#371: Chemicals And Health--Part 3

=======================Electronic Edition========================
RACHEL'S HAZARDOUS WASTE NEWS #371 
---January 6, 1994---
News and resources for environmental justice.
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P.O. Box 5036, Annapolis, MD 21403
Fax (410) 263-8944; Internet: erf@igc.apc.org
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Several studies of industrial dumps and contaminated water supplies during the last decade have reported adverse health effects among exposed human populations. [1] The principal health findings include:

** Significantly reduced stature (height) for a given age among children who lived near Love Canal, the chemical waste dump in Niagara Falls, N.Y., compared to a control group of children living further from the dump. [2]

** A higher prevalence of birth defects and liver disease among persons living near a thorium waste disposal site in Wayne, New Jersey, compared to persons living further away from the site. [3] (Thorium is a naturally-occurring radioactive element processed on this site by a private firm under contract to the old Atomic Energy Commission, now called the Department of Energy.)

** Low birth weight and birth defects in California children born in census tracts having waste disposal sites. [4]

** Enlargement of the liver (hepatomegaly) and abnormal liver function tests reported in residents exposed to solvents from a toxic waste dump in Hardemann County, Tenn. [5]

** Dermatitis, respiratory irritation, neurologic symptoms and pancreatic cancer at 7 waste disposal sites. [6]

** Significantly elevated rates of illness, including chronic kidney disease, stroke, hypertension [high blood pressure], heart disease, anemia, and skin cancer in a population exposed to toxic metals (cadmium and lead) from mine wastes in Galena, Kansas. [7]

** Leukemia (cancer of the blood-forming cells) among a group of children drinking water contaminated with industrial solvents in Woburn, Mass. In addition, a study of 4936 pregnancies and 5018 residents of Woburn aged 18 or younger revealed significant positive associations between intake of contaminated water and birth defects of the central nervous system, eye, ear, and face (e.g., cleft palate), as well as abnormalities of the chromosomes. [8]

** In Lowell, Mass., a group of 1049 people living 1200 feet from a large chemical waste dump was higher in self-reported complaints of wheezing, shortness of breath, cough, and persistent colds; irregular heart beat; constant fatigue and bowel dysfunction, compared to people living 2 and 3 times as far from the dump. [9] This study examined the possibility of recall bias (people selectively remembering health problems, or chemical exposures) and concluded that recall bias did not explain the findings.

** In Hamilton, Ontario, a study of people who lived and/or worked near an industrial dump revealed significantly elevated rates of the following conditions: bronchitis; difficulty breathing; cough; skin rash; arthritis; heart problems (angina [chest pain], and heart attacks); muscle weakness in arms and legs; tremors, cramps, and spasms; headaches; dizziness; lethargy; balance problems; and mood symptoms (anxiety, depression, insomnia, irritability, and restlessness) compared to populations living further from the site. [10] Recall bias was examined and rejected as the source of these problems.

** A survey of 2039 persons in 606 households living near the Stringfellow Acid Pits in Riverside County, California revealed significantly elevated rates for the following conditions: ear infections; bronchitis; asthma; angina [chest pain]; skin rashes; blurred vision; pain in the ears; daily cough for more than a month; nausea; frequent diarrhea; unsteady gait; and frequent urination. [11] Recall bias was examined and rejected as the cause of these problems.

** In Tucson, Arizona, a study of 707 children born with heart defects revealed that 35% of them were born to parents living in a part of the city where the water supply was contaminated with industrial solvents (trichloroethylene [TCE], and dichloroethylene). The rate of birth defects of the heart was three times as high among people drinking the contaminated water, compared to people in Tucson not drinking contaminated water.[12]

** A study of 296 women experiencing a spontaneous abortion during the first 27 weeks of pregnancy, compared to 1391 women having live births, revealed an association between spontaneous abortion and drinking water contaminants (detectable levels of mercury, or high levels of arsenic, potassium and silica). [13]

** Residents of Bynum, North Carolina, drinking raw river water contaminated by industrial and agricultural chemicals, have developed cancers 2.4 to 2.6 times more often than expected. [14]

To summarize: Epidemiological studies cannot prove a cause and effect relationship. Nevertheless, available information indicates that hazardous waste dumps can harm, and have harmed, humans living nearby. Likewise, contaminated water supplies have harmed people.

The problem of waste dumps is continuing to grow. As the National Research Council of the National Academy of Sciences said in 1991, "A limited number of epidemiologic studies indicate that increased rates of birth defects, spontaneous abortion, neurologic impairment, and cancer have occurred in some residential populations exposed to hazardous wastes. We are concerned that other populations at risk might not have been adequately identified." And the Council said, "Millions of tons of hazardous materials are slowly migrating into groundwater in areas where they could pose problems in the future, even though current risks could be negligible." [15]

There is a move afoot now in Washington, and in the mass media, to divert attention away from the problem of toxic wastes. The goal seems to be to cut funding for the federal Superfund program of toxic waste cleanup. It seems clear that such a move, if successful, will result in increased health costs for the American people.

                                                                         
--Peter Montague, Ph.D.

===============

[1] For a review of several studies, see Arthur C. Upton, Theodore Kneip and Paolo Toniolo, "Public Health Aspects of Toxic Chemical Disposal Sites," ANNUAL REVIEW OF PUBLIC HEALTH Vol. 10 (1989), pgs. 1-25.

[2] Beverly Paigen, Lynn R. Goldman, Mary M. Magnant, Joseph H. Highland, and A.T. Steegman, Jr., "Growth of Children Living Near the Hazardous Waste Site, Love Canal," HUMAN BIOLOGY Vol. 59 (June 1987), pgs. 489-508. See also, Lynn R. Goldman and others, "Low Birth Weight, Prematurity and Birth Defects in Children Living Near the Hazardous Waste Site, Love Canal," HAZARDOUS WASTE AND HAZARDOUS MATERIALS, Vol. 2 (1985), pgs. 209-223; see also Beverly Paigen and others, "Prevalence of Health Problems in Children Living Near Love Canal," HAZARDOUS WASTE AND HAZARDOUS MATERIALS, Vol. 2 (1985), pgs. 23-43. And see: Nicholas J. Vianna and Adele K. Polan, "Incidence of Low Birth Weight Among Love Canal Residents," SCIENCE Vol. 226 No. 4679 (December 7, 1984), pgs. 1217-1219.

[3] G. Reza Najem and Lisa K. Voyce, "Health Effects of a Thorium Waste Disposal Site," AMERICAN 
JOURNAL OF PUBLIC HEALTH Vol. 80 (April 1990), pgs. 478-480.

[4] Agency for Toxic Substances and Disease Registry, U.S. Public Health Service, U.S. Department of Health and Human Services, CALIFORNIA: BIRTH DEFECTS STUDY (Atlanta, Ga.: Agency for Toxic Substances and Disease Registry, 1990). See also: Gary M. Shaw and others, "Congenital Malformations and Birthweight in Areas with Potential Environmental Contamination," ARCHIVES OF ENVIRONMENTAL HEALTH Vol. 47 (March/April 1992), pgs. 147-154, which showed increased risk of malformations of the heart and circulatory system (though not a risk of low birthweight) among children born to California mothers residing in census tracts having waste disposal sites.

[5] Channing R. Meyer, "Liver Dysfunction in Residents Exposed to Leachate from a Toxic Waste Dump," ENVIRONMENTAL HEALTH PERSPECTIVES Vol. 48 (1983), pgs. 9-13.

[6] Barry L. Johnson, "Testimony by Barry L. Johnson, Ph.D., Assistant Surgeon General, Assistant Administrator, U.S. Department of Health and Human Services, Public Health Service, Agency for Toxic Substances and Disease Registry [ATSDR], Before the Subcommittee on Superfund, Recycling, and Solid Waste Management, United States Senate, May 6, 1993," pg. 10, citing various studies by ATSDR.

