Top 10: 3rd Quarter 2015

We present the ten most significant news or research stories in environmental health of the last quarter, in CHE’s view. The first three items are statements from major scientific or health organizations summarizing large bodies of research and drawing conclusions about the interaction of our environments and our health. These reports join a growing list of statements and documents (see compilations of consensus statements and of resolutions and scientific statements on CHE’s website).

Additional items in this list present notable new research, new policy developments, new focus or new thinking on their respective topics.

  1. FIGOInternational Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemical: The global health and economic burden related to toxic environmental chemicals is in excess of millions of deaths and billions of dollars every year, including impacts on health and quality of life. On the basis of accumulating robust evidence of exposures and adverse health impacts related to toxic environmental chemicals, the International Federation of Gynecology and Obstetrics (FIGO) joins other leading reproductive health professional societies in calling for timely action to prevent harm.
    Read CHE’s Blog post on the statement, written by a statement author, and join CHE’s call on the statement on October 30th.
  2. Executive Summary to EDC-2: The Endocrine Society’s second scientific statement on endocrine-disrupting chemicals: The full Scientific Statement represents a comprehensive review of the literature on seven topics for which there is strong mechanistic, experimental, animal, and epidemiological evidence for endocrine disruption, namely: obesity and diabetes, female reproduction, male reproduction, hormone-sensitive cancers in females, prostate cancer, thyroid, and neurodevelopment and neuroendocrine systems.
  3. PlanetaryHealthSafeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health: A growing body of evidence shows that the health of humanity is intrinsically linked to the health of the environment, but by its actions humanity now threatens to destabilize the Earth’s key life-support systems.
    See the infographic that accompanies this report.
  4. California bill leads nation with significant steps to limit antibiotic overuse in meat production: The US Centers for Disease Control and Prevention (CDC) has identified antibiotic resistance as one of the top health threats facing the nation. This action puts California at the forefront of efforts in the US to limit the misuse and overuse of antibiotics in meat production and protect the efficacy of precious antibiotics.
  5. Pesticide exposure linked to diabetes development: New studies, including a meta-analysis, appear to show that there is a link between exposure to pesticides and the later development of diabetes, researchers reported at the annual meeting of the European Association for the Study of Diabetes.
    See more about the meta-analysis: Analysis of 21 studies shows exposure to pesticides is associated with increased risk of developing diabetes.
    Although this meta-analysis and other studies were presented at a conference and have not been published, we felt this topic merited inclusion in the Top 10 because it reinforces the growing number of peer-reviewed studies that suggest a link between diabetes and pesticides.
  6. Assessing the carcinogenic potential of low-dose exposures to chemical mixtures in the environment: the challenge ahead: Our analysis suggests that the cumulative effects of individual (non-carcinogenic) chemicals acting on different pathways, and a variety of related systems, organs, tissues and cells could plausibly conspire to produce carcinogenic synergies.
    See news coverage on this report from the National Institute of Environmental Health Sciences (NIEHS): Exposure to low levels of chemical mixtures linked with cancer and Low-dose mixtures and cancer highlighted at NIEHS symposium, plus CHE’s teleconference call on the report: Theories of carcinogenesis: assessing the carcinogenic potential of low-dose exposures to chemical mixtures in the environment.
  7. Association of child poverty, brain development, and academic achievement: Poverty is tied to structural differences in several areas of the brain associated with school readiness skills, with the largest influence observed among children from the poorest households.
    See a news report on the study, drawing from an interview with the study senior author: Effect of poverty on brains may explain poor kids’ lower test scores.
    As the author notes, this study “closes the loop and adds the missing piece” regarding the connection between poverty, brain development and academic achievement, finding that the effects are mediated by a smaller hippocampus and frontal and temporal lobes and that the decrease in volume of the latter two structures explained as much as 15% to 20% of the achievement deficits found. Of note is that children facing numerous other risk factors for poor brain development were screened out from this study. cumulativeImpactsThe impacts of poverty, nutrition, conflict, disease and other stressors in addition to exposures to toxic chemicals and radiation each may have individual and synergistic effects on brain development. This study brings focus to the role of poverty on brain development and achievement, but because children living in poverty often face other adverse conditions concomitant to poverty, the full effects of poverty are likely even greater than reported in this study.
  8. Two articles on health effects of hydraulic fracturing (fracking): Endocrine-disrupting chemicals and oil and natural gas operations: potential environmental contamination and recommendations to assess complex environmental mixtures and Environmental and health impacts of ‘fracking’: why epidemiological studies are necessary. These articles make the case for concern over serious impacts on health and call for more research, including regarding the endocrine-disrupting potential of chemicals used in the process.
  9. The scandal regarding Volkswagen’s programming cars to avoid emissions control. A flurry of news reports on this situation were published. We present two focusing on human health impacts: Scientists say car emissions rigging raises health concerns and How many deaths did Volkswagen’s deception cause in the US? Because 11 million cars worldwide may be affected, and because diesel-fueled cars account for just 3 percent of passenger vehicles in America but closer to 50 percent in Europe, the health impacts of VW’s intentional undermining of clean air standards could be enormous.
  10. The Center for Public Integrity’s series on occupational exposures and health. CPI’s reports published a long list of articles describing the health impacts of occupational exposures on workers and their families, the failure of current safeguards, the push to weaken even those, and recommendations for reform.

