To join the Collaborative on Health and the Environment (CHE) and the LDDI Working Group, please complete the form at http://www.healthandenvironment.org/roles/register?&phase=registerform. Be sure to mark that you want to join the Learning and Developmental Disabilities Initiative Working Group at the bottom of the application.
October 12, 2006
10:30 a.m. - 4:00 p.m.
Albany, New York
at the Legislative Office Building, Room 711
Key New York State policymakers, researchers and advocates will discuss the current and future status of children's environmental health policy in New York State. Recent advances in children's environmental health policy include the new state-level Children's Environmental Health & Safety Council. Top researchers will also present on key scientific research demonstrating the impacts of exposure to environmental toxicants on children.
Contact: Stephen J. Boese, 212-482-0204 or sboese@healthyschools.org
October 13, 2006
8:30 a.m. - 6:00 p.m.
San Francisco, California
at the University of California, San Francisco Laurel Heights Auditorium
This one-day national conference is hosted by the Collaborative on Health and the Environment. This second CHE national educational meeting will provide a solid overview of current scientific knowledge regarding environmental contributors to human disease and state-of-the-art efforts to prevent, treat and otherwise improve such impacts. Researchers and health advocates will come from around the country to provide summaries of their knowledge and work. Physician and nurse continuing education credits will be available through the California Academy of Family Physicians.
Website: http://www.healthandenvironment.org/articles/che-events/702
October 14, 2006
Oakland, California
This half-day training program will introduce participants to the Pediatric Environmental Health Toolkit, a new clinical resource for practitioners. The Toolkit was developed partially in response to the frequent requests by pediatricians for practical, clinical tools that enable providers to incorporate environmental health guidance into everyday practice. It includes materials for both providers and patients on preventing exposures to toxic chemicals and other substances that may affect child health.
Contact: Lucia Sayre, luciasayre@sbcglobal.net
October 19, 2006
2:00 - 3:00 p.m. EDT
This is the third of a series of four webcasts. Schools use and manage a range of hazardous and toxic chemicals and products. Classrooms, science laboratories, art studios, vocational shops, athletic fields, maintenance facilities, boiler rooms, and storage closets are just a few examples of where hazardous chemicals and products may be found. Often, existing stocks of outdated, unknown, excessive, or unnecessarily hazardous chemicals are present in schools. These chemicals can pose safety and health risks to students and staff, and a number of widely reported incidents involving such chemicals have resulted in school closures and costly clean-ups. A Schools Chemical Cleanout and Prevention program insures that excess, legacy, unused, and improperly stored chemicals are removed, and puts mechanisms in place through which chemicals are purchased wisely, stored safely, handled by trained personnel, used responsibly, and disposed of properly. In addition, pesticide use can cause possible health hazards for school occupants and contribute to environmental pollution. Integrated Pest Management (IPM) is a safer, usually less costly option for effective pest management in the school community. A school IPM program employs commonsense strategies to reduce sources of food, water, and shelter for pests in school buildings and grounds. This webcast will share two chemical management success stories -- a schools chemical cleanout campaign with the Poarch Band of Creek Indians in Alabama, and the Monroe County, Indiana IPM Program. To sign up for one of the Children's Health Month webcasts, send an email (with the date of the webcast in which you would like to participate) to ICF International at the address below.
Contact: ICF International, chm@icfi.com
October 21, 2006
8:00 a.m. - 6:30 p.m.
Pittsburgh, Pennsylvania
at Children's Hospital of Pittsburgh
The conference will address clinically important issues in children's health that are affected by the environment. Children of all ages, including those in the fetal stages of development, can be affected by environmental hazards. Exposure to environmental toxins via air, water, food or soil can have a significant impact on the health of children. The conference will focus on the following areas: the built environment, heavy metals exposure and neurocognitive issues, cancer and environmental exposures and newborn outcomes and environmental exposures. This continuing medical education activity is designated for 7.5 credit hours in Category I of the Physician's Recognition Award of the American Medical Association. Contact hours for nurses will be available through CNMC. Health educators seeking CHES Credits can claim the conference as a category II activity.