[7] John S. Neuberger and others, "Health Problems in Galena, Kansas: A Heavy Metal Mining Superfund Site," THE SCIENCE OF THE TOTAL ENVIRONMENT Vol. 94 (1990), pgs. 261-272.

[8] J. Cutler and others, "Childhood Leukemia in Woburn, Massachusetts," PUBLIC HEALTH REPORTS Vol. 101 (1988), pgs. 201-205. See also V.S. Byers, "Association between clinical symptoms and lymphocyte abnormalities in a population with chronic domestic exposure to industrial solvent contaminated domestic water supply and a high incidence of leukaemia." CANCER IMMUNOLOGY AND IMMUNOTHERAPY, Vol. 27 (1988), pgs. 77-81; and: S. W. Lagakos and others, "An Analysis of Contaminated Well Water and Health Effects in Woburn, Massachusetts," JOURNAL OF THE AMERICAN STATISTICAL ASSOCIATION Vol. 81 (1986), pgs. 583-196. Because none of the chemicals in Woburn water were previously known to cause leukemia, the leukemia association was questioned; see B. MacMahon, "Comment on the Article, 'An Analysis of Contaminated Well Water and Health Effects in Woburn, Massachusetts,'" JOURNAL OF THE AMERICAN STATISTICAL ASSOCIATION Vol. 81 (1986), pgs. 597-599.

[9] David Ozonoff and others, "Health Problems Reported by Residents of a Neighborhood Contaminated by a Hazardous Waste Facility," AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Vol. 11 (1987), pgs. 581-597.

[10] Clyde Hertzman and others, "Upper Ottawa Street Landfill Site Health Study," ENVIRONMENTAL HEALTH PERSPECTIVES Vol. 75 (1987), pgs. 173-195.

[11] Dean B. Baker and others, "A Health Study of Two Communites [sic] Near the Stringfellow Waste Disposal Site," ARCHIVES OF ENVIRONMENTAL HEALTH Vol. 43 (Sept./Oct., 1988), pgs. 325-334.

[12] Stanley J. Goldberg and others, "An Association of Human Congenital Cardiac Malformations and Drinking Water Contaminants," JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY Vol. 16, No. 1 (July, 1990), pgs. 155-164. See also: Cleo P. Loeber Mary J. C. Hendrix, Steven Diez De Pinos, and Stanley J. Goldberg, "Trichloroethylene: A Cardiac Teratogen in Developing Chick Embryos," PEDIATRIC RESEARCH Vol. 24 (1988): pgs 740-744. And: Brenda V. Dawson, Paula D. Johnson, Stanley J. Goldberg, and Judith B. Ulreich, "Cardiac Teratogenesis of Trichloroethylene and Dichloroethylene in a Mammalian Model," JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY Vol. 16 (November 1, 1990), pgs. 1304-1309.

[13] Ann Aschengrau and others, "Quality of Community Drinking Water and the Occurrence of Spontaneous Abortion," ARCHIVES OF ENVIRONMENTAL HEALTH Vol. 44 (September/October 1989), pgs. 283-290.

[14] J. Scott Osborne III, Carl M. Shy, and Berton H. Kaplan, "Epidemiologic Analysis of a Reported Cancer Cluster in a Small Rural Population," AMERICAN JOURNAL OF EPIDEMIOLOGY Vol. 132, No.[1] (July 1990), pgs. S87-S95.

[15] Anthony B. Miller and others, ENVIRONMENTAL EPIDEMIOLOGY, VOLUME 1: PUBLIC HEALTH AND HAZARDOUS WASTES (Washington, D.C.: National Academy Press, 1991), pgs. 10, 257.

Descriptor terms: hazardous waste disposal; landfilling; morbidity; mortality; studies; children; growth; love canal; niagara falls; ny; birth defects; liver disease; thorium; wayne; nj; aec; doe; low birth weight; ca; liver disease; hepatomegaly; solvents; hardemann county; tn; dermatitis; neurologic disease; pancreatic cancer; kidney disease; stroke; hypertension; high blood pressure; heart disease; circulatory disease; anemia; skin cancer; cadmium; lead; galena; ks; leukemia; woburn; ma; eye; ear; cns; central nervous system; cleft palate; chromosomes; lowell; respiratory disease; colds; fatigue; cough; bowel disorders; recall bias; hamilton; ontario; cn; bronchitis; skin rash; arthritis; angina; heart attack; tremors; cramps; spasms; headache; dizziness; lethargy; anxiety; depression; incomnia; irritability; restlessness; stringfellow acid pits; asthma; nausea; diarrhea; urination; tucson; az; heart defects; trichloroethylene; dichloroethylene; tce; spontaneous abortion; reproduction; mercury; arsenic; potassium; epidemiology; nrs; nas;

#417: Big-Picture Organizing--Part 1: Some Good News amid the Bad

=======================Electronic Edition========================
RACHEL'S ENVIRONMENT & HEALTH WEEKLY #417
---November 24, 1994---
News and resources for environmental justice.
==========
Environmental Research Foundation
P.O. Box 5036, Annapolis, MD 21403
Fax (410) 263-8944; Internet: erf@igc.apc.org
==========
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========================Original Source========================

First the Good News

Since 1975, grass-roots action at the local level has brought important successes. It was grass-roots action that killed the civilian nuclear power industry in the U.S., principally by making radioactive waste disposal difficult and therefore expensive, and by turning every nuclear power plant into a fight and therefore into a public relations nightmare for its electric-utility owner.

Grass-roots action at the local level crippled the municipal solid waste incinerator industry. Since 1985, 70 incinerators were built, but during the same period at least 280 incinerators were killed. [1]The municipal incinerator industry is on the ropes.

Grass-roots action killed expansion of the industry that buries hazardous wastes in shallow pits in the ground. Since BFI opened the appropriately-named "Last Chance" dump in Colorado in 1991, no new hazardous waste dumps have even been proposed. (After getting a license for its "Last Chance" dump, BFI abandoned the hazardous waste dump business entirely.)

Most importantly, grass-roots action forced the International Joint Commission (IJC) to recommend an entirely new philosophy of chemical regulation --one that assumes chemicals are harmful until proven safe, and one based on the principle of precautionary action. The precautionary principle says that, to avoid irreparable harm to the environment and to human health, wherever it is acknowledged that a practice (or substance) could cause harm, even without conclusive scientific proof that it has caused harm or does cause harm, the practice (or emissions of the substance) should be prevented and eliminated. (U.S. Environmental Protection Agency in 1994 rejected the IJC's recommendations, but the handwriting is on the wall now, officially.) [2]

And Now the Bad

Despite these important successes, chemicals released into the environment are still decimating wildlife, making people sick, and killing people. In this sense, despite thousands of successes in local battles, grass-roots activists are losing the war.

Consider these facts:

** The incidence rates for 5 kinds of cancers are decreasing, but the incidence rates for 19 kinds of cancer are steadily increasing. The death rates for 12 kinds of cancer are dropping, but the deaths rates for 12 other cancers continue to rise. [3] Among the fastest-growing is breast cancer. In 1960, a woman's chance of getting breast cancer was 1 in 20; today it is 1 in 9, moving toward 1 in 8.

** Increasingly, couples in their prime child-bearing years are sterile; this may be due in part to a 53% decline in sperm count that has been documented among men in all industrialized countries over the past 50 years, a decline that is apparently continuing. [4]

** Ectopic pregnancy rates have quadrupled in the last 20 years. [5] An ectopic pregnancy is one that occurs outside the uterus, in one of the fallopian tubes; if not treated, such a pregnancy is fatal to the mother. Even when treated properly, it can result in sterility.