Do-It-Yourself Genetic Engineering

From CBC News, this article appeared today: Synbiota biohacking kits let you do genetic engineering at home.

From the article:

A Canadian company is trying to make it possible for anyone to be a “biohacker” and make custom genetically modified organisms in their home kitchen.

Homemade GMOs may sound scary to some, but Toronto-based Synbiota thinks making genetic engineering technology available to ordinary people will lead to new products that we haven’t yet dreamed of.

Reproductive Health Professionals around the World Take a Stand on Toxic Chemicals

Reproductive Health Professionals around the World Take a Stand on Toxic Chemicals

To commemorate World Environmental Health Day this year and its focus on children’s environment and health, CHE is publishing a series of short essays from partners who are leaders in children’s environmental health.

written by David Tuller, DrPH, and Tracey J. Woodruff, PhD, MPH

In recent years, a growing body of research has documented that the in utero environment has a critical impact on future health and development. A strong body of evidence shows that prenatal exposure to toxic chemicals can usher in a host of adverse effects in childhood and across the lifespan, as well as in subsequent generations.

Now the world’s leading organization of reproductive health specialists, the International Federation of Gynecology and Obstetrics (FIGO), is urging medical professionals to demand stronger government regulation of toxic environmental chemicals.[1] FIGO’s call to action resonates with the theme of this year’s World Environmental Health Day—Children’s Health and Safety and the Protection of Their Environment.

FIGO, which represents doctors in more than 125 countries and territories, published its opinion on reproductive health impacts of exposure to toxic environmental chemicals today, in advance of its World Congress in Vancouver. (Our group at UCSF, the Program on Reproductive Health and the Environment, co-authored the FIGO opinion.)

In its statement, FIGO outlines the compelling evidence of harm and recommends that “reproductive and other health professionals advocate for policies to prevent exposure to toxic environmental chemicals, work to ensure a healthy food system for all, make environmental health part of health care, and champion environmental justice.”

Tens of thousands of industrial chemicals are in everyday use, and biomonitoring studies indicate that virtually everyone is exposed to dozens if not hundreds of them, most never adequately tested for human or environmental safety. Yet efforts to strengthen the regulation of toxic chemicals, in the US and many other countries, have stalled under pressure from powerful business interests.

FIGO“What FIGO is saying is that physicians need to do more than simply advise patients about the health risks of chemical exposure,” said Dr. Jeanne A. Conry, a co-author of the FIGO opinion and past president of the American College of Obstetricians and Gynecologists, in a public statement that accompanied the release of the opinion. “We need to advocate for policies that will protect our patients and communities from the dangers of involuntary exposure to toxic chemicals.”

The chemicals of concern are ubiquitous—in consumer products like cosmetics and plastic containers, in pesticides, and in thousands of industrial goods. Pollutants also contaminate our food, water and air. These chemicals can interfere with normal development through multiple pathways. For example, many are known to be endocrine disruptors—that is, they impede the normal functions of reproductive and other hormones. Multiple studies have linked prenatal exposures to endocrine disruptors to a wide range of poor health outcomes, including miscarriage, low birth weight, and genital abnormalities, as well as delayed or impaired neurocognitive function and higher rates of some cancers.

Chemical manufacturing is a worldwide growth industry, as it has been for decades. Ineffective environmental regulations, lax trade agreements, rapid industrialization across much of the developing world and other factors have all contributed to our current high levels of exposures.

