New Science but Old Policies

A haiku on how we reward ignorance and punish

innovation

Charlotte Brody, RN

• What’s the problem?

• Why do we think the problem has anything to do with chemicals?

• Why has it taken us so long to figure this out?

• What do we do now?

What’s the problem?

We’re living longer,but we’re less healthy

Cancermortalityis goingdown but cancerincidencekeeps going up

Young women may be losing their health and their right to choose to become

mothers

Shaping Our Legacy: Reproductive Health and the Environment. A report on the Summit on Environmental Challenges to Reproductive Health and Fertility, January 28–30, 2007.www.prhe.ucsf.edu/prhe/pubs/shapingourlegacy.pdf andHormone Disruptors and Women’s Health, Reasons for Concern at www.healthandenvironment.org

• 30% more babies are being born premature

• 25 to 50% of women have fibroids

• 10 to 15% suffer from endometriosis

• Girls are developing breasts and starting their periods earlier

• Breast cancer went up 40% between 1973 and 1998

Young men may grow up to be half the man their fathers were

• Sperm counts down 50% over 50 years• Compared with 30years ago• 46% more men get testicular cancer• 76% more men get prostate cancer

Shaping Our Legacy: Reproductive Health and the Environment. A report on the Summit on Environmental Challenges to Reproductive Health and Fertility, January 28–30, 2007. www.prhe.ucsf.edu/prhe/pubs/shapingourlegacy.pdf

•CDC reports 6.1 million U.S. couples with infertility problems in 1995

•7.3 million couples with infertility in 2002

•Largest reported increase in women under 25Barrett, Julia R., Fertile Grounds for Inquiry, EHP, November

2006 and Shaping Our Legacy

Are we losing the right to reproduce?

The Disease Burden is worse for Blacks, Latinos and Native

Americans

Death from cardiovascular disease is 29%

higher for African American adults and 40% higher from stroke.

African American women are twice as likely to die from cervical cancer than white women.

American Indians, Alaska natives, African Americans and Hispanics are at least twice as likely to have diabetes than whites.

Why do we think the problem has anything to do with chemicals?

Wildlife Tragedies

Florida Panther

Human Tragedies: Minamata, JapanChemical Plant Dumps Mercury into

Bay

Human Tragedies: DBCP

Harmful to workers who made it and the workers who used it

Human Tragedies:Thalidomide

http://www.jamd.com/search?assettype=g&assetid=3159439&text=Sherri+Finkbine

Human Tragedies: Diethylstilbestrol (DES)

Exposure to DESin the womb

=Deformed uterus

=Impaired fertilityIncreased risk of

miscarriagePremature labor &

birth

Fibroids

Cancer of the Vagina and Cervix

Third Generation Effects

Animal Studies Predict Human HarmVandenberg, LN, MV Maffini, PR

Wadia, CSonnenschein, BS Rubin and

AM Soto. 2007.

Exposure to environmentally relevant doses of

the xenoestrogen bisphenol-A alters development

of the fetal mouse mammary gland.

Endocrinology 148(1):116-27.

www.cdc.gov/exposurereport/

Bisphenol Ain 92.6% of 2,517 NHANESparticipants 6 years old and olderin 2003-2004

PhthalatesSince 2003, in cells:Human breast cancer cells stimulatedCounteract tamoxifen

In lab animals: Decreased testosteroneChange in mammary glands Additive harm

In humans:Sperm damageMore allergic symptomsIn amniotic fluidCorrelation with anogenital distance and mother’s reported use of baby productsLower levels of thyroid hormone

Why has it taken us so long to figure this out?

Linear dose response curves don’t capture the chemical

problem Outdated

frameworksmiss low dose

effects,mixtures,

synergies,timing,

sensitivitiesand other

differencesbetween people

andlong delays

betweenExposures and

visibleeffects,

includingMultigenerationa

l effects

Hormones: Tiny doses control communication and coordination of body

tissues

300 ppt in a 143 lb. womanis equivalent to .000000000002of one plain M &M

Two Ways to Make Hormones

In a factory

•Atrazine•Bisphenol A•DDT•DES•Dioxins•PBB•PCB•Phthalates

Two Ways to Make Hormones

In a human body

•Estrogens•Testosterone•Adrenaline•Insulin•Thyroid•Progesterone•LH•FSH

Hormone disruptors send the wrong message at the wrong time to the wrong

place

Mixtures and synergies destroy resiliency and create disease

Adapted from T. Schettler’s modification of Hubbs-Tait et al. “Psychological science in the public interest”

Genes

Access toHealth Care

Social SupportNutrition

Radiation

Gene Expression

Poverty

Stress Racism

ToxicChemicals

Infections

Women exposed to relatively high levels of DDT prior to mid-adolescence are 5 times more likely to develop breast cancer

Cohn, BA, MS Wolff, PM Cirillo and RI Sholtz. 2007. DDT and breast cancer in young women: New data on the significance of age at exposure. Environmental Health Perspectives doi:10.1289/ehp.10260

Long Delays

Manufactured doubt and fear prevent

new science from becoming new policy

What do we do now?

Lessen stressors to create resiliency and decrease disease

Adapted from T. Schettler’s modification of Hubbs-Tait et al. “Psychological science in the public interest”

Genes

Access toHealth Care

Social SupportNutrition

Radiation

Gene Expression

Poverty

Stress Racism

ToxicChemicals

Infections

Lower exposures we can lower

Insert slide

Executive Summary, CDC's Third National Report on Human Exposure to Environmental Chemicals, 2005

Change The Framework from LinearDose Response Curves to a Recognition

That Chemicals Work Like Pharmaceuticals

Chemical Facts

Mixtures and synergies

Sensitive populations

Timing

TSCA: US chemical regulation:Reward ignorance and punish

innovation • 81,000 chemicals registered in US in 2003

• 99% of chemicals by volume grandfathered in without evidence of safety when TSCA become law in 1976

Definitions of “unreasonable risk” and “least onerous control” are unworkable

• Under TSCA, restrictions on 5 chemicals are in place, we don’t knowthe health effects of more than 85% of these chemicals

Denison, R.A., Not That Innocent and Tickner, J.A., Introduction to TSCA

How the FDA got the power to require proof

of safety before a drug was marketed

www.fda.gov/cder/about/history/ and Pomper, G.M., Ordinary Heroes and American Democracy

It seems so simpleIf you can’t show that it’s

safethen you can’t sell it

www.womenshealthandenvironment.org

A closing haiku

Thank you.