Website: http://www.gwu.edu/~macche/conference/
Contact: Aurora Amoah, 866-622-2431 or eohaoa@gwumc.edu
October 24 - 25, 2006
Indianapolis, Indiana
at the Marten House Hotel
With a theme of "Healthy Homes For Indiana Children", this year's conference will include tried-and-true sessions as well as new and timely information from experts in the field of lead poisoning prevention, childhood asthma, health care and other healthy homes issues. Pending approval from the Indiana Department of Environmental Management, we will be offering refresher training for Lead Inspector and Risk Assessor licenses.
Website: http://www.ikecoalition.org/Lead_Conf_2006/Conf_Preview_2006.htm
Contact: Janet McCabe, 317-902-3610 or mccabe@ikecoalition.org
October 25 - 28, 2006
San Diego, California
at the Wyndham San Diego Hotel
The National Association for the Dually Diagnosed (NADD) presents their 23rd conference, themed "Promoting Mental Health in Children & Adults with Intellectual Disabilities: Cross Systems Collaboration." At the end of this conference, participants will be able to 1) identify psychopharmacological challenges with children and adults with ID; 2) review new data on assessment and treatment of autism spectrum disorder; 3) cite initiatives that support the development of a qualified workforce; 4) name collaborative/multidisciplinary program or treatment models; and 5) summarize several crisis services developed for persons with co-occurring disorders. Individuals who volunteer for one day can attend another day with the registration fee waived, or if you volunteer for two days, attend two days with the registration fee waived. For more information about volunteering, please contact Brenda Reuss, NADD Conference Assistant, at breuss@thenadd.org or at the phone number below.
Website: http://www.thenadd.org
Contact: 800-331-5362 or info@thenadd.org
October 26, 2006
1:30 - 3:00 p.m. EDT
This is the last of a series of four webcasts. EPA has developed a unique software tool to help school districts evaluate and manage their school facilities for key environmental, safety and health issues. The new Healthy School Environments Assessment Tool (HealthySEAT) is designed to be customized and used by district-level staff to conduct completely voluntary self-assessments of their school (and other) facilities and to track and manage information on environmental conditions school by school. This webcast will help acquaint states, school districts, and others with the capabilities and features of HealthySEAT. To sign up for one of the Children's Health Month webcasts, send an email (with the date of the webcast in which you would like to participate) to ICF International at the address below.
Contact: ICF International, chm@icfi.com
November 2 - 3, 2005
Thursday 8:00 a.m. - 10:00 p.m., Friday 7:30 a.m. - 1:00 p.m.
Sacramento, California
at the UC Davis MIND Institute, 2825 50th Street
Contact: 916-703-0234 or heather.cornwell@ucdmc.ucdavis.edu
The US Environmental Protection Agency is announcing a 60-day public comment period for the external review draft document titled Child-Specific Exposure Factors Handbook. The draft document was prepared by the National Center for Environmental Assessment within EPA's Office of Research and Development. The handbook provides a summary of statistical data on various exposure factors used in assessing children's exposures, including drinking water consumption, soil ingestion and mouthing behavior, inhalation rates, dermal factors including skin surface area and soil-adherence factors, consumption of retail and home-grown foods, breast milk intake and activity pattern data. This handbook serves as a resource for exposure assessors for calculating children's exposures. An interim final version of this handbook was published in 2002. This updated version provides analysis of exposure factors data using the age groups for children recommended in the EPA document entitled Guidance on Selecting Age Groups for Monitoring and Assessing Childhood Exposures to Environmental Contaminants (available online at http://cfpub.epa.gov/ncea/cfm/recordisplay.cfm?de id=146583.