The global health burden is enormous, with the most severe effects falling, as usual, on the countries and populations that can least afford it. Yet when medical groups promote the importance of discussing the harms of environmental exposures with patients, chemical companies charge that they are frightening women unnecessarily. The facts cited in the FIGO opinion suggest that women, and all of us, have good reason to be concerned.

Dr. Woodruff's children

Dr. Woodruff’s children

“We are drowning our world in untested and unsafe chemicals and the price we are paying in terms of our reproductive health is of serious concern,” noted Dr. Gian Carlo Di Renzo, FIGO’s honorary secretary and lead author of the opinion, in a public statement. Reproductive health professionals, he added, “witness first-hand the increasing numbers of health problems facing their patients, and preventing exposure to toxic chemicals can reduce this burden on women, children, and families around the world.”

[1] Di Renzo GC, et al, International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals. Int J Gynecol Obstet (2015)

David Tuller, DrPH, is academic coordinator of UC Berkeley’s joint masters program in public health and journalism and a collaborator in the UCSF Program on Reproductive Health and the Environment Pregnancy Exposure to Environmental Chemicals Children’s Center.

Tracey J. Woodruff, PhD, MPH, is professor and director of the University of California, San Francisco Program on Reproductive Health and the Environment and a co-author of the FIGO Opinion. She is a CHE partner. For more information on the Opinion go to

One Voice: Prioritize the Health of Our Children

One Voice: Prioritize the Health of Our Children

To commemorate World Environmental Health Day this year and its focus on children’s environment and health, CHE is publishing a series of short essays from partners who are leaders in children’s environmental health.

MaidaGalvezwritten by Maida Galvez, MD, MPH
CHE Partner

As an environmental pediatrician and mom, I worry about the thousands of chemicals that get put in our environment. I worry that many of these chemicals are universally detectable in the US population, that higher levels can often be found in children and racial/ethnic minorities, and that the majority have not been tested for basic safety for health effects, especially in vulnerable populations like pregnant women, infants and children. I worry that products are put into the marketplace and decades later we find that they may impact children’s health, their intelligence, their behavior and their risk for chronic conditions like asthma, ADHD, autism and obesity. I hear this worry directly when families, health care providers, communities and schools call our Pediatric Environmental Health Specialty Unit (PEHSU) and ask, “Did exposure to this chemical harm my child?”

This question must be answered by rigorous research before a product gets to the shelf. The consumer cannot bear the burden of figuring out what’s safe for their family and children. Most people don’t even know to question this. Frankly, who has the time? It is often difficult to figure out which chemicals might be in a given product, whether it’s a toy, a piece of clothing, furniture, food containers, foods, cooking products, or personal care products. When one does go down the road of trying to figure it out, it is so hard to tell fact from fiction, even for an environmental pediatrician like me.  Much of what one sees online and in the popular press is just plain scary. This leads to stress, which we commonly see in families who call the PEHSU. This stress is preventable. The exposures are preventable. And if these exposures account for even a small percentage in the rise in the chronic conditions that are epidemic today, that small percentage is also preventable.

So while we tell all families there are simple things they can do to reduce exposures, including regular hand washing with soap and water, wet mopping and wet dusting, opening windows to allow fresh air into their homes, shopping smart and reading labels, using fewer products with less frequency, and choosing safer alternatives when possible, what we really need to do is to stop worrying and start speaking out.

So, here’s the good news. When we speak with one voice, it can make a difference. The voices of families, community organizations, environmental advocates, scientists, physicians, legislators, public health officials, journalists, the media, and city, state and federal agencies amongst many others, have contributed to bans or voluntary withdrawal of specific chemicals. So speak out and be a voice for children. Policy is the single most effective intervention at reducing children’s exposures to harmful chemicals. While we’ve seen success with chemical-specific bans, with thousands of chemicals on the market, we can’t continue on this path. This would take decades. That’s why it’s time for broader chemical safety laws in the US. Families need to be able to trust that everyday items in our homes, schools, communities and workplaces are safe. We need to know exactly what is in the items we are using through full disclosure of ingredients and stricter labeling requirements. We need certification that products have been rigorously tested to assess the potential for harm to women of childbearing age, developing babies in utero, infants, toddlers, and children, whose organ systems are still developing. Finally, we need to know that replacement chemicals are in fact safer, because when a chemical is banned, we’ve seen the levels of exposure to the replacement chemicals simultaneously rise. If we speak together with one voice, we can make a difference. We need a chemical safety policy in this country that prioritizes the health of our children.


