A Story of Health: Something for Everyone

written by Elise Miller, MEd

We all know there are multiple contributors to health and disease, but let’s say you want to figure out what the latest science says on environmental links to, say, asthma? Or learning disabilities? Or childhood leukemia? Pretty daunting, isn’t it? Which websites have the most evidence-based science? Which articles are accessible without paying a subscription or membership fee? What do those research findings mean for your patients, your family, and community? And many other pressing questions. Most health care professionals can’t begin to keep up with the emerging scientific literature, much less the rest of us.

cover of A Story of HealthFortunately, A Story of Health is a brilliant, innovative new resource that can help you find out how various environments interact with our genes to influence health across the lifespan. Based on the latest peer-reviewed research, it’s more than a bunch of scientific facts thrown together with fancy graphics. It’s a story, or really—multiple, interactive, and interconnected stories that touch us and teach us not only about risk factors for disease, but how to prevent disease and promote health and resilience.

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The Effect of Environmental Chemicals on Insulin Production: Implications for All Types of Diabetes

Sarah Howard
Coordinator of CHE’s Diabetes-Obesity Spectrum Working Group

In a recent review, published in the leading diabetes journal Diabetologia, Hectors et al. (2011) describe how numerous environmental chemicals affect the insulin-producing beta cells of the pancreas. These effects, the authors argue, may be significant in the development of type 2 diabetes. Chemicals like bisphenol A, PCBs, dioxin, organophosphorous pesticides, arsenic, heavy metals, and others, can all affect how the beta cells function, and can interfere with their capacity to secrete insulin.

In type 2 diabetes, both insulin resistance—the body’s inability to respond correctly to insulin—and beta cell malfunction contribute to the disease. The inability of the beta cells to produce enough insulin leads to high blood glucose levels, and eventually diabetes (in many people with type 2, insulin production is higher than normal, to compensate for the insulin resistance—but it is still inadequate to bring blood glucose under control).   

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Get a Grip on Toxic Chemicals

Reps. Doyle and Murphy are well positioned to help protect us

Maureen Swanson
CHE Partner and Director of the Healthy Children Project for the Learning Disabilities Association of America

This letter was originally published in the Pittsburgh Post-Gazette. It’s republished here with the author’s permission.

Imagine all the chemicals used in televisions, computers, upholstery, car seats, building materials, even children’s pajamas. Imagine that some of these chemicals migrate from products into dust and dirt, and build up in our bodies. They are found in the cord blood of newborns and in breast milk. Imagine that these chemicals are similar in structure to the notorious PCBs – carcinogens banned from use in the late 1970s.

Now wouldn’t you also imagine that these chemicals were tested and found to be safe to human health before they were allowed into our products and homes?

Unfortunately, that is not the case.

Polybrominated diphyenyl ethers are flame retardant chemicals that persist in the environment and build up in the food chain and in people. Laboratory studies link exposure to PBDEs with lowered IQ and attention problems. This summer, a study of pregnant women found that those with higher levels of PBDEs had reduced levels of thyroid hormone, which is essential to a baby’s brain development.

But despite growing scientific evidence linking toxic chemical exposures to serious disease and disability, our government does not require that PBDEs – or any of the other 80,000 chemicals on the market – be tested for effects on human health.

That could be about to change, and two Pittsburgh members of Congress are in key positions to help make it happen.

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Brain Tumour Risk in Relation to Mobile Telephone Use: Results of the INTERPHONE International Case–control Study

Stelios A Zinelis
CHE Partner

The Interphone Study Group (2010)1 conducted a study on mobile telephone use has made this conclusion:

“Overall, no increase in risk of glioma or meningioma was observed with the use of mobile phones. There were suggestions of an increased risk of glioma at the highest exposure levels, but biases and errors prevent a causal interpretation.”

This study was completed in 2004, but for unknown reasons, the results were  published six years later, upon demand by scientific organisations such as the European Environment Agency and the European Union (2009)2 (which partially funded the study, along with the International Union against Cancer [Mobile Manufacturers Forum and GSM Association]),  who were concerned about the effects of mobile phone use on public health.

