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Patience and Progress May 7, 2013

Posted by Nancy Hepp in Newsletter introductions.
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Steve Heilig, MPH
CHE Director of Public Health & Education
Director of Public Health & Education at the San Francisco Medical Society

“Patience is a virtue”, or so we are told. For environmental health work, it is essential. Progress, in both science and the policies hopefully based upon science, is almost always unavoidably incremental. And thus we tend to develop a “long run” perspective out of necessity, celebrating small or large advances and not letting the oft-glacial pace of progress cause too much cynicism.

Over a decade into working with CHE, I seek inspiration among the continual flow of bad, or at least potentially bad, news. Keeping track of the broader “chemical policy” arena, as many CHE partners probably do, is illustrative. An excellent recent review paper titled “Environmental exposures: an under-recognized contribution to noncommunicable diseases” summarizes the arena as succinctly as possible, and concludes: Previous attempts to determine the degree to which exposure to environmental factors contribute to noncommunicable diseases (NCDs) have been very conservative and have significantly underestimated the actual contribution of the environment…Prevention needs to shift focus from individual responsibility to societal responsibility and an understanding that effective prevention of NCDs ultimately relies on improved environmental management to reduce exposure to modifiable risks.

Those are obviously some tall tasks, for many reasons. Which reminded me of our fairly recent CHE discussion with Dr. Richard Denison on the prospects and pitfalls for truly new chemical policy reform, and an even more recent call, “Late Lessons from Early Warnings: A Retrospective Look at Learning about Precaution“, is also well worth a listen. It is hard not to notice a couple things about these expert resources: first, that they are rarely saying much that is truly new with respect to the policy implications of environmental health science—prevention is key, and the evidence for that grows and grows; and second, that many of the same people who have been working and warning about this are still soldiering on, pushing the evidence base and policy imperatives for years and decades.

Take a look at our most recent (admittedly subjective) CHE quarterly Top 10 list for more examples, both encouraging and daunting; see Environmental Health News’s new special report “Chemicals of high concern found in thousands of children’s products” for more indication on how much work is to be done—as if such reminders were necessary.

So, my real message here, on behalf of those of us at the decentralized “CHE central”, is one of gratitude to those who continue the hard, long work of positive change—including so many CHE partners. Thank you for your perseverance—and patience.

Honeybees, Children and Cumulative Impacts May 3, 2013

Posted by Nancy Hepp in breaking news.
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Ted Schettler
Science Director

A news article today from the Minneapolis Star Tribune raises questions: Bee die-off is linked to many causes. ”A lethal combination of pesticides, parasites and disease, coupled with a shortage of flowers, has been identified as the cause of a perilous decline in honeybees. But there is insufficient evidence to single out insecticides that many beekeepers blame for the die-off, federal officials said.” (see the report: Report on the National Stakeholders Conference on Honey Bee Health)

This appears to be a cumulative impacts problem—similar to many complex diseases. Bee keepers describe “being on the brink.” Yet, regulators decide that since there’s no single cause, they won’t address one that is highly likely to be contributing

There is a real coherence developing around recent bee science. A recent paper in Science pointed out that analysis of the bee genome suggests that honeybees lack many of the cellular and humoral immune genes of other insects, making them inherently more vulnerable to infectious and toxic exposures.

Another recent study led to the hypothesis that honeybees that live off the same sweetener found in soft drinks (high fructose corn syrup) could be more vulnerable to the microbial enemies and pesticides believed to be linked to catastrophic collapse of honeybee colonies worldwide. Researchers identified an enzyme found in the wall of plant pollen that appears to activate the genes that help metabolize toxins, including pesticides, according to the study published Monday in the Proceedings of the National Academies of Science. Although pollen winds up in the honey produced by Apis mellifera, these bees used to pollinate crops spend more time sipping on the same sugar substitute that is ubiquitous in processed foods—high-fructose corn syrup. The honey substitute is an important way for the industry, which contributes about $14 billion to the U.S. economy, to make ends meet.

So it does not seem at all mysterious that combinations of pesticides and infectious agents could result in widespread bee deaths. Bees are inherently vulnerable.

So are children… poverty, poor nutrition, toxic exposures, trauma, infectious disease, and other stressors separately and collectively have life long impacts. We try to address these problems, collectively when we can but knowing that single interventions are often necessary but not sufficient. We got lead out of most gasoline and still drive cars. But it looks as if regulators are unwilling to take on the pesticide industry and their support for neonicotinoids without a evidence of a smoking gun…. a level of evidence that will nearly always be absent in complex disorder analysis.

