danger posed by thimerosal in vaccines.
(Note: In this multi-part installment, based on dozens of reports, conferences and interviews, Ped Med is keeping an eye on autism, taking a backward glance at its history and surrounding controversies, facing facts revealed by research and looking forward to treatment enhancements and expansions.)
from the Associated Press, Houston Chronicle
October 18, 2006
http://www.chron.com/disp/story.mpl/ap/fn/4268495.html
BRUSSELS, Belgium -- Leading medical associations on Wednesday urged European lawmakers not to bend to industry demands and dilute a proposal that would force chemical companies to substitute dangerous chemicals with safer alternatives. A second vote on the controversial legislation known as REACH -- for registration, evaluation and authorization of chemicals -- is scheduled in the European Parliament next month, after the bill drafted by the European Commission was substantially amended by the EU assembly last year and then further changed by EU governments.
Doctors and scientists argue that cancer, congenital malfunctions and asthma are often linked to toxic chemical pollutants in the environment and weak chemicals laws would further increase the incidence of cancer on the continent. "Babies are contaminated by hundreds of substances. There is a risk of cancer developing. We have managed to pollute the future generation," Dominique Belpomme, oncologist at a leading Paris hospital and chairman of the Association for Cancer Treatment Research, said at the European Parliament where he and other experts lobbied for stringent toxicological standards and a mandatory substitution of the most dangerous chemicals. Belpomme and other doctors and scientists called for the substitution of formaldehyde, mercury, dental amalgam and other substances which they said have grave health effects.
Seven years of negotiations on REACH have been marked by intense lobbying by the multibillion-dollar European chemicals industry and by environmentalists who seek more restraints on the industry. The draft legislation puts the burden of proof on businesses to show that around 30,000 commonly used industrial chemicals and substances they put on the market are safe. Under the rules, producers would have to register the properties of chemicals in an EU database, ask for authorization for high-risk substances and replace those for which alternatives exist. The rules must still be approved by the EU member states. Governments and the EU parliament hope they will come into effect next year. The EU Parliament is scheduled to vote on the legislation Nov. 14, followed by a Dec. 4 vote by EU governments.
press release from the Ecology Center
October 18, 2006
http://www.ecocenter.org/releases/20061018_greenchem.shtml
Michigan public health and environmental leaders today applauded a precedent-setting initiative signed Tuesday by Governor Granholm that will make the state a national leader in the fast-growing field of green chemistry. Granholm's Green Chemistry Executive Directive promotes safe technologies and innovations aimed at lowering health risks and preventing harmful chemical pollution at the source. "Green chemistry is a cleaner, safer, and healthier way to make the chemicals and products that we use in our homes and businesses every day," said Tracey Easthope, Environmental Health Director of the Ecology Center, which had advocated for the last year for a Green Chemistry initiative. "Designing chemicals up front so they are safe is the wave of the future for industry, including the chemical, auto and pharmaceutical industries, and Michigan is now positioning itself to be an R&D center for this work."
In addition to the Ecology Center, the Green Chemistry Executive Directive was supported by state environmental and public health leaders, including Clean Water Fund, the Michigan Network for Children's Environmental Health, which includes the Michigan Chapter of the American Academy of Pediatrics, and the Learning Disabilities Association of Michigan and other medical and public health organizations, as well as national green chemistry leaders.
Sustainable business development experts agree. "This is an important step forward for the development of the new economy in Michigan. There is a potentially enormous market in Michigan for biomaterials and fuels in the auto and furniture industries. Green Chemistry is a key strategy needed to move our state into a leadership position for the most innovative and safe technologies" said Bill Stough, CEO of Sustainable Research Group in Grand Rapids.