** The prevalence of endometriosis (a painful disease of the tissues lining the uterus, which often results in sterility) is steadily increasing and now afflicts somewhere between 5 and 9 million American women; [6]

** Immune system disorders (such as asthma and diabetes) are increasing. In 1990 the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (JAMA) observed that death rates from asthma have been increasing in the U.S., Canada, England, France, Denmark and Germany. [7] Other sources report increasing death rates from asthma in Wales and Australia. [8] In the U.S., the increase has been rapid. Asthma death rates increased 31% between 1980 and 1987 (from 1.3 per 100,000 population to 1.7 per 100,000). The biggest increase occurred among children between the ages of 5 and 15.

The prevalence of asthma is also increasing, especially among young children. Among children ages 6 to 11, the prevalence of asthma increased from 4.8% in 1971-74 to 7.6% in 1976-1980, a 58% increase in a short period. More recent studies indicate that the increases are continuing.

Another immune system disease, diabetes, is also increasing rapidly in the U.S. The prevalence of IDDM (insulin-dependent diabetes mellitus, also called Type I diabetes) doubled between 1964 and 1981. [9] A 1993 study says, "[W]e are undergoing an epidemic of IDDM with the rapid increase in the number of cases seen recently." [10]

** The prevalence of nervous system disorders (Lou Gehrig's disease, and Parkinson's disease) is increasing; [11]

** A new disease has emerged called "multiple chemical sensitivity," characterized by extreme sensitivity to low levels of various chemicals, sometimes including odors from new carpets, perfumes, and the fragrances in commercial products such as waxes and detergents. Paints and solvents can set off an allergic-type reaction. Symptoms of MCS range in severity from an itchy rash to coma. An estimated 10% to 15% of the U.S. population now suffers from this disease in one form or another, and the prevalence appears to be rising. [12]

** Birth defect rates are steadily increasing. The federal Centers for Disease Control in 1990 summarized the trends in 38 types of birth defects; they found 29 increasing, 2 decreasing, and 7 remaining unchanged. [13]

** Eight studies of air pollution in U.S. cities have now shown that fine particles (the invisible soot emitted by incinerators, automobiles, power plants and heating units) are presently killing about 60,000 Americans each year. [14] More than a dozen studies have, in one way or another, confirmed this relationship. Furthermore, there appears to be no threshold, no level below which effects disappear. This means that people are being killed by air pollution levels well within existing federal standards.

** In 1990, the American Public Health Association (APHA) estimated that each year 50,000 to 70,000 Americans die of diseases developed from toxic exposures on the job. Furthermore, APHA estimated that 350,000 new cases of occupational disease develop each year from toxic exposures. [15]

Good News Amid the Bad

It seems clear that the opportunity is ripe, and steadily growing, for a major political organizing campaign with health as the centerpiece. Everyone cares about their health and the health of their children. A health-centered organizing campaign offers a clear entryway into the much larger question, "What has gone wrong with America?" Addressing this question would require what we call "Big-Picture Organizing."

[To be continued.] #419

 --Peter Montague

===============

[1] Ellen Connett, "Since the 1980's a Minimum of 280 Proposals to Build Municipal Waste Incinerators in the U.S. Have Been Defeated or Abandoned," WASTE NOT #283 [from: Work On Waste, U.S.A., 82 Judson St., Canton, N.Y. 13617: phone 315/379-9200] (July 1994), pg. 1. The 280 figure is an underestimate; several incinerators have been defeated since July 1994, according to Ellen Connett, personal communication to Maria Pellerano November 22, 1994.

[2] See Peter Montague, "Our Greatest Accomplishment: Grass-roots Action has Forced a Major Shift in Thinking," THE WORKBOOK [from: Southwest Research and Information Center, P.O. Box 4524, Albuquerque, N.M. 87106; phone 505/ 262-1862.] Vol. 19, No. 2 (Summer 1994), pgs. 86-90.

[3] Incidence rate means occurrence of cancer per 100,000 population, age-adjusted; death rate means deaths from cancer per 100,000 population, age-adjusted. The 5 cancers with decreasing incidence are mouth and pharynx; uterus; stomach; cervix; and esophagus. The 18 cancers with increasing incidence are: colon/rectum; larynx; testicles; bladder; Hodgkin's; childhood cancers; leukemia; thyroid; liver; pancreas; ovaries; lung; skin; female breast; prostate; kidney; brain; non-Hodgkin's lymphoma; and multiple myeloma. Death rates are dropping for mouth and pharynx; uterus; stomach; cervix; colon/rectum; larynx; testicles; bladder; Hodgkin's; childhood cancers; leukemia; and thyroid. Death rates are increasing for esophagus; liver; pancreas; ovaries; lung; skin; female breast; prostate; kidney; brain; non-Hodgkin's lymphoma; and multiple myeloma. Source of information: Barry A. Miller and others, editors, CANCER STATISTICS REVIEW 1973-1990 [National Institutes of Health Publication No. 93-2789] (Bethesda, Md.: National Cancer Institute, 1993), Table I-3, pg. I.[27].

[4] Increasing infertility among Americans in their prime reproductive years is discussed in Appendix A, "Reproductive Dysfunction in the Population," pgs. 341-346, in Office of Technology Assessment, REPRODUCTIVE HEALTH HAZARDS IN THE WORKPLACE [OTA-BA-266] (Washington, D.C.: U.S. Government Printing Office, December, 1985).

[5] Increases in ectopic pregnancies are documented in MMWR [Morbidity and Mortality Weekly Report] CDC SURVEILLANCE SUMMARIES Vol. 39 No. SS-4 (December, 1990), pgs. 9-19.

[6] David E. Larson, editor, MAYO CLINIC FAMILY HEALTH BOOK (N.Y.: William Morrow, 1990), pgs. 1101-1102. Sherry E. Rier and others, "Endometriosis in Rhesus Monkeys (Macaca mulatta) Following Chronic Exposure to 2,3,7,8-Tetrachlorodibenzo-P-dioxin," FUNDAMEN-TAL AND APPLIED TOXICOLOGY Vol. 21 (1993), pgs. 433-441.

[7] A. Sonia Buist and William M. Vollmer, "Reflections on the Rise in Asthma Morbidity and Mortality," JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION October 3, 1990, pgs. 1719-1720. Kevin B. Weiss and Diana K. Wagener, "Changing Patterns of Asthma Mortality," JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Vol. 264 (1990), pgs. 1683-1687.

[8] Peter J. Gergen and others, "National Survey of the Prevalence of Asthma Among Children in the United States, 1976 to 1980," PEDIATRICS Vol. 81 (1988), pgs. 1-7.

[9] National Diabetes Data Group, DIABETES IN AMERICA [NIH Publication No. 85-1468] (no place of publication [Bethesda, Md.?]: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases, August 1985), Table 2, pgs. VI-4, VI-5.

[10] Ingrid Libman and others, "How Many People in the U.S. Have IDDM [insulin-dependent diabetes mellitus]?" DIABETES CARE Vol. 16, No. 5 [May 1993], pgs. 841-842.

[11] Increases in Parkinson's disease and in amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease) are documented in Office of Technology Assessment, NEUROTOXICITY; IDENTIFYING AND CONTROLLING POISONS OF THE NERVOUS SYSTEM [OTA-BA-436] (Washington, D.C.: U.S. Government Printing Office, April, 1990); see Figures 2-2 and 2-3 on pg. 55.

[12] See Board on Environmental Studies and Toxicology, National Research Council, MULTIPLE CHEMICAL SENSITIVITIES (Washington, D.C.: National Academy Press, 1992). Multiple chemical sensitivity afflicts 10% to 15% of the American public, and appears to be increasing, says Bette Hileman, "Multiple Chemical Sensitivity," C&EN [Chemical & Engineering News] Vol. 69 No. 29 (July 22, 1991), pg. 34. This emerging disease has been subject of two excellent book-length studies: In 1990 the New Jersey Department of Health published a report by Nicholas Ashford and Claudia Miller, CHEMICAL SENSITIVITY, which is distributed by National Center for Environmental Health Strategies (NCEHS), 1100 Rural Ave., Voorhees, NJ 08043; phone (609) 429-5358. $17.00. See also Nicholas Ashford and Claudia Miller, CHEMICAL EXPOSURES: LOW LEVELS AND HIGH STAKES (New York: Van Nostrand Reinhold, 1990).