Top 10 Selections: April 2013 April 30, 2013

Posted by Nancy Hepp in science pick.
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For our third quarterly Top 10 list, we again selected from several dozen candidate news articles, journal articles, policy decisions and reports that have had a significant impact or are likely to have a significant impact on thinking and action in the field of environmental health. We consider these selections to be the biggest contributors toward new insights, toward changing the conversation or expanding the scope of the conversation on a topic to a new audience or awareness, or toward defining a new trend. Comments are welcome.

The selections, in no particular order:

  1. Report: Late Lessons from Early Warnings: Science, Precaution, Innovation from the European Environment Agency.
    As stated in the promotional text for this report: “The case studies across both volumes of Late Lessons from Early Warnings cover a diverse range of chemical and technological innovations, and highlight a number of systemic problems. The ‘Late Lessons Project’ illustrates how damaging and costly the misuse or neglect of the precautionary principle can be, using case studies and a synthesis of the lessons to be learned and applied to maximizing innovations whilst minimizing harms.” This report explores weaknesses in regulatory science and expands on histories of past environmental and public health mistakes. It includes new substances with potential for harm and several false positives. All is drawn together to provide a framework in which precaution guides policy.
    See more information about the partnership call CHE hosted on this report: Late Lessons from Early Warnings: A Retrospective Look at Learning about Precaution.
  2. The need to look at mixtures in assessing safety.
    Two items this quarter address the need to look at interactions among exposures when determining risk of exposures. First is Research Brief 217: Majority of Women Exposed to Multiple Pollutants, from the National Institute of Environmental Health Sciences (NIEHS). According to a new analysis of thousands of US women of child-bearing age, almost 83% of women aged 16 to 49 meet or exceed median blood levels of one or more of three environmental pollutants—lead, mercury, and polychlorinated biphenyls (PCBs)—that are known to harm brain development of fetuses and babies. Most women exceeded the median blood level for two or more of these pollutants, even though “scientists do not yet know whether co-exposure to all three chemicals is more harmful than each chemical alone.” With exposures this pervasive, it is imperative that risks be assessed and policies adopted to protect fetuses and children. The second item is a statement from NIEHS on this topic:  Unraveling the health effects of environmental mixtures: an NIEHS priority. NIEHS recognizes that it “is imperative to develop methods to assess the health effects associated with complex exposures in order to minimize their impact on the development of disease.” NIEHS draws from its background in both supporting and conducting combined exposure research to state that this topic will continue to be a priority at the Institute.
  3. America’s real criminal element: lead  and Correlation between exposure to lead and violence is being taken seriously across scientific world.
    “New research finds that lead is the hidden villain behind violent crime, lower IQs, and even the ADHD epidemic. And fixing the problem is a lot cheaper than doing nothing.” This line of investigation has deep repercussions socially. With substantial costs not only to individuals and their families, but to our entire society, from crime, lowered educational attainment and attendant problems. There is new impetus to prevent or to find and remediate lead in housing, in soil, and in consumer goods. Beyond the social significance, though, this story is a great case study in epidemiology and criminology.
  4. New report: U.S. Health in International Perspective: Shorter Lives, Poorer Health.
    This report from the National Research Council and the Institute of Medicine investigates potential reasons for the US health disadvantage and assesses its larger implications. No single factor can fully explain the US disadvantage:  It likely has multiple causes and involves some combination of inadequate health care, unhealthy behaviors, adverse economic and social conditions, and environmental factors, as well as public policies and social values that shape those conditions. This report packages the ecological model of health which CHE encourages our partners to consider when investigating environmental effects on health.
  5. Further impacts from smoking tobacco.
    Three studies provide new thinking around an old problem, in case anyone still needed a reason to reduce tobacco use.

    1. Passive smoking can dramatically increase the risk of developing severe dementia Breathing in someone else’s cigarette fumes increases your risk of severe dementia, according to researchers. The study is the first to find a significant link between passive smoking and the neurological disease.
      See the study: Association between environmental tobacco smoke exposure and dementia syndromes
      Between the widespread exposure to environmental tobacco smoke and the substantial costs to society of dementia, this is a huge public health issue. If reducing exposures to tobacco smoke can decrease the incidence or severity of dementia, the benefits to society could be enormous, in addition to the improvement in quality of life for individuals and their families.
    2. Cigarette smoke may increase microbial virulence
      A new study expands the potential health effects to a new front, showing that acute in vitro exposure of Staphylococcus aureus to cigarette smoke promoted biofilm formation and adhesion to human cells.
      See the study: Cigarette smoke increases staphylococcus aureus biofilm formation via oxidative stress.
    3. Cutting smoking saves more in health bills than lost tax: EU
      The cost and health benefits of getting people not to smoke—and better still, not to start—more than outweigh the taxes the tobacco industry pays to governments, the European Commission said Monday.
  6. Pollution crisis in China.
    A long series of news reports on air and water pollution, the resulting unrest in the population, and the government’s response describes a society’s struggle with chemical contamination in China.