Direct your comments to Docket ID No. EPA-HQ-ORD-2006-0812; The 60-day public comment period begins October 6, 2006, and ends December 5, 2006. Technical comments should be in writing and must be received by EPA by December 5, 2006. For more information, please visit http://www.epa.gov/fedrgstr/EPA-RESE ARCH/2006/October/Day-06/r16573.htm.
by Roger Highfield, London Daily Telegraph
October 10, 2006
http://www.telegraph.co.uk/news/main.jhtml;jsessionid=TN4FE5TDQOSHNQFIQMGCFFOAVCBQUIV0?xml=/news/2006/10/10/nautism10.xml
Studies of girls who make an unusually large amount of male sex hormone in their bodies have backed the idea that autism is caused by an "extreme male brain". Prof Simon Baron-Cohen and Sally Wheelwright have uncovered new evidence that testosterone and other sex hormones thought to shape sex differences may cause autism by pushing brain development beyond that of a typical male.
In a study published in the journal Hormones and Behaviour, the team, with colleagues at City University, studied 34 girls with congenital adrenal hyperplasia (CAH) who, for genetic reasons, have high levels of a form of testosterone, and compared them with 24 unaffected sisters. They found that the CAH girls, who develop some male physical characteristics, have more autistic traits than typical females. Although they are not classed as having autism, which is marked by an inability to recognise and show emotions, they are closer to this end of the spectrum. "These results suggest that prenatal exposure to high levels of testosterone influences some autistic traits and that hormonal factors may be involved in vulnerability to autism", said Prof Baron-Cohen of Cambridge University, the leading proponent of the "extreme male brain" theory.
To back this work, the team is to launch a new study of the mirror image condition, called androgen insensitivity syndome (AIS). These individuals, such as Danielle Fray, 33, from Suffolk, are chromosomally male (XY) but are feminised because they have no docking sites in their bodies for testosterone. A range of ambiguous genitalia result. In extreme cases they are raised as girls, and discover they are chromosomally male at puberty, only when they fail to menstruate because they lack ovaries. "This is a very rare group, but we predict that they should have even fewer autistic traits than typical males or females," said Prof Baron-Cohen, adding that the study will also benefit those with AIS by highlighting their special needs. "We are keen to encourage people with AIS to visit our website at http://www.cambridgepsychology.com/gender to help our research," he said.
The Cambridge team has assembled a wide range of support for the theory, which says that people with autism match an extreme of the male profile, with a particularly intense drive to systemise -- find the laws that govern how a system works -- and an unusually low drive to empathise. Puberty tends to come earlier in boys with autism, supporting the idea that they have higher testosterone levels. In physical terms, children with autism tend to have masculinised brains, being larger with a thinner corpus callosum and less long-range connectivity when compared with female brains.
by Lisa STiffler, Seattle Post-Intelligencer
October 10, 2006
http://seattlepi.nwsource.com/specials/brokenpromises/288097_plastic10.asp
He loves to stroll beaches searching for the oddities that wash ashore -- the 10-foot-tall Yogi Bear, pieces of plastic from the 1940s, and bottles and caps galore. This summer on the Strait of Juan de Fuca, Ebbesmeyer found two large, weathered chunks of plastic of unknown origins measuring about 1 cubic foot. As he ran his hands along one's surface it disintegrated into a dusty powder. This, said the oceanographer, is how plastics break down and become a part of the ecosystem. The material doesn't biodegrade but rather undergoes a slow process of "photodegradation" as the sun breaks it into smaller and smaller pieces.
Pollutants -- such as PCBs and the pesticide DDT -- can be absorbed by plastics like a sponge sopping up water. The chemicals might become concentrated a millionfold compared with the surrounding water, researchers say. Plastic can also contain chemicals that mimic natural hormones, which, like birth control pills, can cause male fish and birds to exhibit female traits.