The Executive Directive will help the state devise strategies to promote green chemistry and engineering education, development, and the production of bio-materials, chemicals, and catalysts that reduce or eliminate the use or generation of hazardous substances. "I am deeply impressed that Governor Granholm is providing international leadership through her Green Chemistry Executive Directive," said Terry Collins, Director of the Institute for Green Oxidative Chemistry, and one of the leading green chemists in the country. "Governor Granholm is inspiring the people of the great State of Michigan to work together to ensure that the chemical products and processes of the future are both economic winners and blessings to future generations by being compatible with the long-term welfare of living things."
"When businesses innovate by using green chemical processes, they not only can save money, but they also avoid the costs of cleaning up toxic pollutants, provide for a safer workplace, and deliver safer products to consumers," said Dave Dempsey, noted environmental author and Great Lakes policy advisor to Clean Water Fund. According to a 2002 study conducted for the U.S. Department of Energy and the USDA, bio-based materials are estimated to grow from .5% of current production to more than 12% by 2010, and 25% by 2030.
Research on green chemistry is already underway at Michigan Tech, Michigan State University, and the University of Michigan. Right now, Michigan businesses are testing, using, and producing bio-based materials and green chemistry processes. For example, Interface Fabrics Group, in Kentwood, is using PLA (polylactic acid, or corn-based) fabrics. KTM Industries, in Lansing, is using PLA packaging material, and Pfizer is manufacturing widely used drugs with green chemistry processes.
Michigan's Executive Directive is the first of its kind in the country. While the field of Green Chemistry is very promising, public and private investment is only beginning, so Michigan has an opportunity to create industry leaders. Just two weeks ago, the U.S. House of Representatives passed a measure to increase federal funding for Green Chemistry.
Link to the Executive Directive: http://michigan.gov/gov/0,1607,7-168-36898-153806--,00.html.
For more information on how Green Chemistry is making a difference already, see http://www.epa.gov/greenchemistry/ or visit the Green Chemistry Institute website: http://www.chemistry.org/portal/a/c/s/1/acsdisplay.html?DOC=greenchemistryinstitute%5Cindex.html.
press release from the US Environmental Protection Agency
October 18, 2006
http://yosemite.epa.gov/opa/admpress.nsf/177f410e8a398c0f85257021005643a7/0edb5f39e2ed3c428525720b00629872!OpenDocument
(Washington, D.C.) Today EPA sent letters to more than 500 organizations and individuals inviting participation in the design and development of a stewardship program that will help the agency better understand the potential risks and benefits of nanotechnology. Nanotechnology is the science of creating or modifying materials at the atomic and molecular level to develop new or enhanced materials and products. The stewardship program will complement the agency's new and existing chemical programs under the Toxic Substances Control Act (TSCA) and will provide a firm scientific foundation for regulatory decisions by encouraging the development of key scientific information and any appropriate risk management practices.
"By bringing people together to address this emerging technology, we can be well positioned to ensure the responsible development of nanotechnology, while at the same time, realizing its promise for a better tomorrow," said Jim Gulliford, assistant administrator for Prevention, Pesticides and Toxic Substances at EPA. "Through open dialogue, public engagement and sound science, we can establish the appropriate oversight for nanoscale materials and ensure public confidence in its safety."
EPA is inviting the public, industry, environmental groups, other federal agencies and other stakeholders to participate in the design, development and implementation of this program. These include 1) public scientific peer consultations to discuss risk management practices and characterization for nanoscale materials; 2) an overall framework document describing the TSCA program for nanoscale materials; 3) a document on distinguishing the TSCA Inventory status of "new" versus "existing" chemical nanoscale materials; 4) a concept paper describing EPA's thinking for the Stewardship Program, as well as an Information Collection Request to collect data under the Stewardship Program; 5) workshops examining the pollution prevention opportunities for nanoscale materials; and 6) a public meeting to discuss these documents and program elements.