[13] Larry D. Edmonds and others, "Temporal Trends in the Prevalence of Congenital Malformations at 
Birth Based on the Birth Defects Monitoring Program, United States, 1979-1987," MMWR [Morbidity and Mortality Weekly Report] CDC SURVEILLANCE SUMMARIES Vol. 39, No. SS-4 (December 1990), pg. 22.

[14] Seven studies are reviewed by Joel Schwartz, "Particulate Air Pollution and Daily Mortality: A Synthesis," PUBLIC HEALTH REVIEWS 1991/1992 Vol. 19 (1992), pgs. 39-60. The 8th is Douglas Dockery and others, "An Association Between Air Pollution and Mortality in Six U.S. Cities," NEW ENGLAND JOURNAL OF MEDICINE Vol. 329 (1993), pgs. 1753-1759; see also pgs. 1807-1808. The 60,000 figure is taken from "Air Pollution in Typical U.S. Cities Increases Death Risk," press release dated May 13, 1991, from the Harvard School of Public Health, Boston, Mass. describing findings later reported in Joel Schwartz and Douglas W. Dockery, "Increased Mortality in Philadelphia Associated With Daily Air Pollution Concentrations," AMERICAN REVIEW OF RESPIRATORY DISEASE Vol. 145 (1992), pgs. 600-604. Two million deaths occur in the U.S. each year; according to Schwartz and Dockery, fine particles account for 3%.

[15] Philip J. Landrigan, "Commentary: Environmental Disease--A Preventable Epidemic," AMERICAN JOURNAL OF PUBLIC HEALTH Vol. 82 (July 1992), pgs. 941-943.

Descriptor terms: grass-roots citizen action; civilian nuclear power; municipal solid waste incineration; msw; landfilling; dumps; hazardous waste; ijc; regulation; reverse onus; burden of proof; precautionary principle; principle of precationary action; wildlife; human health; morbidity; mortality; studies; statistics; cancer; breast cancer; sterility; reproductive disorders; ectopic pregnancies; tubal pregnancies; endometriosis; immune system disorders; diabetes mellitus; type I diabetes; asthma; nervous system disorders; lou gehrig's disease; amyotrophic lateral sclerosis; parkinson's disease; multiple chemical sensitivity; mcs; birth defects; air pollution; fine particles; apha; american public health association; occupational safety and health;

#411: Birth Defects -- Part 2: Why Birth Defects Will Continue To Rise

=======================Electronic Edition========================
RACHEL'S ENVIRONMENT & HEALTH WEEKLY #411
---October 13, 1994; revised October 16, 1994---
News and resources for environmental justice.
==========
Environmental Research Foundation
P.O. Box 5036, Annapolis, MD 21403
Fax (410) 263-8944; Internet: erf@igc.apc.org
==========
RACHEL-4CM = DIOXIN FOCUSED DIRECTORY Remote Access Chemical Hazards Electronic Library. Dioxinnz.com
========================Original Source========================

Last week#410  we saw that 30 types of birth defects are increasing steadily in the United States, some increasingly rapidly, others more slowly. Some of these increases are due to better diagnosis; however, many of the increases are real. This week we examine 10 reasons why birth defects are rising and will almost certainly continue to rise.

There is abundant scientific evidence that birth defects in laboratory animals and in humans have occurred as a result of exposure to five classes of pollutants: radiation; [1-2] pesticides; [3-9] metals (including mercury, cadmium, lead, and others); [10-14] solvents; [15-23] and dioxin-like chemicals including PCBs [polychlorinated biphenyls]. [24-27] From studies of pharmaceutical drugs found to cause birth defects, it is certain that other chemicals are teratogens (causing birth defects) as well. [28]

Because municipal landfills and toxic waste dumps are laced with pesticides, toxic metals, solvents, dioxin-like compounds, and sometimes even radioactive materials, at least seven studies have now reported finding unusually high numbers of birth defects in children born to parents residing near dumps. [29-35]

** The main reason why birth defects will continue to increase is that more than 500 new chemicals are introduced into commercial use each year. There will never be enough money available for independent scientists to conduct definitive (or even adequate) studies of all these chemicals to see if they cause birth defects in laboratory animals. For ethical reasons, chemicals cannot be tested in any organized way on humans (though, contrarily, most Americans don't object to the experimental exposures that occur routinely in the workplace, and in the home via consumer products). In addition to 500 new chemicals appearing each year, more than 50,000 chemicals already in commercial use have never been tested for their ability to cause birth defects.

** The prevailing American philosophy is that chemicals are innocent until proven guilty. Therefore, when new chemicals are released into the environment, the burden of proof rests on the general public to show that damage has occurred before scientific studies are undertaken to describe the damage in detail. This philosophy guarantees that people MUST BE HARMED before study can begin.

** Scientific studies can take years to complete. Even when an effect is grossly obvious, pinning down the cause can take a decade or longer. For example, mercury poisoned dozens of babies in the womb at Minamata, Japan, in 1955 but scientists did not clearly establish the cause for 15 to 18 years. [11]

** After research scientists are convinced, there is a long delay before the general public learns the facts, if it ever does. (As an anti-environmental viewpoint comes to dominate major media, such as the NEW YORK TIMES, LOS ANGELES TIMES, and 20/20 on ABC-TV, in many cases new information simply never gets widely disseminated).

** Furthermore, the results of studies may not be clear-cut, for many reasons: it is difficult to measure exposure so usually a "surrogate" for exposure is used, such as place of residence, or occupation; many birth defect studies rely upon mothers recalling what chemical exposures occurred during their early months of pregnancy and all such recollections are dubious; therefore it is difficult to absolutely rule out many possible causes of an observed effect.

** A society that demands scientific certainty before it will restrict the use of suspected teratogens, guarantees that the rate of birth defects will continue rising. Scientific certainty about anything involving humans is, and will remain, elusive and rare.

** Given the philosophical climate, public health officials are reluctant to raise an alarm on less-than-100%-certain data. As a practical matter, an official will get in much more trouble for raising a false alarm about a suspected chemical than for making the opposite error (which allows birth defects to continue). In the present philosophical climate (requiring scientific certainty), even well-justified alarm based on less-than-certain data draws an angry response from powerful monied interests. On the other hand, allowing birth defects to continue will only affect one family at a time. Individual, unorganized victims do not threaten a public health official's job security. [36]

** When studies reveal that a particular chemical probably causes birth defects, the producers and users of the chemical typically conduct a lengthy campaign to deny and obscure what is known. For example, the lead industry has known for at least 100 years that lead causes reproductive and developmental disorders in humans. But starting in 1925 medical doctors hired by the lead industry argued that lead occurs naturally in the human body and, therefore, the dangers of lead in gasoline were not worth worrying about, much less studying. This strategy was persuasive to the public health community for 40 years. [37]

** The public health community relies almost exclusively on a decision-making technique that cannot take into account multiple exposures and cumulative effects, a technique called "risk assessment." (See RHWN #393, #394, #395.) At its best, risk assessment can provide a ballpark guesstimate of a few of the many hazards created by a single toxic chemical. However in real life we are all exposed to multiple chemicals all the time, and risk assessment cannot account for cumulative effects and multiple interactions. Heavy reliance upon such an unrealistic tool for decision-making leads to decisions that harm public health.