The presence of microscopic plastic "is just a new threat that has become visible and really looked at in the last five years, or 10 years," Ebbesmeyer said. "All the food out in the sea has some plastic in it, is the conjecture. And that is a horrific conjecture," Curtis Ebbesmeyer, oceanographer and marine debris expert. He's been tracking the sea's woes for much longer. Over the past four decades, Ebbesmeyer has been a consultant on major public works, including multiple sewage treatment plants. He's sat on panels advising numerous state administrations.
Recently, he's turned his focus from policy-makers to the Play-Doh set, working on a children's book about circumnavigating rubber duckies that were accidentally dumped by a cargo ship. The true-life tale emphasizes our global connections and impacts. But the ocean admittedly is a massive place, covering 71 percent of the planet. How can a 2-liter bottle here and a cigarette lighter there become such a problem?
About 300 billion pounds of plastic are produced each year, said Charles Moore, founder of the Algalita Marine Research Foundation. That's 1,000 pounds for every American. And massive amounts of it are washing into the sea. Swirling in the Pacific Ocean is an area of man-made trash the size of Texas. A few years ago Moore towed a fine mesh net like a giant cheesecloth through the area -- dubbed the "great garbage patch." The haul contained six times more plastic than plankton. "The quantities of plastics in the marine environment have gone up exponentially in the last decade," said Moore.
His group recently did a study of two Los Angeles rivers in which he collected all of the trash floating out to sea over the course of three days. They netted 6 tons of plastic. The trouble is that there's no effective way to remove the plastic pollution, whether it's in chunks or microscopic bits. Researchers say the solution is keeping it out of the water in the first place. And there's good reason to do so: It's on our dinner plates. "All the food out in the sea has some plastic in it, is the conjecture," Ebbesmeyer said. "And that is a horrific conjecture."
by Angela Epstein, UK Daily Mail
October 10, 2006
http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=409521&in_page_id=1774
Each year more than 1,200 boys in the UK are born with a genital abnormality. Experts say the number has doubled over the past 25 years, and that 'gender-bending' chemicals are to blame. Correcting such abnormalities can be a traumatic experience for both child and parent. Here a mother whose sons were affected describes their experience. Sue Phipps gave birth to twin boys after a six-hour labour and she was thrilled when the two dark-haired bundles were placed in her arms. But euphoria quickly turned to confusion when she was told that both boys had been born with malformed penises. 'I just couldn't understand it. I'd had a straightforward pregnancy and nothing had ever shown up on any of my scans to suggest there was a problem,' says Sue, 43.
Yet what the scans were not able to show was that her sons had hypospadias. This is a condition where the opening of the urethra -- the tube that carries urine and semen out of the body -- is on the underside of the penis instead of at the end. In some cases the penis curves downwards, with the foreskin covering only the front. In severe forms of hypospadias the urethral opening is so far back it is almost in the scrotum. 'As I held my newborn children I could see that the hole through which the boys would pass urine was not at the tip of the penis but halfway down, further underneath,' says Sue. 'I realised it didn't look right, but I was so glad that my babies had been born without any life-threatening complications that my main feeling was relief. 'It was my husband who was really shocked by the boys' condition. As a father, he couldn't believe this vital part of their manhood was somehow malformed.'
Mr and Mrs Phipps were told that while the immediate physical problem could be corrected with surgery, the condition was also linked to low sperm count and a higher risk of developing testicular cancer. Hypospadias can be triggered by a random genetic fault -- and initially the doctors suggested this as the cause of their sons' problem. However the Phipps have no family history of the condition, and they -- and their specialist -- are convinced environmental factors are to blame. There is increasing evidence to show that male reproductive abnormalities such as this are linked to exposure to 'gender-bending' chemicals found in everyday products such as shampoo and carpets.
These chemicals are known as hormone disruptors or EDCs -- endocrine disrupting chemicals. They include phthalates, a group of chemical liquids which are used to give many ordinary products a flexible texture. Phthalates are found in plastic, carpets, fabric, make-up, perfume, cosmetics, milk, vegetables and pesticides. In a two-year experiment by the Medical Research Council's Human and Reproductive Sciences Unit in Edinburgh, rats exposed to high levels of phthalates had double the rate of genital defects and low sperm counts. More crucially, in the first human study, researchers from the University of Rochester in New York have now linked exposure to phthalates to a higher risk of genital abnormalities in baby boys.