More information about the Nanoscale Materials Stewardship Program under TSCA: http://epa.gov/oppt/nano/index.htm
from Cox News Service, Dallas Morning News
October 18, 2006
http://www.dallasnews.com/sharedcontent/dws/dn/latestnews/stories/101906natchildobesity.2a78142.html
ATLANTA -- The nation's childhood obesity problem is hitting pediatricians' offices as children, aging before their time, show up with conditions more common in middle-aged adults. In Atlanta, as across the country, doctors are seeing young patients with Type 2 diabetes, gallstones, and even nonalcoholic cirrhosis that can require a liver transplant. Although the overall numbers of cases are small, the nation's physicians are expressing concern that rising obesity in children has grave implications for the future. As children put on additional pounds, their rates of diseases are likely to increase, shortening lives and expanding demand for health care. "Childhood obesity is not just a cosmetic problem," said Dr. William Cochran, who specializes in treating overweight children and adolescents at the Geisinger Clinic in Danville, Pa. "It's a serious health problem facing our entire society."
The occurrence of adult diseases in obese children has been the subject of much discussion in the medical community lately. It was discussed at an American Academy of Pediatrics meeting in Atlanta this month and has been the topic of articles in recent medical journals.
Fatty liver disease, a key cause of cirrhosis, was not even recognized in children until the mid-1990s, said Dr. Miriam Vos, a pediatric hepatologist at Emory University School of Medicine. Now, she said, it's the most common liver disease in children. Such diseases are just the latest result of a steep rise of obesity among children over the last two decades. According to the National Center for Health Statistics, about 34 percent of U.S. children ages 6-19 are overweight. About half of those -- or 17 percent -- are considered obese, up from 11 percent in 1994. Meanwhile, an estimated 66 percent of American adults are obese or overweight, compared to 56 percent a dozen years ago. Health statisticians base the ratings on the body mass index, or weight-to-height ratio, adjusted for gender.
Rates are highest among African-American and Hispanic adolescents. Statistics from 2002 showed that almost 24 percent of black girls 12-19 and almost 19 percent of black teenage boys were obese. Likewise, almost 20 percent of Mexican-American teenage girls and 15 percent of boys were obese. Poverty is a key factor, experts say. About 20 percent of children and adolescents below the poverty level were considered obese.
Research shows -- and doctors are seeing -- that overweight children, like overweight adults, have more hypertension, breathing disorders, sleep problems and bone-and-joint complications than their thinner counterparts. Long term, they are at greater risk of developing heart disease and some forms of cancer.
But researchers are only beginning to realize the full effects of severe obesity in children. Often conditions intertwine and overlap. Uncontrolled diabetes, for instance, is linked to fatty liver disease. Type 2 diabetes, formerly referred to as adult-onset, now represents up to 45 percent of new diagnoses of diabetes in children and adolescents, according to surveys reported in pediatric journals. Unlike so-called juvenile diabetes, or Type 1, it is linked to weight. "This has been developing insidiously," said Alice Smith, who manages a diabetes prevention program as part of her duties at Children's Healthcare of Atlanta. "It tracks along with the increase in prevalence of obesity over the last 15 to 20 years."
Uncontrolled diabetes can result in amputation of limbs, blindness and kidney disease. It is aggravated by heavy consumption of fats and sugars -- which can also tax the liver and cause damage, eventually possibly leading to cirrhosis. In a study published this month, researchers at the University of California, San Diego found that 38 percent of obese children among a group of 742 accident victims had fatty livers -- a problem that for many would have developed into a serious health threat. Five to 10 percent of adults with fatty livers eventually develop cirrhosis and may need transplants, said Vos, who specializes in fatty liver disease in children at Children's Healthcare of Atlanta. Although cirrhosis is still uncommon in children, some teenagers have already had transplants as a result of obesity-related cirrhosis; others are on lists awaiting transplants, Vos said. "If you say a third of obese children have liver disease, and 10 percent of them will end up with cirrhosis, that is a very frightening number," she said.
