Health Environments for the Next Generation:

Transcription

1 Health Environments for the Next Generation: Before, During & after Pregnancy Collaborative on Health and the Environment

2 Mission To work collaboratively with diverse groups to eliminate harmful environmental exposure effecting children during their most critical development years: pre-conception to age eight. Join Website: Listserve: Northwest Kids Environmental Health Group Meeting: Second Thursday of the month, 9:30 11:30 Location rotates In-person or call-in options

3 Children s Environmental Health 101 Nicole Thomsen, REHS, HHS Public Health Seattle & King County Environmental Public Health Planner Nicole.thomsen@kingcounty.gov

4 Social Justice is a matter of life and death. It affects the way people live, their consequent chance of illness, and their risk of premature death. WHO Commission on Social Determinants of Health

5 What We Know About Health Where People Live 60% Genetics 30% Health Care 10% Source: New England Journal of Medicine, Sept. 2007

6 Children's environmental health" focuses on environmental exposures before, during and after birth, and the resulting health effects.

7 Schettler, T., Reproductive Health NW Children s Environmental Health Forum Available at

8 Developmental windows of susceptibilities Physiological differences Behavioral differences

9 Increased speed of. Myelination Cell division Differentiation Synapse development

10 TEDX The Endocrine Disruption Exchange.

11 Children s physiology, compared to an adult Breathing: Drinking: Surface Area:

12 Children s behavior, compared to an adult Mouthing: Time on ground: Playing:

13 Chemical Contaminants Lead Mercury Environmental tobacco smoke Formaldehyde Polybrominated diphenyl ether (PBDE) Bisphenol A (BPA) Pesticides

14 Health Outcomes Birth defects Reproductive capacity age of menarche, semen quality, menstrual irregularities Infant mortality, pre-term birth Obesity Neurological disorders Endocrine disorders Cancers

15 Cost to children in King County, per birth cohort $177 million 172,000 healthy life-years

16 Live Play Learn

17 Cumulative Exposures Steve Gilbert, PhD, DABT Institute of Neurotoxicology and Neurological Disorders Director & Founder

18 Inheriting The Future Global Warming Burning Coal Coal Waste Mercury from Coal to Fish Nuclear waste Chemical body burden Chemical use Sustainability

19 Implications for Future Generations

20

21 Cumulative exposures vs. Cumulative effects Cumulative exposures Food, chemical/contaminant, built, social environments; multi-level Cumulative effects Health outcomes: increased risk of various adverse pregnancy outcomes; increased risk of chronic diseases; comorbidities From Ted Schettler

22 Dose / Response Risk = Hazard X Exposure Individual Sensitivity

23 The Chemical Data Vacuum 12 or 0.4% good data 21.4% some data 78.2% no data U.S. Environmental Protection Agency. TSCA Chemical Substance Inventory Vogel. S.A. and J.A. Roberts, Why the Toxic Substances Control Act Needs An Overhaul, And How To Strengthen Oversight of Chemicals In The Interim. Health Affairs, (5):

24 Consequences Developmental disabilities: one in six, or about 15%, of children aged 3 through 17 years have a one or more developmental disabilities Learning disabilities: 5-10% of kids in public school ADHD: 5% of all school kids, maybe higher. Approximately 11% of children 4-17 years of age (6.4 million) have been diagnosed with ADHD as of Boyle CA, Boulet S, Schieve L, Cohen RA, Blumberg SJ, Yeargin-Allsopp M, Visser S, Kogan MD. Trends in the Prevalence of Developmental Disabilities in US Children, Pediatrics. 2011; 27:

25 Conditions that ensure that all living things have the best opportunity to reach and maintain their full genetic potential. Steven G. Gilbert, 1999 Gilbert SG. Ethical, legal, and social issues: our children's future. Neurotoxicology. 2005;26:521-30

26 "A thing is right when it tends to preserve the integrity, stability, and beauty of the biotic community. It is wrong when it tends otherwise." Aldo Leopold 1949, A Sand County Almanac

27

28

29 Violent Crime and Blood Lead Levels

30 Blood Lead (ug/dl) Acceptable Childhood Lead Levels CDC 1960 CDC 1973 CDC 1975 CDC 1985 WHO 1986 EPA 1986 CDC 1990 CDC 2012 CDC 20?? Agency and Year

31 PolyBrominated Diphenyl Ether O Br x Br y

32 PBDE s in House Dust (ppb) Environmental Working Group. In the Dust: Toxic Fire Retardants in American Homes

33 PBDE s in Breast Milk (ppb, lipid) Environmental Working Group. Mother's Milk

34 Precautionary Principle 3 days 32 attendees When an activity raises threats of harm to human health or the environment, precautionary measures should be take even if some cause and effect relationships are not fully established scientifically. 1 statement Wingspread Conference, 1998