Dr. Galvez, a board-certified pediatrician, completed the Academic Pediatric Association sponsored fellowship in Environmental Pediatrics at Mount Sinai School of Medicine in New York. She is currently an Associate Professor in the Departments of Preventive Medicine and Pediatrics at Mount Sinai. She directs Mount Sinai’s Region 2 Pediatric Environmental Health Specialty Unit and practices general pediatrics.

Brains Needed for the Future

Brains Needed for the Future

To commemorate World Environmental Health Day this year and its focus on children’s environment and health, CHE is publishing a series of short essays from partners who are leaders in children’s environmental health.

PhilippeGrandjeanwritten by Philippe Grandjean, MD, PhD
CHE Partner

Climate change and chemical pollution are serious challenges that require tough decisions, and the solutions will depend on human ingenuity. In other words, we need smart people to help clean up the problems that present and previous generations have created.

GrandjeanWEHDay2015But counter to this notion, we are promoting toxic chemicals that can damage human brain development. So we are essentially generating a vicious circle: industrial chemicals damage the development of the brains of the future that should have helped us design safer uses of chemicals that would not endanger the nervous system of the next generation.

We already know that more than 200 industrial chemicals can detrimentally affect brain functioning in adults. Although we have so far gathered enough evidence only on a dozen or so substances that can damage a child’s developing brain, we know that such toxicity occurs at much lower doses than those that affect the adult brain. Still, only a few of these chemicals have so far been regulated in order to protect the brains of the next generation.

The consequences are dire. Adverse effects on brain development are likely to be permanent. Some cases may be severe enough to trigger a diagnosis of ADHD, cerebral palsy, autism, or other serious disorders, but the vast majority of children will suffer minor functional losses in cognitive functioning, which can involve memory, language skills, problem-solving abilities, or some other aspect of higher mental functions. The total loss in terms of IQ points has been calculated to be many millions of points. The societal value of smart brains is difficult to assess but the costs due to lead, mercury and pesticides have been calculated to correspond to an annual loss of many billions of dollars.

The greatest loss is of course incurred by children and adults who never got the chance to fully develop their skills and talents. But the societal cost also includes the loss of overall intelligence—the smart ideas and initiatives that we need to make this world a safer place, one that allows brains to develop without toxic interference.

We already know of initiatives that are well justified and could be applied right now to protect the brains of the future. Stricter limits for usage and dissemination of brain-toxic chemicals should be applied to reduce or eliminate our exposure to them. As relatively few chemicals have been tested for such effects so far, we must initiate proper testing of chemicals new and old to determine whether they result in any risks. Such testing is being discussed in the European Union, but must be done internationally. Is there a better purpose than protecting the brains of our children and grandchildren? I would think not, and we definitely need brains in the future who are smarter than we are.

Dr. Grandjean is professor and chair of Environmental Medicine at the University of Southern Denmark and adjunct professor of Environmental Health in the Department of Environmental Health at Harvard School of Public Health. He has devoted his career to studying how environmental chemicals affect children and their brain development.

On World Environmental Health Day: The Call to Protect Children’s Environment and Health

On World Environmental Health Day: The Call to Protect Children’s Environment and Health

To commemorate World Environmental Health Day this year and its focus on children’s environment and health, CHE is publishing a series of short essays from partners who are leaders in children’s environmental health.

A very young Frederica Perera

Dr. Perera’s son

written by Frederica Perera, DrPH
CHE Partner

The protection of children, and especially poor children, from air pollution and climate change resulting from the massive burning of fossil fuel is an urgent moral imperative. The large and mounting health and economic costs of pollution and climate change necessitate bold policy change.

The entire global population is affected; however, the first thousand days of life represent the greatest window of susceptibility both to toxic exposures and stressors from climate change. The developing fetus and young child undergo very rapid development during which time they lack the innate defense mechanisms operating in older children and adults. Thus, they tend to be the most affected both by toxic air pollutants and climate change. The impacts of exposure to air pollution include adverse birth outcomes, cognitive and behavioral disorders, asthma and other respiratory problems in children, while climate change increases the likelihood of heat waves, floods, drought, malnutrition, infectious disease, and social and political instability. These early impacts can translate to lifelong consequences for the young.