Dr. Mark Wulkan, a pediatric surgeon at Emory Medical School and Children's Healthcare, sees the consequence of obesity in children's gallbladders, the pear-shaped organs that store bile. Surgeons, he said, used to talk about the "three F's of gallbladder disease -- fat, forty and fertile," meaning most patients were middle-aged women. Now, Wulkan said, it's showing up in adolescents, and "occasionally even in younger kids." Eight years ago when Wulkan started work at Egleston, the seven pediatric surgeons removed a child's gallbladder because of gallstones every couple of months. Now, he said, the rate is more like every couple of weeks. Gallstones -- deposits of cholesterol or calcium salts in the gallbladder or nearby bile ducts -- are often symptomless. If they cause pain, or if the gallbladder becomes swollen or infected, it should be removed, said Wulkan. Some children get gallstones as a result of other medical conditions, such as sickle-cell anemia. But Wulkan said pediatric gastroenterologists are seeing more gallstones. "It's clearly related to weight," he said. One of the few recent studies that attempt to quantify the increase of gallbladder disease in children came from Germany earlier this year. Scientists at the University of Ulm looked at 493 obese children and adolescents 8-19 years old. They found gallstones in 10 -- or about 2 percent -- all of whom had been through puberty. Eight were girls.
Physicians dealing with obese children who have these formerly adult conditions say the complications are likely to become even more common if the country doesn't do better by its children's nutrition. "It has to be a multifaceted approach," said Cochran of the Geisinger Clinic, who spoke at the American Academy of Pediatrics in Atlanta earlier this month. "Children, families, schools, communities, health care providers, insurance companies, the government. No one institution can solve this problem."
by John M.R. Bull, Hampton Roads [Virginia] Daily Press
October 18, 2006
http://www.dailypress.com/news/local/dp-55593sy0oct18,0,4130877.story?coll=dp-news-local-final
The military must inspect the chemical weapons it dumped into the ocean decades ago to determine the danger they now pose to people or marine life, under a bill signed into law on Tuesday. Then the Army will have to figure out how to clean up or contain -- if possible -- the mess it secretly made in more than two dozen offshore locations. "We're elated," said Dave Helfert, a spokesman for U.S. Rep. Neil Abercrombie, D-Hawaii, who pushed for the new law. "This is the first concrete step that addresses a serious threat to the public. It's very important."
A Daily Press investigation last October revealed that the Army dumped at least 64 million pounds of deadly mustard and nerve gas -- included in artillery shells, bombs and rockets -- off the U.S. coastline, kept it secret and stopped checking 30 years ago to see whether the weapons were leaking. Some evidence suggests the munitions may now be leaking and pose a danger to marine life and people who eat some types of seafood. The weapons are off the coast of at least 11 states, including Virginia, New Jersey, North Carolina, Hawaii, Alaska and Florida. But more dumpsites may exist because the Army's records are sketchy and were destroyed long ago. If not cleaned up, the weapons likely pose a threat for generations to come. Metal deteriorates at different rates in the ocean, depending on the depth, temperature and prevailing currents. This causes the weapons to potentially leak at different times and at different rates.
The Daily Press investigation prompted the Army to conduct an extensive search of all surviving ocean-dumping records. A report on that research is finished but has sat unreleased in the hands of top Pentagon officials for more than a month. After reading the newspaper's findings, several lawmakers demanded the military do more than just check records for unrevealed dumpsites. A provision in the defense authorization act -- signed into law Tuesday by President Bush -- requires that the military inspect its known chemical weapons dumps and record the locations on nautical charts so mariners know the potential dangers. The inspections must include water and seabed environmental testing to see whether the weapons are leaking, or have leaked, and determine the current and potential future threat to sea life. The military also must assess the risks to humans.
Mustard gas survives in seawater in a concentrated gel that can last for years, pushed around by ocean currents. Other chemicals can accumulate in seafood and be passed up the food chain to humans. "This requirement is absolutely necessary to protect the public health of everyone who lives, works or visits the oceans near these munitions dumps as well as the condition of the oceans and marine life," said U.S. Rep. Rob Andrews, D-New Jersey, one of the first lawmakers to raise a fuss. The bill requires the military to monitor each site -- most, but not all, are located in deep water -- and determine how to clean them up if that is possible. The weapons are likely to be unstable and extremely hazardous to disturb after decades in the ocean. They were dumped between 1940 and 1972.