** Finally, even the knowledgeable environmental community fails to fully adopt the clear requirements of a public health policy based on prevention of disease: persistent toxic pollutants must be banned. Recently when Environmental Defense Fund (EDF) and Physicians for Social Responsibility (PSR), followed separately by Greenpeace, published their recommendations for public policy on dioxin, they all argued that 

U.S. dioxin policy should be modeled on U.S Environmental Protection Agency's lead policy. [38] (Greenpeace set a goal of zero dioxins, but recommended the lead policy as a way to get there.) Over the last 20 years EPA's lead policy has forced a mere 8% reduction in total U.S. "consumption" of lead. At this rate it will take 3500 years for lead "consumption" to fall below 1000 pounds per year and thus disappear as a public health problem.

 --Peter Montague

===============

[1] Niel Wald, "Evaluation of Human Exposure Data," in K.Z. Morgan and J.E. Turner, editors, PRINCIPLES OF RADIATION PROTECTION; A TEXTBOOK OF HEALTH PHYSICS (Huntington, N.Y.: Robert E. Krieger Publishing, 1973), pgs. 448-496.

[2] John W. Gofman, RADIATION AND HUMAN HEALTH (San Francisco: Sierra Club, 1981); see chapter 21.

[3] Anne Kricker and others, "Women and the environment: a study of congenital limb anomalies," COMMUNITY HEALTH STUDIES Vol. 10, No. 1 (1986), pgs. 1-11.

[4] M. Restrepo and others, "Prevalence of adverse reproductive outcomes in a population occupationally exposed to pesticides in Colombia," SCANDINAVIAN JOURNAL OF WORK, ENVIRONMENT AND HEALTH Vol. 16 (1990), pgs. 232-238.

[5] P. Rita and others, "Monitoring of Workers Occupationally Exposed to Pesticides in Grape Gardens of Andhra Pradesh," ENVIRONMENTAL RESEARCH Vol. 44 (1987), pgs. 1-5.

[6] David A. Schwartz and others, "Congenital Limb Reduction Defects in the Agricultural Setting," AMERICAN JOURNAL OF PUBLIC HEALTH Vol. 78, No. 6 (June 1988), pgs. 654-658.

[7] D.A. Schwartz and others, "Parental occupation and birth outcomes in an agricultural community," SCANDINAVIAN JOURNAL OF WORK, ENVIRONMENT AND HEALTH Vol. 12, No. 1 (February 1986), pgs. 51-54.

[8] T.E. Taha and R.H. Gray, "Agricultural pesticide exposure and perinatal mortality in central Sudan," BULLETIN OF THE WORLD HEALTH ORGANIZATION Vol. 71 (1993), pgs. 317-321.

[9] Jun Zhang and others, "Occupational Hazards and Pregnancy Outcomes," AMERICAN JOURNAL OF INDUSTRIAL MEDICINE Vol. 21 (1992), pgs. 397-408.

[10] Thomas W. Clarkson and others, "Reproductive and developmental toxicity of metals," SCANDINAVIAN JOURNAL OF WORK, ENVIRONMENT AND HEALTH Vol. 11 (1985), pgs. 145-154.

[11] Masazumi Harada, "Congenital Minamata Disease: Intrauterine Methylmercury Poisoning," TERATOLOGY Vol. 18 (1978), pgs. 285-288.

[12] H.A. Ragan and T.J. Mast, "Cadmium Inhalation and Male Reproductive Toxicity," REVIEWS OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY Vol. 114 (1990), pgs. 1-22.
[13] Petter Kristensen and others, "Perinatal Outcome among Children of Men Exposed to Lead and Organic Solvents in the Printing Industry," AMERICAN JOURNAL OF EPIDEMIOLOGY Vol. 137, No. 2 (1993), pgs. 134-144.

[14] D.G. Wibberley and others, "Lead levels in human placentae from normal and malformed births," JOURNAL OF MEDICAL GENETICS, Vol. 14, No. 5 (October 1977), pgs. 339-345.

[15] Jorma Tikkanen and Ollie P. Heinonen, "Cardiovascular Malformations and Organic Solvent Exposure During Pregnancy in Finland," AMERICAN JOURNAL OF INDUSTRIAL MEDICINE Vol. 14 (1988), pgs. 1-8.

[16] Gary M. Shaw, "Maternal Workplace Exposures to Organic Solvents and Congenital Cardiac Anomalies," JOURNAL OF OCCUPATIONAL MEDICINE AND TOXICOLOGY, Vol. 1, No. 4 (1992), pgs. 371-376.

[17] Andrew F. Olshan and others, "Paternal Occupation and Congenital Anomalies in Offspring," AMERICAN JOURNAL OF INDUSTRIAL MEDICINE Vol. 20 (October 1991), pgs. 447-475.

[18] C. Loffredo and others, "Organic solvents and cardiovascular malformations in the Baltimore-Washington Infant Study [abstract]," TERATOLOGY Vol. 43 (May 1991), pg. 450. 

[19] Evert Hansson and others, "Pregnancy outcome in women working in laboratories in some of the pharmaceutical industries in Sweden," SCANDINAVIAN JOURNAL OF WORK, ENVIRONMENT AND HEALTH Vol. 6 (1980), pgs. 131-134.

[20] Stanley J. Goldberg and others, "An Association of Human Congenital Cardiac Malformations and Drinking Water Contaminants," JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY Vol. 16, No. 1 (July, 1990), pgs. 155-164.

[21] Anders Ericson and others, "Delivery Outcome of Women Working in Laboratories During Pregnancy," ARCHIVES OF ENVIRONMENTAL HEALTH Vol. 39, No. 1 (1984), pgs. 5-10.

[22] Sylvaine Cordier and others, "Maternal occupational exposure and congenital malformations," SCANDINAVIAN JOURNAL OF WORK, ENVIRONMENT AND HEALTH Vol. 18, No. 1 (February 1992), pgs. 11-17.

[23] Urban Blomqvist and others, "Delivery outcome for women working in the pulp and paper industry," SCANDINAVIAN JOURNAL OF WORK, ENVIRONMENT AND HEALTH Vol. 7, No. 2 (1981), pgs. 114-118.

[24] Hugh A. Tilson and others, "Polychlorinated Biphenyls and the Developing Nervous System: Cross-Species Comparisons," NEUROTOXICOLOGY AND TERATOLOGY Vol. 12 (1990), pgs. 239-248.

[25] Joseph L. Jacobson and others, "Effects of in utero exposure to polychlorinated biphenyls and related contaminants on cognitive functioning in young children," JOURNAL OF PEDIATRICS Vol. 116 (January, 1990), pgs. 38-45.

[26] Joseph L. Jacobson and others, "Effects of Exposure to PCBs and Related Compounds on Growth and Activity in Children," NEUROTOXICOLOGY AND TERATOLOGY Vol. 12 (1990), pgs. 319-326.

[27] Richard A. Albanese, UNITED STATES AIR FORCE PERSONNEL AND EXPOSURE TO HERBICIDE ORANGE, INTERIM REPORT FOR PERIOD MARCH 1984-FEBRUARY 1988 (United States Air Force: Brooks Air Force Base, Texas, Feb., 1988).

[28] Muin J. Khoury, "Epidemiology of Birth Defects," EPIDEMIOLOGIC REVIEWS Vol. 11 (1989), pgs. 244-248.

[29] L. Goulet and M. Goldberg, "Reproductive Outcomes among Women Living Near a Sanitary Landfill Site in Montreal, Quebec, Canada, 1979-1989 [abstract]," AMERICAN JOURNAL OF EPIDEMIOLOGY Vol. 138, No. 8 (1993), pg. 587.

[30] G. Shaw and others, "Congenital Malformations and Birthweight in Areas with Potential Environmental Contamination," ARCHIVES OF ENVIRONMENTAL HEALTH Vol. 47, No. 2 (March/April 1992), pgs. 147-154.