The population at risk is huge. Of the 7 billion world’s population, 1.9 billion are children below 15 years of age. According to the World Health Organization (WHO), children under 5 years of age bear more than 40 percent of the burden of environmentally related disease and more than 88 percent of the existing global burden of disease from climate change. Compounding the children’s biological susceptibility to exposure is their exposure to socioeconomic stressors related to poverty that can heighten risks of both toxic exposures and climate change. Globally, 1 billion children are living in poverty.

Coal combustion for power generation has continued to be one of the largest sources of toxic air pollution emissions and the leading source of carbon dioxide (CO2) emissions, the primary human cause of global climate change. Besides emitting CO2, coal-fired electric generating utilities directly emit toxic air pollutants such as fine particulate matter (PM2.5), sulfur dioxide, and nitrogen oxides, as well as precursors to ozone. Diesel- and gasoline-powered trucks, cars and buses are also a major contributor of these pollutants.

As with impacts of CO2 emissions on climate change, toxic air pollutants emitted by ground-level emission sources are a global problem. Although populations living close to ground-level emission sources are often most affected, air pollutants can be transported hundreds and thousands of miles from their source, potentially affecting large populations downwind. For example, intercontinental transport of PM2.5 and O3 result in global impacts.

PereraPostEstimated costs of climate change and air pollution are substantial. For example, a recent review paper in The Lancet reported that the impact of climate change on lives lost and ill health in Organisation for Economic Co-operation and Development (OECD) countries, India, and China, was estimated to cost $3.5 trillion annually. Globally, WHO estimated that climate change will result in more than 250,000 annual deaths between 2030 and 2050 through increases in diseases such as diarrhea, malnutrition, malaria, and heat stress, with an estimated cost of $2-4 billion (USD)/year by 2030. In California, childhood asthma, childhood cancer, childhood lead exposures, and childhood neurobehavioral disorders associated with environmental exposures amount to $254 million every year and $10-13 billion over the lifetime of all children born every year.

By reducing our dependence on fossil fuel and moving to a decarbonized economy, we will gain significant health and economic benefits for our children and their future and meet our moral responsibility for their protection.

Dr. Perera is a professor at Columbia University, Mailman School of Public Health, Department of Environmental Health Sciences, and the director of The Columbia Center for Children’s Environmental Health.

We Need a Rational Policy on Chemical Safety

We Need a Rational Policy on Chemical Safety

To commemorate World Environmental Health Day this year and its focus on children’s environment and health, CHE is publishing a series of short essays from partners who are leaders in children’s environmental health.

written by Philip J. Landrigan, MD, MSc, FAAP
CHE Partner and Chair of CHE’s Science Advisory Committee

Children’s health and the environment is a most fitting topic for World Environmental Health Day 2015. Children are the most vulnerable among us to degradation of the environment. Any actions that we take to protect infants and children against health threats in the environment will protect not only children, but will also safeguard all of us and preserve the health and well-being of future generations.

Toxic chemicals are a particularly serious threat to children’s health. More than 80,000 new synthetic chemicals have been invented in the past 50 years. These chemicals are found in thousands of products that we use every day. They have become widespread in the earth’s environment. They are routinely detected in the bodies of all Americans in annual surveys conducted by the Centers for Disease Control and Prevention. And time and time again synthetic chemicals that we carelessly incorporated into consumer products with no premarket safety testing have been found to cause disease in children—cancer, birth defects, learning disabilities, attention deficit/hyperactivity disorder (ADHD) and impairment of the reproductive organs.

Our government’s failure to mandate rigorous safety testing of chemicals before they come to market is a national and international scandal and a grave threat to the health of children. We as a society need urgently to develop a rational policy on chemical safety, a policy that is founded on a strictly enforced requirement that all chemicals in commerce be tested for safety before they come to market.

On this World Environmental Health Day of 2015 let us reaffirm our commitment to preserve the health of our children and the well-being of future generations by protecting them against toxic chemicals in our environment.


Dr. Landrigan has been a member of the faculty of Mount Sinai School of Medicine since 1985 and served as Chair of the Department of Preventive Medicine from 1990 until July 2015. He is also professor of Pediatrics at Mount Sinai. He was named Dean for Global Health in 2010.

CHE will be hosting a telephone conversation with Dr. Landrigan on September 29th. The call is open to the public.