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Dioxin – Scientific Analysis

This letter is reprinted with permission from the Environmental Working Group, a CHE partner. See the original letter with full science analysis on EWG’s website.  

Dr. Timothy Buckley, Chair
Dioxin Review Panel
Science Advisory Board
Environmental Protection Agency (EPA)
Washington, DC

Dear Dr. Buckley,

Twenty-five years after publishing its first assessment of dioxin, a common industrial pollutant and food contaminant, the Environmental Protection Agency (EPA) has yet to establish a safe daily dose for human exposure to this potent chemical.

Dioxin (2,3,7,8-Tetrachlorodibenzo-p-dioxin, also known as 2,3,7,8-TCDD, or TCDD) may well be one of the most-studied of all chemical pollutants. The U.S. National Toxicology Program has listed dioxin as a known human carcinogen since 2001 (NTP 2005), and the U.S. Environmental Protection Agency has proposed to do the same (EPA 2010a). There is a large and persuasive body of research dating from the 1950s showing that dioxin undermines fetal development, damages the reproductive and immune systems and causes severe skin ailments and other disorders.

As U.S. industrial data demonstrate, dioxin is released from municipal waste incinerators; industrial and military hazardous waste treatment facilities; pesticide manufacturing and paper bleaching plants; and a wide range of other industrial processes. In the 1970s, dioxin was identified as a contaminant in Agent Orange, the notorious defoliant deployed by the U.S. during the Vietnam War and blamed for diabetes and other diseases among exposed personnel (Chamie 2008; Cranmer 2000; Gupta 2006).

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Letter to Michelle Obama

March 25, 2010 

First Lady Michelle Obama
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500

Dear Mrs. Obama:
We, the undersigned, are partners in the Collaborative on Health and the Environment, an international network of scientists, health professionals and advocates committed to using the best available science to improve the health of our families and our communities. We are deeply grateful for your leadership in facing the challenge of the obesity epidemic, which has concerned many of us for years. We also strongly support the initiatives that you are undertaking to address this major public health issue, which is having such a devastating effect on the health of American families.

We would like to underscore in this letter that the obesity epidemic is the result of many interacting factors and not just a lifestyle challenge—something that you acknowledge, but is rarely highlighted in the media or understood by the general public. The Institute of Medicine (IOM), for example, has publicly stated the importance of access to healthy food to help curb the increasing prevalence of obesity.[1] Along these lines, it is clear the federal government, given its ability to influence food production through subsidies, needs to incorporate strategies to promote more healthful and less calorie-dense, nutrient-poor food.

Other factors contributing to obesity include socioeconomic status and genetic predisposition, as well as poorly designed communities that discourage walking and biking.

In addition to these issues, the prestigious international Endocrine Society published a seminal report last year stating that, “scientific research implies the impact of environmental substances in the generative roots of obesity.”[2] The rapidly growing body of scientific evidence suggests that chemicals known as endocrine disruptors may be associated with a range of health concerns, including various cancers, developmental disabilities and infertility. In addition, some of these chemicals may also act as “obesogens” – that is, substances that trigger the propensity to develop obesity. Of critical importance, these obesogens appear to reprogram metabolism starting before birth, thereby increasing a child’s predisposition for obesity before he/she is even born. In addition, research shows that these chemicals may also promote the development and maturation of fat cells throughout life. In other words, we cannot ignore the evidence that these chemicals, found in everyday products and in our food and water, may also contribute to this epidemic.

The science on obesogens is very clear in animal studies (please see the attached article in press for the San Francisco Medical Society Journal [available on CHE’s website]). Although we have little information yet about how obesogens impact humans, there is some initial research in humans suggesting the urgent need for further study.[3]

The truth is that we as a society need to recognize all the interacting factors that can contribute to obesity—including the risk that exposures to obesogens can pose. Any campaign that does not take into account the role of these chemicals in the obesity epidemic will run counter to President Obama’s promise that this administration will be guided by the best available science. Given this, the emerging science clearly indicates that national chemical policy reform is an essential ingredient of your campaign against childhood obesity.