    1. Chinese struggle through ‘airpocalypse’ smog
    2. Beijing air pollution soars to hazard level
    3. Beijing orders official cars off roads to curb pollution
    4. Chinese take fight against water pollution to social media
    5. Chinese Internet users scream for clean air act
    6. Eye-stinging Beijing air risks lifelong harm to babies
    7. Water pollution: a Bay of Pigs moment in China
    8. China’s toxic harvest: a “cancer village” rises in protest
    9. China steps up toxics controls
    10. Waiting to exhale in China
    11. A new environment for fight against pollution
    12. In China, breathing becomes a childhood risk
  7. Global data and meta-analayses of prenatal exposures and birth outcomes.
    Two large studies showcase the effects of environmental exposures on pregnancy outcomes.

    1. Environmental risk factors of pregnancy outcomes: a summary of recent meta-analyses of epidemiological studies
      The meta-analyses found statistically significant negative associations between environmental tobacco smoke and stillbirth, birth weight, and any congenital anomalies; PM2.5 and preterm birth; outdoor air pollution and some congenital anomalies; indoor air pollution from solid fuel use and stillbirth and birth weight; polychlorinated biphenyls (PCB) exposure and birth weight; disinfection by-products in water and stillbirth, small for gestational age, and some congenital anomalies; occupational exposure to pesticides and solvents and some congenital anomalies; and agent orange and some congenital anomalies.
    2. Maternal exposure to particulate air pollution and term birth weight: A multi-country evaluation of effect and heterogeneity
      A growing body of evidence has associated maternal exposure to air pollution with adverse effects on fetal growth; however, the existing literature is inconsistent. The objectives of this study were to quantify the association between maternal exposure to particulate air pollution and term birth weight and low birth weight (LBW) across fourteen centers from nine countries and to explore the influence of site characteristics and exposure assessment methods on between-center heterogeneity in this association. Maternal exposure to particulate pollution was associated with low birth weight at term across study populations. This study helps clarify previous disparate findings on air pollution and birth weight. Taking into account differences in location and methodology, these findings support the association between maternal particulate matter exposure and low birth weight.
  8. US report urges deeper look into breast cancer’s environmental links.
    A new federal advisory panel report makes a forceful case for more research into environmental causes of breast cancer, which was diagnosed in 227,000 women, killed 40,000 and cost more than $17 billion to treat in the United States last year. For years, the focus in breast cancer has been on early detection and treatment, and this move toward prevention shifts the focus upstream.
    See the report: Breast Cancer and the Environment: Prioritizing Prevention and information about CHE’s partnership call on the report.
  9. UN, WHO panel calls hormone-disrupting chemicals a ‘global threat.’
    An international team of experts reported today that evidence linking hormone-mimicking chemicals to human health problems has grown stronger over the past decade, becoming a “global threat” that should be addressed. There’s still much research needed, but this moves the conversation about health effects of endocrine disrupting chemicals onto a bigger stage.
    See the report: State of the Science of Endocrine Disrupting Chemicals and other coverage: European Parliament vote on EDCs conveys urgency of protecting health.
  10. Transgenerational effects of prenatal exposure to environmental obesogens in rodents.
    Three studies were published this quarter:

    1. Transgenerational inheritance of increased fat depot size, stem cell reprogramming, and hepatic steatosis elicited by prenatal obesogen tributyltin in mice
    2. plastics derived endocrine disruptors (bpa, dehp and dbp) induce epigenetic transgenerational inheritance of obesity, reproductive disease and sperm epimutations
    3. Hydrocarbons (jet fuel JP-8) induce epigenetic transgenerational inheritance of obesity, reproductive disease and sperm epimutations

    This is a new finding in both obesity research and in transgenerational research. These studies all show the ability of environmental chemicals (not only endocrine disruptors, but also jet fuel) to promote obesity in three generations of rodents.
    See information about CHE’s working group call on these studies: Transgenerational Effects of Prenatal Exposure to Environmental Obesogens in Rodents.

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