[31] Agency for Toxic Substances and Disease Registry, U.S. Public Health Service, U.S. Department of Health and Human Services, CALIFORNIA: BIRTH DEFECTS STUDY (Atlanta, Ga.: Agency for Toxic Substances and Disease Registry, 1990).

[32] G. Reza Najem and Lisa K. Voyce, "Health Effects of a Thorium Waste Disposal Site," AMERICAN JOURNAL OF PUBLIC HEALTH Vol. 80 (April 1990), pgs. 478-480.

[33] Nicholas J. Vianna and Adele K. Polan, "Incidence of Low Birth Weight Among Love Canal Residents," SCIENCE Vol. 226, No. 4679 (December 7, 1984), pgs. 1217-1219.

[34] Lynn R. Goldman and others, "Low Birth Weight, Prematurity and Birth Defects in Children Living Near the Hazardous Waste Site, Love Canal." HAZARDOUS WASTE & HAZARDOUS MATERIALS Vol. 2 No. 2 (1985), pgs. 209-223.

[35] Lawrence Budnick, and others. "Cancer and Birth Defects Near the Drake Superfund Site, Pennsylvania," ARCHIVES OF ENVIRONMENTAL HEALTH, Vol. 39, No. 6 (November/December, 1984), pgs. 409-413.

[36] David Ozonoff and Leslie I. Boden, "Truth and Consequences: Health Agency Responses to Environmental Health Problems," SCIENCE, TECHNOLOGY & HUMAN VALUES Vol. 12 Nos. 3 & 4 (Summer/Fall 1987), pgs. 70-77. In statistical terms, public health officials will get in less trouble for making a Type I error than a Type II error. Therefore, experiments are often designed to favor avoidance of Type I errors rather than Type II errors.

[37] Alan Loeb, "The First Federal Environmental Review: Its Long-Term Consequences," INTERNATIONAL SOCIETY OF EXPOSURE ANALYSIS NEWSLETTER (Fall 1993), pg. 3.

[38] Julia Moore and others, PUTTING THE LID ON DIOXINS (Washington, D.C.: Physicians for Social Responsibility, 1994); Joe Thornton, ACHIEVING ZERO DIOXIN (Washington, D.C.: Greenpeace, 1994). PSR and EDF failed to call for real prevention; instead they advocated that the major source of dioxin emissions (incinerators) be operated "at optimal conditions" rather than be shut down or phased out.

Descriptor terms: birth defects; congenital anomalies; radiation; pesticides; mercury; lead; cadmium; pcbs; dioxin; landfilling; minamata; japan; ny times; los angeles times; 20/20; tv; television; journalism; news media;

#410: Birth Defects -- Part 1

=======================Electronic Edition========================
RACHEL'S ENVIRONMENT & HEALTH WEEKLY #410
---October 6, 1994---
News and resources for environmental justice.
==========
Environmental Research Foundation
P.O. Box 5036, Annapolis, MD 21403
Fax (410) 263-8944; Internet: erf@igc.apc.org
==========
RACHEL-4CM = DIOXIN FOCUSED DIRECTORY Remote Access Chemical Hazards Electronic Library. Dioxinnz.com
========================Original Source========================

The Birth Defects Monitoring Program (BDMP) is a U.S. government effort to monitor birth defects (congenital malformations) using data collected when newborn infants are discharged from the hospital. [1] The BDMP was initiated by the federal Centers for Disease Control (CDC) in 1974. The current BDMP database includes information on roughly 15 million births that have occurred at 1200 predominantly mid-sized community hospitals in the U.S. during the past 20 years.

The BDMP database is not comprehensive (it does not include information on every birth that occurs in the U.S.). Neither does it represent a randomly-selected sample of all U.S. births; therefore data from the BDMP cannot be considered representative of the entire "universe" of all U.S. newborns. In 1987 the BDMP received information on 15% of all U.S. births, which gives an idea of how comprehensive the coverage is. Because the data are mostly from mid-sized hospitals, we might expect that some of the largest hospitals in the largest cities are under-represented. Nevertheless, as the CDC says, the BDMP "represents the largest single set of uniformly collected and coded discharge data on congenital malformations in the United States." It is simply the best information available on birth defects in the U.S.

CDC says that the BDMP "functions primarily as an early warning system; however it can be useful also for correlating incidence [occurrence] patterns with such trends as the temporal [time-related] and geographic distribution of drugs, chemicals, and other possible human teratogens." A teratogen (from the Greek words meaning "monster producing") is anything that causes birth defects. Examples of teratogens are diseases such as German measles; infections; inherited genetic defects; radiation; and certain chemicals.

In 1990, researchers looked for trends in the BDMP database, examining records for 38 types of birth defects from 1979-80 through 1986-87. During this 7-year period, of the 38 types of birth defects, 29 increased; 2 decreased; and 7 remained stable (meaning they changed less than 2% per year during the 7-year period.)

Table 1 shows the annual percent change for 30 types of birth defects. All of them increased during the 7-year period (though some increased at a rate less than 2% per year, and are thus classified as "stable" by the CDC).

Table 1 contains 3 columns of numbers. The first two columns show the actual number of birth defects per 10,000 births; the first column shows data for the earlier period, 1979-80; the second column shows the later period, 1986-87. The third column shows the yearly percentage increase during the 7-year period.

Some of these increases are explained by better health care and better diagnosis. For example, some of the heart defects listed in Table 1 are so serious that an infant might not have survived such a defect 10 years ago but might survive it today. Likewise, some of the heart defects might be revealed by high-tech medical diagnostic machines today, whereas they might have gone unnoticed 10 years ago.

However, many of the increases in birth defects in Table 1 cannot be explained by better health care or better diagnosis. If a child were born 10 years ago with the iris missing from one or both of its eyes, chances are good that the mother or her doctor or a nurse would see it. (The iris is the part of the eye that makes blue eyes blue and brown eyes brown.) So the 5.2% ANNUAL INCREASE in "aniridia" (absence of an iris) is very likely a real increase.

The same can be said for birth defects of the central nervous system, facial clefts, musculoskeletal defects and some of the gastrointestinal and genitourinary defects. Most of these defects are so obvious that they would have been noticed as easily 10 years ago as today. Therefore, increases in these defects are very likely real increases.

Some of the increases shown in Table 1 are surprisingly large. For example, coloboma of the eye increased 9.6% each year during the 7-year period; this means the occurrence of this defect doubled during the study period. (Coloboma of the eye means a wedge-shaped piece is missing from the iris, or some other part of the eye is missing.) Other eye disorders (congenital cataract, for example) are increasing about 5% each year, thus doubling every 14 years. (The relationship of annually-increasing quantities to the doubling time was detailed in RHWN #197 and #199.)

Are most birth defects caused by the parents' genetic characteristics, or by something in the environment?

In July of this year an important study of birth defects in Norway appeared in the NEW ENGLAND JOURNAL OF MEDICINE. [2] It indicated that environmental factors may be more important than previously thought.

Norway has maintained a Medical Birth Registry since 1967; the registry now contains data on 1.5 million births. Norwegian and American researchers examined records of 371,933 women who had given birth to first and second children in Norway between 1967 and 1989. For the 9192 women whose first infant had a birth defect, they examined the risk of similar or dissimilar effects in the second infant. And they examined the risk of a birth defect in the second child among mothers who lived in the same municipality during both pregnancies vs. mothers who moved to a new municipality before the second child was born. (The control group was the 362,741 women whose first infant did not have a birth defect.)

The researchers found that 2.5% of all infants born in Norway have a birth defect. Examining 23 different kinds of birth defects, they found that in every category, mothers whose first infant had a defect were more likely to have a second infant with a defect, as would be expected if birth defects are genetic in origin. What was "surprising" to the researchers was that women who moved to a new city between pregnancies were only half as likely to have a second child with a birth defect. Mothers whose first child had a defect were 11.6 times as likely to have a second child with a defect (compared to mothers whose first child did not have a defect), but if a mother moved to a new municipality between pregnancies she was only 5.1 times as likely to have a second child with a defect. The researchers concluded, "...[W]e find strong, if indirect, evidence... suggesting that important environmental teratogens have yet to be discovered."