The bill went a step further than experts expected because it applies to all ocean-dumped munitions, not just chemical weapons. "That really is quite amazing," said Craig Williams, director of the Kentucky-based Chemical Weapons Working Group, a citizen advocacy operation that monitors the Army's disposal of land-based chemical weapons. "I'll be in the ground 100 years before they get around to all of that. This isn't going to be cheap."
The Army and Navy extensively dumped surplus conventional weapons off the side of ships for decades and in the late 1960s and early 1970s loaded old ships with old weapons and blew them up, scattering unexploded ordnance in all directions. The military will abide by the new law "in an effort to ensure the continued protection of the environment and safety of the American public," said Pentagon spokeswoman Cheryl Irwin.
There is no estimate on what the new law's requirements will cost, and this year's defense-funding bill doesn't include any money for the military to begin complying with the new law's provisions. Congress makes such appropriations annually. The law does not apply to U.S.-created chemical weapon dumpsites off the coasts of at least 11 other countries. At the end of World War II, the Army dumped its overseas chemical weapon stockpiles where they were located, killing or injuring hundreds in the ensuing decades.
by Celia Hall, London Daily Telegraph
October 18, 2006
http://www.telegraph.co.uk/news/main.jhtml;jsessionid=G34UNFMUA421PQFIQMGCFFOAVCBQUIV0?xml=/news/2006/10/18/nbreast118.xml
Chemical pollutants that mimic the female hormone oestrogen may play a part in the development of breast cancer and could account for the increase in cases, a scientist said yesterday. The "gender-bending" chemicals are found in a host of common products, from scented candles and air fresheners to plastics used for babies' bottles and the casings of mobile phones. They are known as endocrine disrupters and a new study for WWF (World Wildlife Fund) says they could be implicated in the development of breast cancers at two crucial stages, when a girl is in the womb and at puberty. They can act singly or as a much more powerful cocktail, according to Dr Andreas Kortenkamp, from London University's School of Pharmacy.
Because of their oestrogenic effect endocrine disrupters have also been blamed for "feminised" fish and frogs, as well as declining sperm counts and malformed male reproductive organs in humans. Now Dr Kortenkamp, director of the Centre of Toxicology at the School of Pharmacy, says they could be implicated in breast cancer. He says that less than half of new breast cancers can be explained solely by lifestyle factors, such as drinking alcohol, being overweight and taking hormones, or by a family history of breast cancer. He believes too little research has been carried out into the effects of endocrine disrupters and breast cancer. "To prove or dismiss a link with breast cancer exposure to chemicals must be recorded many years before the cancer becomes manifest," he said. "Measuring chemicals at a time when the disease is diagnosed will miss important features and will provide a warped picture."
Dr Kortenkamp said a recent Spanish study had demonstrated an association between breast cancer risk and oestrogen-mimicking chemicals. "This is the first evidence that chemicals in our environment, with oestrogenic properties that are 'accidental', and not just natural hormones or pharmaceutical oestrogens, may contribute to the development of breast cancer," he said.
The paper calls for strong legislation to control endocrine disrupters. The European Union is to vote soon on new chemical legislation in a programme called Reach that is designed to protect people and the environment from harmful man-made chemicals.
WWF says the British Government is not seeking strong enough legislation. Paul King, a spokesman for WWF UK, said: "It would be an outrage for European governments to gamble with the health of their citizens by allowing endocrine disrupting chemicals to continue to be used even where safer alternatives are available."
Oestrogen plays a significant part in the development of breast cancer. Currently 42,000 British women are diagnosed each year. One in nine will develop breast cancer sometime in her life, mostly commonly after the menopause. In the 30 years to 2004 breast cancer cases rose by 81 per cent. However, mortality rates have fallen by 20 per cent in about 15 years.