35 Consensus Statement Setting goals (Health indicators) Taking preventive action in the face of uncertainty Shifting the burden of responsibility to the proponents of an activity (Who benefits?) Exploring a wide range of alternatives to possibly harmful actions (Is it necessary?) Increasing public participation in decision making (transparency of information & environmental justice)

36 Epigenetics Epi, means upon, "above", "in addition to" Epigenetics is the study of changes in gene expression caused by mechanisms other than changes in the genetic (DNA) code

37 Epigenetics

38 Epigenetics Environmental hazards Cigarette smoke Arsenic Alcohol Phthalates Bisphenol A (BPA) Nutiriton Mercury Social and maternal behavior toward child

39 Epiprecaution Moving above or beyond precautionary approach Doing good Loving & supportive environment Doing no Harm is not doing enough Ensure children can reach and maintain their full potential Biological support epigenetics

40 Effective Actions Holly Davies, PhD Washington State Department of Ecology Senior Scientist

41 The American College of Obstetricians and Gynecologists Evidence is sufficiently robust linking toxic environmental agents to reproductive and developmental health outcomes. Reducing exposures is critical. Pre-conception & pre-natal Profound and lasting effects Healthcare providers should provide guidance American College of Obstetricians and Gynecologists. Committee of Health Care for Underserved Women Opinion No Exposures to Toxic Environmental Agents. Obstetrics & Gynecology, (4): 931-5

42 Susan Buchanan, MD, MPH University of Illinois at Chicago School of Public Health nvironmental%20exposure%20history.pdf

43 = Minutes Topics Risk Lead Mercury in fish Pesticide use Endocrine disruptors Am J Obstet Gynecol Dec;207(6): doi: /j.ajog Epub 2012 Feb 14. Environmental exposures: how to counsel preconception and prenatal patients in the clinical setting. Sathyanarayana S 1, Focareta J, Dailey T, Buchanan S.

44

45 Averting toxic exposures and avoiding future costs is the smartest, cheapest and healthiest approach. Safer Alternatives Phase out PBTs Identify Chemicals of Concern Green Chemistry Benign design Kids & environment protected Manufacturers share the responsibility Bans, Limits, Reporting Gather data

46 Ecology s Efforts >>>BANS PBDEs, including deca-bde in certain products Toxics in packaging >>> DATA COLLECTION Children s Safe Product Act reporting rule Bisphenol A in children s bottles/cups, sports bottles Lead in wheel weights Product testing Copper in brake pads, boat paint Coal tar sealants Brake pad law >>> STAKEHOLDER PROCESSES Chemical Action Plans for Persistent, Bioaccumulative Toxics Alternatives assessment guidance Green Chemistry Center

47 Flame Retardants PBDEs (polybrominated diphenyl ethers) PBTs Neurodevelopment and behavior effects, cancer Endocrine disruptor (thyroid hormone) High levels in foam, plastics, textiles House dust and environmental media Advice Reduce exposure to dust- cleaning Purchasing Fish advisory

48 Flame Retardants - Regulation PBDEs Voluntary phase out with EPA ( ) 2006, PBDE chemical action plan (CAP) recommended ban In 2007, Washington passed a law (RCW 70.76) banning the manufacture, distribution, and sale of certain products with PBDEs Exemptions Deca-BDE was prohibited after an alternatives assessment Good compliance Other states also have bans Other flame retardants Sleepwear in the 1970s California TB117 update (2014) Current bill in WA legislature Other state laws (bans, labeling, disclosure) and bills Safer alternatives What are they using instead?

49 Flame Retardants - Alternatives Chlorinated Tris TCEP, TDCPP, TDPP, TCPP, V6 Firemaster 550 HBCD Tetrabromobisphenol A (TBBPA) Polybrominated diphenyl ethanes TPP Other brominated compounds Alternatives Assessments and Green Chemistry

50 Federal Chemical Reform 1976 Toxics Control Substances Act (TSCA) Frank R. Laugtenberg Chemical Safety for the 21 st Century Act Senate and House bills Chemical review by EPA High and low State pre-emption 50

51

52 Governor s Toxics Reduction Package Water Quality rule updating Human Health Criteria Budget Package Toxics Reduction Act Expand the use of CAPs for priority chemicals, including emerging contaminants Prevention of distributed sources Alternatives assessments to avoid regrettable substitutions State purchasing

53 Mission To work collaboratively with diverse groups to eliminate harmful environmental exposure effecting children during their most critical development years: pre-conception to age eight. Join Website: Listserve: Northwest Kids Environmental Health Group Meeting: Second Thursday of the month, 9:30 11:30 Location rotates In-person or call-in options

54 Nicole Thomsen, REHS, HHS Public Health Seattle & King County Environmental Public Health Planner Steve Gilbert, PhD, DABT Institute of Neurotoxicology and Neurological Disorders Director & Founder Holly Davies, PhD Washington State Department of Ecology Senior Scientist