Patience and Progress

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.

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Honeybees, Children and Cumulative Impacts

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.