Josephine Querido, a spokesman for Cancer Research UK, said: "There is considerable public concern about whether hormone-disrupting chemicals -- both in the environment and in household goods -- affect breast cancer risk. "But it has not been proven conclusively that they do, and a number of studies have contradicted the suggestion. "Compared with the levels of natural oestrogen circulating in a woman's blood, the levels of these chemicals are very small indeed. "The increase in breast-cancer rates in the last few decades has been linked to lifestyle changes. These include the trend for women to have fewer children later in life."
by Jim Giles, Nature
October 17, 2006
http://www.nature.com/news/2006/061016/full/061016-5.html
Tentative evidence has emerged to suggest that low doses of caffeine, equivalent to just one or two cups of coffee per day, can affect the development of unborn babies. The findings are almost certainly too preliminary to prompt public health officials to change official advice to pregnant women, who at present are told only to avoid large amounts of caffeine. But the researchers involved, who have detected behavioural and cellular changes in rats whose mothers drank caffeine during pregnancy, say they themselves are advising pregnant women to avoid caffeine altogether.
Joseph Nunez and his colleagues from Michigan State University in East Lansing, who presented their results on 16 October at the annual meeting of the Society for Neuroscience in Atlanta, Georgia, say the findings came as a surprise. In an initial experiment, they examined brain cells from new-born rats whose mothers had been given a dose of caffeine, equivalent to one or two cups of coffee for a human, every day during pregnancy. "I was a skeptic," says Deborah Soellner, a colleague of Nunez's. "I didn't expect to see this at such a low dose." But in the exposed rats, Nunez's team found odd effects in brain cells of the hippocampus, a region of the brain associated with memory and spatial navigation. For example, the cells absorbed less glutamate, a molecule that makes brain cells more active. Whatever glutamate was absorbed also exited the cells sooner than usual.
Reduced inhibition
To see how the cellular changes were affecting behaviour, the Michigan team took baby rats whose mothers had been caffeined-up and ran them through a series of behavioural tests. Nunez says that the animals showed no cognitive defects, but were more active and less inhibited than those whose mothers had not received caffeine. The rats were more willing to explore new environments, for example. When placed in a small dark space with an opening into a larger lit area, it took control animals around 4 minutes on average to emerge. But the caffeine rats left after an average of just 25 seconds. Other tests showed similar, if less pronounced, changes. The rats were more likely to explore exposed environments, and spent more time interacting with other animals. "You have an animal that doesn't know when to stop," says Nunez.
Safe not sorry
Although there is no reason to assume that these differences are negative or harmful, Nunez would like pregnant women to be advised to avoid caffeine as a precautionary measure. On his display was pinned a photograph of his four-month-old baby; he says his team's rat results started to emerge when his wife was pregnant, so he immediately advised her to stay away from caffeine. Current public health guidelines say only that women should limit themselves to 300 millilitres or less a day, but that is equivalent to what Nunez fed his rats. He points out that caffeine is able to cross the placenta, and the developing fetus is known to take up to 4 days to clear out the caffeine from a single cup of coffee drunk by mum.
Nunez says that any effects of caffeine on humans may have been missed because it is so widely used and assumed to be relatively safe. "No one has ever systematically done this research before," he says. Nunez's team plans to follow up their studies by looking in more detail at the effect that caffeine is having on brain cells.
by Aaron Rupar, United Press International
October 17, 2006
http://www.upi.com/ConsumerHealthDaily/view.php?StoryID=20061017-014133-9441r
WASHINGTON -- A new study suggests that soot emissions from diesel trucks may exacerbate asthma in children. "We went in and actually measured personal exposures to traffic pollution, which had not been done before," said George Thurston, associate professor of environmental medicine at the New York University School of Medicine and one of the study's principal researchers. "Our results confirm that diesel soot particles in air pollution are causing exacerbations of asthma in children." The study, which was conducted by researchers at NYU and the Robert F. Wagner Graduate School of Public Service, monitored the expression of asthmatic symptoms in 40 elementary school students who live in the South Bronx area of New York City. The study found that asthmatic symptoms -- particularly wheezing -- doubled among the children on high traffic days when diesel soot emissions were highest.