 --Peter Montague

===============

[1] Larry D. Edmonds, "Temporal Trends in the Prevalence of Congenital Malformations at Birth Based on the Birth Defects Monitoring Program, United States, 1979-1987," MORBIDITY AND MORTALITY WEEKLY REPORT, CDC SURVEILLANCE SUMMARIES Vol. 39, No. SS-4 (Dec., 1990), pgs. 19-23.

[2] Rolv Terje Lie and others, "A Population-Based Study of the Risk of Recurrence of Birth Defects," NEW ENGLAND JOURNAL OF MEDICINE Vol. 331, No. 1 (July 7, 1994), pgs. 1-4.

==========================================================
TABLE 1
Birth Defects: Annual Percent Change in Occurrence During 7-year
Period, 1979-80 to 1986-87, United States
==========================================================

DEFECT TYPE	Number of defects per 10,000 births		Annual Percent change in occurrence, 1979-80 to 1986-87
	------------------------
	1979-80	1986-87
CENTRAL NERVOUS SYSTEM
Hydrocephalus without spina bifida (fluid in the skull)	4.34	5.84	4.3%
Encephalocele (gap in the skull)	1.10	1.16	0.8%
Microcephalus (small head)	2.12	2.61	3.0%
EYES
Anophthalmos (absence of eyes)	0.57	0.68	2.6%
Congenital cataract (eye cataracts at birth)	0.71	1.02	5.3%
Coloboma of eye (eye parts missing)	0.21	0.40	9.6%
Aniridia (absence of the iris)	0.07	0.10	5.2%
HEART
Common truncus (undeveloped main arteries)	0.19	0.40	11.2%
Transposition of great arteries (reversal of main arteries)	0.87	1.45	7.6%
Tetralogy of Fallot (4 common defects simultaneously)	0.73	1.82	13.9%
Ventricular septal defect (opening between lower chambers)	11.34	20.49	8.8%
Atrial septal defect (opening between upper chambers)	1.16	3.69	18.0%
Endocardial cushion defect	0.34	0.95	15.8%
Pulmonary valve atresia and stenosis (obstructed blood flow)	0.58	3.44	29.0%
Tricuspid valve atresia and stenosis (obstructed blood flow)	0.16	0.36	12.3%
Aortic valve stenosis and atresia (obstructed blood flow)	0.22	0.79	20.0%
Hypoplastic left heart syndrome (undeveloped left side)	0.56	1.25	12.2%
Patent ductus arteriosus (pulmonary artery open to aorta)	17.87	35.43	10.3%
Coarctation of aorta (constriction of the aorta)	0.74	1.15	6.5%
Pulmonary artery anomaly	1.12	2.66	13.2%
Lung agenesis and hypoplasia (undeveloped lungs)	1.66	3.84	12.7%
FACIAL CLEFTS
Cleft palate without cleft lip	5.05	5.33	0.8%
Cleft lip	7.76	9.35	2.7%
GASTROINTESTINAL
Tracheoesophageal anomalies (upper airway problems)	1.86	2.49	4.3%
Rectal and intestinal atresia (blockage)	3.23	3.80	2.3%
GENITOURINARY
Renal agenesis and hypoplasia (one kidney or small kidneys)	1.23	2.34	9.6%
Bladder exstrophy (gap in abdomen, revealing bladder)	0.29	0.33	1.9%
MUSCULOSKELETAL
Reduction deformity, upper limbs (arms deformed or missing)	1.53	1.58	0.5%
Reduction deformity, lower limbs (legs deformed or missing)	0.78	0.83	0.9%
Congenital arthrogryposis (contracted or bent limbs)	1.33	1.93	5.5%

===========
Source: Larry D. Edmonds and others, "Temporal Trends in the Prevalence of Congenital Malformations at Birth Based on the Birth Defects Monitoring Program, United States, 1979-1987," MORBIDITY AND MORTALITY WEEKLY REPORT, CDC SURVEILLANCE SUMMARIES Vol. 39, No. SS-4 (December, 1990), pg. 22.
=========================================================
Descriptor terms: birth defects monitoring program; centers for disease control; cdc; bdmp; new england journal of medicine; norway; hydrocephalus; encephalocele; microcephalus; anophthalmos; congenital cataract; coloboma of the eye; aniridia; common truncus; heart; head; brain; tetralogy of fallot; ventricular septal defect; atrial septal defect; endocardial cushion defect; pulmonary valve atresia and stenosis; tricuspid valve atresia and stenosis; aortic valve stenosis and atresia; hypoplastic left heart syndrome; patent ductus arteriosus; coarctation of aorta; pulmonary artery anomaly; lung agenesis and hypoplasia; cleft palate; tracheoesophageal anomalies; rectal and intestinal atresia; renal agenesis and hypoplasia; reduction deformity; congenital arthrogryposis;

#490: Our Stolen Future, Part 3: Flying Blind

=======================Electronic Edition========================

RACHEL'S ENVIRONMENT & HEALTH WEEKLY #490
---April 19, 1996---
News and resources for environmental justice.
==========
Environmental Research Foundation
P.O. Box 5036, Annapolis, MD 21403
Fax (410) 263-8944; Internet: erf@rachel.clark.net
==========
RACHEL-4CM = DIOXIN FOCUSED DIRECTORY Remote Access Chemical Hazards Electronic Library. Dioxinnz.com ========================Original Source========================

OUR STOLEN FUTURE, the new book on hormone-disrupting chemicals, [1] provides many lessons about our use of chemicals, and about our reliance on science as a guide for public policy.

Here is a short discussion of the main lessons we find in the book (numbers inside parentheses are page numbers from the book):

** Genes are not destiny. Many people seem to think that we may be able to explain everything from cancer to homosexuality by locating the responsible genes. But in a series of scientific papers starting in 1980, Frederick vom Saal at University of Missouri demonstrated that there are other powerful forces shaping individuals--both females and males--before birth. Genes are not the whole story. Before birth, levels of both male and female sex hormones in the womb can affect the physical characteristics and the behavior of mice, giving rise to great variation in offspring that are genetically identical. By examining human twins, scientists have now revealed similar effects in humans. [2]Thus we now know that hormones are a way that nature provides variation within a species. Profound variation among individuals can be caused by miniscule hormone differences in the womb, differences of a few parts per trillion. (One part per trillion is a million times lower than one part per million.) This is a degree of sensitivity to hormones that approaches the unfathomable, a sensitivity, vom Saal says, "beyond people's wildest imagination." This exquisite sensitivity provides rich opportunities for creating varied offspring from the same genetic stock. However, the dark side is that this same sensitivity also makes the reproductive system vulnerable to serious disruption if something interferes with normal hormone levels. (pgs. 39-41)

** The exposure of a million American women to the drug, DES, in the 1960s and 1970s showed that the human body could mistake a synthetic (human-created) chemical for a natural hormone. (pg. 66)

** Another lesson from the work of vom Saal and others is that hormones in the womb permanently program (and organize) cells, organs, the brain, and behavior prior to birth, in many ways determining an individual's course for life. (pgs. 39-40)

** The dose of hormones that an embryo receives is not the only thing that matters; the TIMING of the dose --WHEN it occurs during development in the womb --can be as important as the dose itself. (pgs. 50-51)

** Birth defects may not be noticeable at birth. Serious effects of hormones on the unborn and on the newborn may not be recognizable for decades. (pg. 66)

** In fact, birth defects may never become visible at all, but may involve cellular damage that undermines an organism's ability to survive. For example, exposure to the drug DES, a synthetic hormone, gave rise to a rare form of cancer in female children of DES-exposed women. (pg. 66)

** Mice and humans share a common fate. To an astonishing degree, evolution has retained through hundreds of millions of years a basic strategy for embryonic development in vertebrates [creatures with a backbone] which depends on hormones. Regardless of whether the offspring is a human or a mouse, a whale or a bat, a turtle or an alligator, hormones regulate its development in fundamentally the same way. In the field of cancer research, scientists argue that data gathered from experiments on mice may not reveal anything useful about humans. This uncertainty occurs because the underlying causes of cancer are poorly understood. On the other hand, the working of hormones is better understood, and knowledge gained from experiments on non-humans CAN reveal useful information about humans. "It is important to take the effects we see in animals seriously," says Dr. Earl Gray, a senior research biologist with U.S. Environmental Protection Agency [EPA]. (pg. 66)

** Industrial chemicals at exceedingly low levels can combine together to produce additive effects. Dr. Ana Soto at Tufts University combined 10 hormone disrupters, each at one-tenth of the dose required to produce a minimal response; she found that the combination produced a response. [3] Thus combinations of chemicals must be taken into account when we try to learn how much "effective exposure" we are getting to hormone-disrupting chemicals.