We congratulate you on your foresightedness in choosing obesity as one of your signature issues as First Lady. Please know we would also be happy to discuss ways to address the full range of concerns associated with obesity and to work with you and your colleagues to champion prevention as essential to real health care reform for all Americans.

Thank you again for your leadership and consideration.

With best wishes,

Bruce Blumberg, PhD, Professor, Departments of Developmental and Cell Biology and Pharmaceutical Sciences, University of California, Irvine

Susan Braun, Executive Director, Commonweal

Linda C. Guidice, MD, PhD, MSc, Professor and Chair, Department of Obstetrics, Gynecology and Reproductive Science, The Robert B. Jaffe, MD Endowed Professor in the Reproductive Sciences, Director, Center for Research on Origins and Biological Consequences of Human Infertility, Director UCSF Women’s Reproductive Health Research Career Development Center, University of California, San Francisco

Andrea Gore, PhD, Gustavus and Louise Pfeiffer Professor, Division of Pharmacology and Toxicology, The University of Texas, Austin

Richard J. Jackson, MD, MPH, Chair and Professor, Environmental Health Sciences, School of Public Health, University of California, Los Angeles

Phil Landrigan, MD, MSc, Ethel H. Wise Professor and Chairman, Department of Preventive Medicine, Professor of Pediatrics and Director of the Center for Children’s Health and the Environment, Mount Sinai School of Medicine

Philip R. Lee, MD, Former United States Assistant Secretary of Health, Chancellor of the University of California at San Francisco, Professor at Stanford University

Michael Lerner, PhD, President, Commonweal

Elise Miller, MEd, Director, Collaborative on Health and the Environment

John Peterson Myers, PhD, Founder, CEO and Chief Scientist of Environmental Health Sciences

Ted Schettler, MD, MPH, Science Director, Science and Environmental Health Network

Carlos Sonnenschein, MD, Professor, Department of Anatomy and Cellular Biology, Tufts University School of Medicine

Ana Soto, MD, Professor, Department of Anatomy and Cellular Biology, Tufts University School of Medicine

R. Thomas Zoeller, PhD, Chair and Professor, Biology Department, Morrill Science Center

[1] Institute of Medicine reports: The Public Health Effects of Food Deserts. Workshop Summary, Local Government Actions to Prevent Childhood Obesity and Progress in Preventing Childhood Obesity: Focus on Industry—Brief Summary: Institute of Medicine Regional Symposium. Available on the IOM website, http://www.iom.edu/Reports.aspx?search=obesity, viewed March 11, 2010.

[2] Diamanti-Kandarakis E et al. Endocrine-disrupting chemicals: An Endocrine Society Scientific Statement. Endocr Rev. 2009 Jun;30(4):293-342. Available online at http://www.endo-society.org/journals/scientificstatements/, viewed March 11, 2010.

[3] Grün F, Blumberg B. Endocrine disrupters as obesogens. Mol Cell Endocrinol. 2009 May 25;304(1-2):19-29. Heindel JJ, vom Saal FS. Role of nutrition and environmental endocrine disrupting chemicals during the perinatal period on the aetiology of obesity. Mol Cell Endocrinol. 2009 May 25;304(1-2):90-6.

CHE’s Letter to President-Elect Obama

Dear President-Elect Obama:

We write as Partners in the Collaborative on Health and the Environment, a national and international partnership dedicated to protecting the health of our families and communities. Our 3000 Partners include patient group representatives, health professionals, scientists, government officials, environmental health advocates, and citizens from over 48 states and 45 countries.

We provide a respected nonpartisan forum where informed, thoughtful, civil dialogue on health and the environment takes place. We share your dedication to civility and to listening to each other. By our founding mandate, we are prohibited from speaking for all CHE Partners. But we are permitted to convey the shared understanding that has emerged for many of us from six years of intensive dialogue on the implications of the revolution in environmental health sciences for safeguarding human health.