The major type of air pollutant associated with exacerbated asthma symptoms was elemental carbon. "Diesel vehicles are the vehicles that emit this elemental carbon soot -- in general, gasoline vehicles don't," Thurston told United Press International. The study found that only about 10 percent of the total mass of tiny particles in the air was elemental carbon, but it was this portion that was most closely related to children's adverse health effects. Elemental carbon has also been cited as a causal agent in asthma in a number of other laboratory studies.
The South Bronx has among the highest incidences of asthma hospital admissions in the city, and a recent survey in the South Bronx's Hunts Point district found the asthma prevalence rate in elementary schools to be between 21 percent and 23 percent. The South Bronx is a major traffic hub. At Hunts Point Market alone, some 12,000 trucks roll in and out daily.
An NYU news release detailing the study's findings suggests that the city's decision to place elementary schools near highways is partly responsible for the exacerbated asthma symptoms, but Thurston told UPI that he believes the problem has deeper roots. "We looked at some schools that were four and five blocks away from these highways and they were still subject to high levels of pollution," he said. "The South Bronx is encircled by interstates."
In order to effectively combat the exacerbated asthma symptoms identified by the study, Thurston believes that the South Bronx's heavy truck traffic needs to be addressed. "Instead of patching the symptoms we need to deal with the underlying causal problem," he said, "we need to start talking about bringing in goods by rail or water. Why are trucks used all the time?"
Nationally, the prevalence of childhood asthma has grown at a startling rate over the past 25 years. According to a Centers for Disease Control study, the percentage of American children suffering from asthma has grown from 3.6 percent in 1980 to 9 percent in 2001. "No one really knows why asthma has increased," Thurston told UPI. He speculated that auto emissions are only one of many environmental factors that may be responsible for its increased prevalence.
by Judy Peres, Ronald Kotulak and Peter Gorner, Chicago Tribune
October 17, 2006
http://www.chicagotribune.com/news/custom/newsroom/chi-061017cancergap,1,2240035.story
A study showing an alarming gap in breast cancer death rates for black and white women in Chicago has mobilized health experts to find the root causes and recommend within a year ways to reduce the unusually high mortality among African-Americans. Why black women are more likely to die of breast cancer is unclear, but medical leaders said genetics, lack of awareness about breast self-examination, inability to afford routine mammograms and limited access to medical facilities may play crucial roles. Some Chicago researchers are also beginning to look at whether the stress of social isolation and living in impoverished or crime-ridden neighborhoods might make some women more vulnerable to cancer.
Another possibility is that some facilities serving black women are doing a poor job of detecting cancers early. "Women are dying -- overwhelmingly poor and black women -- because of inadequate quality of the mammography process. That's our hypothesis," said Steve Whitman, director of the Sinai Urban Health Institute, which conducted the study released Tuesday. The study, which has not yet been published or undergone the scrutiny of peers, found that the odds that a woman will die of breast cancer has been declining steadily for close to two decades, yet African-American women have been seeing the reverse. (The report did not analyze data for women of other races.)
As recently as the 1980s, mortality rates for black and white women in Chicago were both around 38 breast cancer deaths per 100,000 women per year, according to the study. The rates started to diverge in the 1990s, as overall mortality rates began to drop thanks to improvements in treatment and early detection. By 2003, the last year for which statistics are available, the rate for Chicago's black women was 73 percent higher: 40.5 breast cancer deaths per 100,000, compared with 23.4 for white women. For the U.S. as a whole, the mortality rate for white women is 25.2, compared with 34.6 for black women -- 37 percent higher. The study reported the gap in New York City was only 17 percent (35.8 for blacks, 30.7 for whites), which suggests "it's not just an issue of big urban areas," Whitman said.