** Testing hormones at high doses may reveal no effects whereas testing the same hormones at low doses may reveal dramatic effects. This is contrary to the traditional assumptions of toxicology [study of poisons]. The dose-response curve for many hormones is U-shaped: at low doses, the hormones cause effects but at high doses the system becomes overwhelmed and shuts down. This has profound implications for testing. Traditionally, chemicals have been tested on laboratory animals at high doses; now we know that tests must be conducted at low doses as well. (pgs. 169-170)

** Up to now our concept of injury from toxic chemicals had focused on two things: (a) whether a chemical attacks the DNA inside cells, possibly causing cancer; or, (b) whether a chemical damages and kills cells, the way poisons do. However, hormone-disrupting chemicals may not kill or damage cells, and they may not damage DNA. Thus they do not fit the definition of "poisons" or "carcinogens" yet they may cause great harm by disrupting normal growth and development of many organs and tissues, including sex organs, the brain, the nervous system, and the immune system. The key concept in thinking about this kind of toxic assault is the disruption of chemical messages. (pgs. 203-204)

** The traditional approach to toxic chemicals is to look for disease as a result of exposure. However, hormone-disrupting chemicals may not cause "disease" at all: they may cause diminished function --reduced IQ, poorer short-term memory, diminished ability to pay attention, reduced sperm count. These are not signs of "disease" yet they are toxic effects that can be caused in some species by some hormone-disrupting chemicals. (pgs. 205-206)

** To screen for chemicals that cause diminished function, it will be necessary to look for developmental effects across three generations. The first generation (the generation that gets the initial exposures) may not be affected at all. The second generation may have diminished function (for example, diminished ability to reproduce) but the actual effects may not be apparent until the third generation (the grandchildren of the exposed generation). (pg. 207)

** We are flying blind. (pgs. 243, 246) We cannot know whether the ominous shape looming into view is a cloud bank or a mountain. If anything is certain, it is that we must expect more unpleasant surprises. We are flying blind; we can never know that new chemicals are safe (though, if we chose to, we could do a much more thorough job of testing them than we've done in the past).

To show that we are flying blind, OUR STOLEN FUTURE relies on the evidence of hormone-disrupting chemicals and of depletion of the earth's ozone shield by human-created chemicals (see REHW #246, #259, #259).     But there is much additional evidence that could have been cited as well. For example, during just the past 25 years, we have been surprised by:

** Global warming brought on by combustion of fossil fuels (REHW #467, #466);   

** Mercury build-up to toxic levels in the bodies of fish (chiefly from burning coal, oil, and municipal solid waste) (REHW #291);

** Increasing birth defects in American children. Of 38 kinds of birth defects for which the Centers for Disease Control maintains records, 29 have increased during the past 20 years (REHW #410, #411);  

** Steadily increasing cancers, particularly of the reproductive system (prostate; testicles; female breast) and nervous system (brain) (REHW #412, #447, #462);    

** The astonishing toxicity of a family of chemicals called dioxins and furans (including some PCBs, or polychlorinated biphenyls), which now contaminate the entire planet from the depths of the oceans to the polar ice caps (REHW #390 , #391, #414);

** The accelerated loss of species, which, according to the fossil record, is now occurring at rates 10 to 1000 times as fast as natural background rates that were occurring before humans appeared on the scene (REHW #441);

** Acid rain damaging lakes, killing trees, stunting forests, and washing nutrients from soils across much of the northeastern U.S., southern Canada, and northern Europe (REHW #476); ** Rapidly increasing immune system disorders such as asthma (REHW #374) and diabetes (REHW #417);

** Epidemics of disease among marine mammals (seals, dolphins, etc.), apparently related to chemical contamination and to blooms of toxic algae caused by excesses of nutrients (chiefly nitrogen and phosphorus) in near-shore marine ecosystems (REHW #466);

** Diminished IQ and reduced ability to concentrate among 1.7 million American children and 300 to 400 thousand fetuses (at any given moment in time), as a result of exposures to the toxic metal, lead (REHW #369);

** Disappearance or decline of some frog and other amphibian populations worldwide (REHW #380, #441);

** Steep declines or near-total depletion of fish stocks at 13 of the world's 17 major fisheries (REHW #399).

** Decline of 50% in sperm among men in industrial countries (REHW #432, #446 , #448a), and a significant loss of sperm quality during the same period.

** A 60% increase in the rate of migraine headaches among Americans during the period 1980 to 1990. 

Most (71%) of the increase occurred among people aged less than 45 years. [4]

This does not exhaust the evidence, but represents a fair sample of the kinds of problems that have suddenly loomed into view since 1970. Have we encountered the last of such unsuspected and unlooked-for problems? Certainly not. No, there doesn't seem to be any doubt about it: we are rushing forward at high speed with no sure way to learn what hazards lie ahead. We really are flying blind. To us, this seems the most important lesson of OUR STOLEN FUTURE.

Under such circumstances, can science provide us with adequate guidance? 

Next week.#491

--Peter Montague

=============== 

[1] See REHW #485 and #486, reviewing Theo Colborn, Dianne Dumanoski and John Peterson Myers, OUR STOLEN FUTURE (N.Y.: Dutton, 1996).

[2] F. vom Saal and F. Bronson, "Sexual Characteristics of Adult Female Mice Are Correlated with Their Blood Testosterone Levels During Prenatal Development," SCIENCE Vol. 208 (1980), pgs. 597-599. And see: M. Clark and others, "Hormonally Mediated Inheritance of Acquired Characteristics in Mongolian Gerbils," NATURE Vol. 364 (1993), pg. 712. Hormones have also been shown to affect humans exposed in the womb: D. McFadden, "A Masculinizing Effect on the Auditory Systems of Human Females Having Male Co-Twins," PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCE Vol. 90 (1993), pgs. 11900-11904.

[3] Reported in Ana M. Soto and others, "The Pesticides Endosulfan, Toxaphene, and Dieldrin Have Estrogenic Effects on Human Estrogen-Sensitive Cells," ENVIRONMENTAL HEALTH PERSPECTIVES Vol. 102, No. 4 (April 1994), pgs. 380-383.

[4] "Prevalence of chronic migraine headaches -United States, 1980-1989," MORBIDITY AND MORTALITY WEEKLY REPORT Vol. 40, No. 20 (May 24, 1991), pgs. 331-333.

Descriptor terms: endocrine disrupters; hormones; our stolen future; des; diethylstilbestrol; frederick vom saal; ana soto; science; oceans; marine mammals; global warming; mercury; fish; wildlife; birth defects; cancer; dioxins; furans; pcbs; species loss; acid rain; lead; migraine headaches; theo colborn; john peterson myers; dianne dumanoski;