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. International 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. Safeguarding 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. The 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.

Reflections on 2009

Elise Miller, MEd
Director

Maybe it’s just me, but it feels like the environmental health train picked up some extraordinary speed in 2009. Starting with the National Academy of Science’s report “Science and Decisions: Advancing Risk Assessment,” which makes recommendations to address the current limitations of risk assessment; moving to the appointments of Dr. Lisa Jackson as the new EPA Administrator and Dr. Linda Birnbaum as the new Director of NIEHS; then to the seminal publication of The Endocrine Society’s statement on the health implications of endocrine disrupting chemicals (EDCs) (and the subsequent resolution on EDCs passed by the American Medical Association); the publication of the “Common Agenda for Health and the Environment‘” by the Lowell Center for Sustainability with input from hundreds of colleagues, offering principles for implementing concrete steps towards a healthier future; Nicholas Kristof’s compelling series of New York Times op-eds focused on EDCs; Administrator Jackson’s consistent message that we must ensure children’s health is at the center of every regulatory and policy decision; the significant push to prioritize the health of vulnerable populations in the climate change discussions; and the increasing momentum on chemical policy reform on state and national levels – to name just a few noteworthy events over the course of the year.

I also want to acknowledge that many of you, our CHE partners, played pivotal roles in these and other remarkable actions and publications this year – often behind the scenes and in understated ways, but with no less potency. And of course, what we see manifesting today is built on decades of courageous and tenacious efforts of those on the front lines of science and on the fence lines of communities.

So what is next? I believe the burgeoning science and reflective discussions in CHE and elsewhere are encouraging us more and more to figure out how to move not only one train faster down a track, but to understand how myriad tracks interact and loop back and join together at different times and in different modalities – in short, to apply complexity theory to ecological health in concrete, effective terms. Taking a systems approach would entail finding meaningful ways to address the fact that, as Michael Lerner, co-founder and Vice Chair of CHE, summarized in a recent e-mail to the CHE Science listserv, “a high number of different endogenous and exogenous factors in and around the human organism encounter different inherited genetic dispositions and different patterns of gene expression so that different people reach the ‘final common pathways’ of different diseases for different combinations of reasons.” We are seeing this in the scientific literature on metabolic syndrome, autism, Alzheimer’s and many other conditions. The task at hand then is to press for restructuring our regulatory system, our food system, our health care system, and our economic system to make health, justice and sustainability the highest priorities — in fact, to make those inalienable rights of current and future generations. Daunting, yes. Impossible, no.

We each are engaged in various aspects of this dynamic system, and we each need to stay focused on our part to ensure its success. At the same time, we need to consistently review our efforts in relationship to the whole. This is nothing new. It just gets harder to do as our understanding of the variables and complexity grows. That said, if we bring our intelligence, creativity and wisdom to our collective conversations and initiatives, we can and will make healthier choices based on the best available science. That is what CHE is all about. In 2010, we invite you to continue to contribute your expertise and insights to our common work.  

Warmest wishes for the holidays and a healthier-than-ever New Year.

Changing the Landscape

Elise Miller, MEd
Director

The American Medical Association (AMA) took an unprecedented action yesterday: It unanimously passed a resolution calling for new policies to decrease public exposure to endocrine disrupting chemicals (EDCs) [read more] based on the Endocrine Society’s seminal scientific statement on EDCs published last summer [read the statement]. Both The Endocrine Society Statement and the AMA’s resolution mark an historical turning point for mainstream medical associations. For the first time, tens of thousands of prestigious health professionals are saying in no uncertain terms:

Exposures to many industrial chemicals are contributing to the epidemic of chronic diseases and disabilities, including diabetes, obesity, learning and developmental disorders, infertility and other reproductive health problems. 

• We have enough science to undertake proactive health measures.
• The risk to public health is too great to wait any longer. 
• We need to act now to implement health protective policies and regulations.

Many CHE partners were involved in catalyzing this remarkable action. We now would like to encourage other health-related professional societies to adopt similar resolutons to signal to national leaders and policymakers that fundamental chemical policy reform can no longer be side-lined. In fact, chemical policy reform is not only integral to health care reform, as I suggested in last month’s CHE e-newsletter, but to climate change as well. EPA Administrator Jackson made this point on Monday in her remarks at the American Public Health Association conference. She announced greenhouse gas emission standards for automobiles, a first for the EPA, saying the limits would mean “less harmful pollution that sends people to the hospital with asthma, heart disease, and any number of other conditions.”