Researchers have been trying for years to discover why black women in America have a higher risk of dying of breast cancer, even though they're less likely to get the disease. Some studies have found biological differences that may cause black women to get more aggressive types of breast cancer. Experts say black women are more likely than white women to have a combination of three genetic defects that makes their tumors harder to treat. "We've known for years that African-American women have a more aggressive type of breast cancer compared to white women," said Dr. Virginia Kaklamani, an oncologist at the Northwestern University Feinberg School of Medicine. "One of the reasons for that is that the kind of breast cancer they get is genetically worse."
At the University of Chicago, meanwhile, a large federally funded study is under way to look at social factors that might bring about biological changes that lead to breast cancer. The team includes specialists in the medical, biological, behavioral and social sciences. "We think the black-white disparity is due to complex interactions of genetic and environmental factors. By joining together is the only way we're going to get a handle on them," said study leader Sarah Gehlert, director of the Center for Interdisciplinary Health Disparities Research. "Between 70 and 80 percent of all breast cancers are due to sporadic mutations, not inherited mutations. That means it's things that happen in the environment," Gehlert said. "We think that if you live in really adverse circumstances in a neighborhood with a lot of crime, so the threat's always there, you'll be afraid to go out and will develop what we call a dysregulated stress response," she said. "And you'll be more likely to have spontaneous mutations of the breast cancer genes."
Gehlert said her study is based on the work of U. of C. psychologist Martha McClintock, who showed that socially isolated female laboratory rats suffered an increase in spontaneous breast cancers. "We're testing this hypothesis in Chicago and Gary on 233 newly diagnosed African-American breast cancer patients," Gehlert said. "We go into their homes and look at their neighborhoods. Then we examine their tumors after they've been biopsied to see if they're due to spontaneous mutations or are inherited."
Experts also noted that black women also are more likely to get inferior care, fail to seek appropriate testing and be unable to afford routine mammograms. Sandra Stewart, 55, who lives on Chicago's South Side, said she hadn't had a mammogram in 10 years when she felt a hardness in her breast one morning last October -- breast cancer awareness month. "Most of us can't afford it," she said. "I didn't have any insurance." Scared, she called a cancer hot line she'd seen on TV and was able to receive a free mammogram. "They found an advanced cancer," she said. "The very same day, they sent me up for a biopsy." The Stand Against Cancer project arranged for Medicaid to cover her treatment, and today Stewart is in complete remission.
To address the idea that the mammography available to black women may be of poor quality, the Sinai report calls on area hospitals and breast centers to collect and share mammography quality measures as the first step toward improving services. "In health care, what gets measured gets better," said Alan Channing, president of the Sinai Health System. Mammograms, which are specialized X-rays, are difficult to read, and their effectiveness in spotting cancer early depends in part on how well they are interpreted. The American College of Radiology has established quality standards and recommends that all mammography programs keep track of their performance. But many programs do not, and most do not release the data if they have it. To stimulate transparency and perhaps challenge other facilities to release their data, the Sinai report includes quality measures for Mt. Sinai Hospital (part of the Sinai Health System) and Mercy Hospital.
The task force organized to figure out how to reduce Chicago's racial gap in breast cancer death rates will call a summit meeting in January with leaders in radiology, mammography, medical financing and others concerned about breast cancer. "We expect experts from all the leading medical centers to participate, as well as breast cancer survivors and epidemiologists, and map out a plan to eliminate these terrible disparities," Whitman said. The task force will be co-chaired by Ruth Rothstein, former CEO of the Cook County Bureau of Health and now president of the board of Rosalind Franklin University of Medicine; Sister Sheila Lyne, CEO of Mercy Hospital and former commissioner of the Chicago Department of Public Health; and Donna Thompson, CEO of Access Community Health Network. Calling the co-chairs "the three most powerful women in health care in Chicago," Whitman said, "I think the task force has a real chance at fixing this. I'm optimistic."