Mr. President, there has been a revolution in environmental health sciences over the past decade. New technologies, new scientific research, and new paradigms of human health and disease have revolutionized our understanding of human health. Indisputably, we face an epidemic of chronic diseases and disorders. Cancer, heart disease, diabetes, metabolic syndrome, obesity, asthma, allergies, learning and developmental disabilities, infertility, neurodegenerative diseases, autoimmune diseases, and many other serious diseases and disorders are epidemic in our time.

There are three core insights from the revolution in environmental health sciences. First, most of these diseases are multifactorial in origin. Second, many begin during fetal and early childhood development. And third, most include among their causes exposures to chemical contaminants, particularly those that persist and bioaccumulate. These contaminants interact with genetic inheritance, gene expression, nutrition, stress, socioeconomic status, and much, much more. We call this the complexity model, or ecological model, of human health. You can call it a multifactorial model just as well. Whatever we call it, few scientists disagree with its main outlines.

The implications of these three core insights from the environmental health science revolution are profound. They bear directly on your administration’s plans for health care reform.

Mr. President, you know our health care system is broken. You want to fix it. You have spoken eloquently of the need to prevent disease. The question we face is HOW to prevent the diseases that are bankrupting our health care system and imposing enormous costs on our economy — to say nothing of their cost in human suffering.

Mr. President, the simple truth is that REAL health promotion and disease prevention requires a national commitment to making our inner and outer environments less toxic and stressful — and richer in nutrients and resilience factors. That is what the multifactorial or ecological model of human health ineluctably implies. What this means is that most of the major policy issues you face — the economy, climate change, health care reform, school reform, food and agriculture and much more — are ultimately your real health promotion and disease prevention policies.

You know that the global financial crisis is unquestionably the single greatest immediate stressor on human health. But to what degree do you recognize how important it is that your policies reduce income disparities, which are the single strongest predictor of disparities in health outcomes? If you want to reduce health care costs, the single most powerful lever to do that is to reduce income disparities and enhance buffers against the stresses of income disparities. The MacArthur Network on Socioeconomic Status and Health is a respected source on this point.

Likewise, you know that climate change is a potentially overwhelming stressor on human health. So your green energy program is not only an economic, national security and environmental priority, as you have said. It is also one of your most important health programs. But to what degree do you recognize that green energy must be accompanied by a commitment to green chemistry and green materials?

Mr. President, it is vital to understand that your chemical management policy will have a profound impact on our health. This is the area in which CHE Partners have the greatest expertise. Chemical contaminants are major contributors to many of the chronic disease epidemics we face. Green energy is necessary but not sufficient to sustaining our health. Green energy, green chemistry, and green materials are all vital components of a health policy that recognizes the implications of the environmental health science revolution and the ecological or multifactorial model of human health.

Beyond green energy, green chemistry and green materials, many of us also share a view that your administration needs to be aware of the health threats of new and emerging technologies. There is increasing concern about the health effects of disrupted electromagnetic fields, biotechnologies and nanotechnologies. Again and again, we have failed to test new technologies for health and safety adequately before loosing them on our citizens and the world.

We cannot expect you to address all of these questions at once, Mr. President. So let us leave you with this summary. Universal health care will fail — it will be far too expensive to sustain — if it is not accompanied by a commitment to real health promotion and disease prevention. The green economy you are committed to creating can only be truly green if it includes green energy, green chemistry, and green materials. That is the path to a just and sustainable country and a just and sustainable world.

Thank you for listening, Mr. President. We wish you well,

Michael Lerner, PhD
Founding CHE Partner

Steve Heilig, MPH
Director of Public Health and Education, San Francisco Medical Society

Génon K. Jensen, MA
Executive Director, Health & Environment Alliance

Philip R. Lee, MD
Chairman, CHE
Professor and Chancellor Emeritus, University of California, San Francisco
Professor of Medicine Emeritus, Stanford University
Former United States Assistant Secretary of Health and Human Services

Elise Miller, MEd
Executive Director, Institute for Children’s Environmental Health

Ted Schettler, MD, MPH
Science Director, Science and Environmental Health Network

Lisette van Vliet, PhD
Toxics Policy Advisor, Health & Environment Alliance