Philip J. Landrigan, MD, MSc, FAAP

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1 Philip J. Landrigan, MD, MSc, FAAP Professor and Chairman, Department of Preventive Medicine Professor of Pediatrics Director, Children s Environmental Health Center Mount Sinai School of Medicine

2 Children s Health and the Environment: Why is this a Time of Crisis? Rates of disease in children are rising. Ever increasing numbers of chemicals are being dispersed into children s environments without adequate testing. These chemicals are showing up in nursing mothers and their children. Evidence is increasing that chemicals in the environment cause disease. It has become painfully clear that we must take intelligent action now if we are to prevent disease in our children, in ourselves, and save our planet.

3 The Estimated Increasing Prevalence Percent Prevalence of Asthma in of the US Asthma by Age and Year, Children <18 All Ages Percent Source: CDC MMWR, October 19, 2007 / 56(SS08);1-14;18-54

4 Source: National Cancer Institute

5 Source: National Cancer Institute Source: National Cancer Institute

6 Annual Prevalence of Male Genital Birth Defects, (per 10,000 live births) Percent Source: CDC s Metropolitan Atlanta Congenital Defects Program (MACDP)

7 Overweight and Obesity Prevalence has nearly quadrupled in American children. 2.5-fold increased risk of overall mortality. 4-fold risk of cardiovascular mortality. 5-fold risk of diabetes. Risk of hypertension, gall bladder disease, and some cancers. Source: Willet et al., New Eng J Med, 1999

8 Developmental Disabilities Affect % of all US children Rates are increasing Dyslexia Learning disabilities Mental retardation ADHD now 14% of US children are diagnosed with ADHD Autism now 9% of US children are diagnosed with Autism Spectrum Disorder (ASD)

9 Evidence is Strong and Increasing that Toxic Chemicals in the Environment Cause Disease in Children

10 Evidence for Environmental Causation of Neurodevelopmental Disorders Lead Methyl Mercury Polychlorinated Biphenyls (PCBs) Organophosphate Pesticides Organochlorine Pesticides Ethyl alcohol Nicotine PBDE s Phthalates PAH Arsenic Manganese Are there others?

11 Are there other developmental neurotoxicants? N=12

12 The Solution What is our Center doing to prevent disease of environmental origin in children? Research Providing medical care for children who have been exposed. Guiding prevention by producing sound evidence. Training the next generation of those who will lead.

13 The Solution What is our Center doing to prevent disease of environmental origin in children? Research. Providing medical care for children who have been exposed. Guiding prevention by producing sound evidence. Training the next generation of those who will lead.

14 Research in the Center The Autism and Learning Disabilities Discovery and Prevention Project Newest project of the Mount Sinai Children s Environmental Health Center. Launched one year ago today. Goal: To discover the environmental causes of autism and learning disabilities in children and then to translate those scientific discoveries into an evidence-based blueprint for prevention. Strategy: To harness new tools in neuroscience as engines for discovery of preventable causes of autism.

15 The Autism and Learning Disabilities Discovery and Prevention Project What have we done? To launch the program, we convened an International Symposium, Exploring the Environmental Causes of Autism and Learning Disabilities on December 8, We have built collaborations with researchers across Mount Sinai - especially in the Seaver Autism Center. We published a major scientific paper showing that prenatal exposure of babies to organophosphate insecticides causes a 3-7 point loss of IQ. We have published papers showing that prenatal exposures to two plastics chemicals - phthalates and Bisphenol A - are linked to ADHD and autism.

Prenatal Exposure to Organophosphate Pesticides Causes IQ Loss Prenatal Exposure to Organophosphates, Paraoxonase 1, and Cognitive Development in Childhood S. Engel, J. Chen, C. Zhu, D. Barr, R.

16 Prenatal Exposure to Organophosphate Pesticides Causes IQ Loss Prenatal Exposure to Organophosphates, Paraoxonase 1, and Cognitive Development in Childhood S. Engel, J. Chen, C. Zhu, D. Barr, R. Canfield, M. Wolff 7-Year Neurodevelopmental Scores and Prenatal Exposure to Chlorpyrifos, a Common Agricultural Pesticide V. Rauh, S. Arunajadai, M. Horton, F. Perera, L.Hoepner, D. Barr, R. Whyatt Prenatal Exposure to Organophosphate Pesticides and IQ in 7-Year Old Children M. Bouchard, J. Chevrier, K. Harley, K. Kogut, M. Vedar, N. Calderon, C. Trujillo, C. Johnson, A. Bradman, D. Barr, B. Eskenazi

17 Prenatal Exposures to Phthalates are linked to ADHD Prenatal phthalate exposure is associated with childhood behavior and executive functioning. SM Engel, A. Miodovnik, RL Canfield, C. Zhu, MJ Silva, AM Calafat, MS Wolff. Environmental Health Perspectives Apr;118 (4):

18 Prenatal Exposures to Phthalates and Bisphenol A are Linked to Autistic Behaviors Endocrine disruptors and childhood social impairment. A. Miodovnik, SM Engel, C. Zhu, LV Soorya, MJ Silva, AM Calafat, MS Wolff. Neurotoxicology Mar;32 (2):261-7.

19 The Autism and Learning Disabilities Discovery and Prevention Project We have developed a list of the 6 most highly suspect chemicals: Organophosphate pesticides DDT Phthalates Bisphenol A Brominated flame retardants Perfluorinated compounds (PFOA and PFOS)

20 The Solution What is our Center doing to prevent disease of environmental origin in children? Research. Providing medical care for children who have been exposed. Guiding prevention by producing sound scientific evidence Training the next generation of those who will lead.

21 Sound Evidence for Prevention Three Major Health Policy Papers Children's Vulnerability to Toxic Chemicals Philip J. Landrigan and Lynn R. Goldman Environmental Disease in Kids Cost $76.6 Billion in 2008 Leonardo Trasande and Yinghua Liu Pollutants and Respiratory Illness in Infants Perry Sheffield, Angkana Roy, Kendrew Wong, Leonardo Trasande

22 Sound Evidence for Presenting Testimony Letters US Congress Philip J. Landrigan Connecticut Legislature Andrea Wershof Schwartz

23 The Solution What will our Center do next to prevent disease of environmental origin in children? The Endocrine Disruptor Discovery Project Introducing Dr. Shanna Swan World class reproductive epidemiologist Expert in studies of endocrine disruptors Our newest faculty member

Introduction to Children s Health and the

Introduction to Children s Health and the Environment Philip J. Landrigan, M.D., M.Sc. Professor of Pediatrics Chair, Department of Preventive Medicine Mount Sinai School of Medicine September 30, 2009