In this context, what if we prioritized these same health-focused principles in climate change decisions across the board? That is, in essence, what CHE organizational partners, the Health and Environmental Alliance (HEAL) and Health Care Without Harm (HCWH), are calling for in a new campaign entitled “Prescription for a Healthy Planet.” To date, protecting public health has been essentially left out of the conversation in international talks on climate change. At the upcoming Copenhagen summit in December, however, we have an opportunity to ensure that children’s health and that of other vulnerable populations are prioritized. As stated in the “Prescription”, “a fair and binding international agreement in Copenhagen means: less global warming, less illness, lower healthcare costs, better health for the world population and a healthier planet.” This sounds promising. But right now very little research and discussion has focused on climate change and health.

What we do know is that children will be the most impacted by climate change. Nine percent of American children already suffer from asthma and those attacks will become more numerous and severe with increased air pollution and ozone levels – and of course, the number of children affected in developing countries, where there may be even less regulation on pollutants, will likely be far higher. In addition, we will be faced with increased exposures to industrial chemicals as recently outlined by the World Health Organization. For example, with more extreme storms and floods, there will be greater runoff of chemicals used in urban and agricultural areas into surface and ground waters. With increased drought, non-volatile chemicals and toxic metals will concentrate and rapidly enter groundwater supplies through parched soil when rain finally comes. In addition, global warming will release chemicals currently trapped in glacial ice, and changing weather patterns will move persistent chemicals through water and air streams in ways previously unanticipated. And this doesn’t even begin to describe other concerns about increased infectious diseases and the challenges of whole populations migrating elsewhere because of rising sea water and less fertile land.

All of this is to say that the AMA and myriad other health professional societies in the US and abroad are essential to figuring out solutions to this thorny nexus of pressing public health issues, namely: chemical policy reform, health care reform and the impact of climate change on human health. Through ongoing efforts to translate the best available science for lay audiences and to incubate strategic health-focused initiatives, I have no doubt CHE partners can continue to change the landscape in which these major decisions – decisions affecting all of us and future generations – are made.

Toward a Sustainable, Health-based Food System

Elise Miller, MEd
Director

Most of us have heard of Michael Pollan’s ‘An Eater’s Manifesto’: “Eat food. Not too much. Mostly plants.” Excellent advice for those of us who are fortunate enough to have a variety of food choices. The challenge of course is that our current industrialized food system (and related sectors such as advertising) encourages us to eat lots of food-like substances and high on the food chain—and for many in inner cities, finding a fresh vegetable, much less an organic one, can be as rare as gold.

In addition to these challenges, hormone disruptors (also known as endocrine disrupting chemicals) are found in everything from the feed given to animals to the pesticides sprayed on crops to the plastic additives in packaging—all of which we end up ingesting. These chemicals are now associated with a range of health concerns, including obesity, diabetes, certain cancers, neurological disorders and reproductive health problems, as the Endocrine Society described in their recent consensus statement. And then there are issues such as the use of antibiotics in food, the importation of foods that aren’t required to meet US standards, and food-borne viruses like e.coli.

The good news is that organizations on national, state and local levels are beginning to press for a health-based food system. For example, the American Medical Association (AMA) recently adopted a policy resolution “in support of practices and policies within health care systems that promote and model a healthy and ecologically sustainable food system.” In addition, the Institute of Medicine (IOM) and The National Research Council (NRC) released a report last week that emphasized the need for local governments to create environments in which people make healthful lifestyle decisions. The statement calls for municipalities to “discourage fast-food restaurants near schools and playgrounds through zoning, provide tax incentives for groceries in underserved areas, and create nutritional standards for government-run after-school programs.” In addition, myriad groups across the country are promoting Community Supported Agriculture (CSAs) and working with local school districts to develop “farm to school” initiatives that would help local farmers as well as improve the quality of the food served in schools.

The question is whether these actions are enough to shift the economy towards a sustainable, health-based food system given the deeply intertwined and diverse set of players involved in the production and marketing of food. In an ecological or systems biology model, all the interacting factors work in concert, each as a complement to the other and each supporting the system as a whole. Right now at the federal level, the Department of Agriculture doesn’t collaborate with the Food and Drug Administration which doesn’t work with Environmental Protection Agency nor the Department of Housing and Urban Development nor the Department of Transportation, and so on—at times, in fact, some of these agencies even work at odds. Then on the local level, public health departments rarely work with school districts or planning commissions, certainly not in regards to the availability of high quality food.

This of course means we need to coordinate these efforts more effectively on every level if we are to improve the health of current and future generations. If you are interested in learning more about these issues and what we can do to address then, please join us on our next CHE Partner call entitled Food Matters: The Impact of Food Systems on Public Health to be held on September 22, 2009.