The researchers, who examined 134 boys, found women with higher levels of phthalate-related chemicals in their blood were more likely to give birth to babies with undescended, or small testicles and small penises. Professor Richard Sharpe of the MRC's Human Reproductive Sciences Unit believes that all these male reproductive abnormalities are interrelated and that the increase is linked to environmental and lifestyle factors. 'The problem is that we don't know the exact cause. But the fact is that phthalates are the most ubiquitous of environmental chemicals. They contaminate house dust, even rain water. There is no definitive proof yet that they are linked to male birth abnormalities. But they are a strong candidate.'
Aivar Bracka, a consultant genito-urethral surgeon who specialises in hypospadias, is convinced that environmental factors are to blame. 'All the solid evidence points to a strong link between the rise of male reproductive abnormalities and something in our environment.' Hereditary factors can only partly explain hypospadias, he says. 'For example I have seen twins where one has the condition and one hasn't even though the children are genetically identical. 'That situation can only arise from an external factor affecting foetal development. Otherwise both twins would be affected.' The theory is that phthalates interfere with the manufacture of the male sex hormone, testosterone at a critical stage in foetal development -- the first three or four months of pregnancy. It is testosterone which gives a foetus its male characteristics.
There is no doubt that women in particular are vulnerable to chemical exposure. According to Julia Mitchell, spokeswoman for environmental website http://www.chemicalsafeskincare.co.uk, the average woman will use 12 different cosmetic products a day -- unwittingly applying 175 different chemicals to her body. And in recent tests carried out by WWF, formerly the World Wide Fund for Nature, man-made pollutants and chemicals were found in every one of 27 food products tested, including bread and eggs. The amount of contaminants was well within legal limits, but the worry is that the chemicals may represent a serious risk when they mix together in the body.
At the moment it seems that only baby boys are at risk of reproductive abnormalities. (Indeed Sue Phipps and her husband Peter, 52, a retired businessman, have a 14-year-old daughter, Harriet, who has not suffered any problems.) However, as Professor Sharpe explains, 'just because the studies have not yet been carried out doesn't mean that females are not also vulnerable'. Changes in women would be more subtle, and not visible. 'However there is potential for any organ of the body to be affected by exposure to chemicals.'
Sue, who gave birth to the twins at Warwick Hospital in April 1995, was told that her sons' condition was 'mild to moderate'. And while there was no rush for surgery, it was clear the condition could not be left untreated: the children would have been unable to pass water standing up, since the urine would have been impossible to direct. 'We also knew they could face psychological problems of having a penis that looked different. And, though it seemed ridiculous to think of it when they were so young, hypospadias could also compromise their ability to have intercourse. 'It seemed right to correct the problem while none of these things were an issue.'
In every other way the children were normal healthy boys. They were referred to a consultant plastic surgeon at their local hospital who assessed the boys every year until they were four. The operation was finally scheduled for July 2000 -- by then they were considered old enough to cope with surgery and the timing meant they could start school in September without appearing 'different'. The surgery involved extending the existing urethra. This was done by creating an artificial urethra using a tube of skin taken from the foreskin and then stitching it to the end of the existing urethra. Grafting on this new piece of urethra would close the existing hole and the plastic surgeon then guided the artificial urethra to the end of the penis. 'It's awful watching not one, but two, of your children going down to surgery,' says Sue. 'Henry went first for the 90-minute operation. And as he came back from theatre, Charlie, who was already sedated, was wheeled down.'
In order to allow the stitches to heal, urine was not initially allowed to pass down the new urethra. Instead the boys were fitted with a stent which diverted urine from the bladder into a catheter bag. However shortly after the boys were brought back from theatre it was clear something was wrong. Within 20 minutes they were both writhing in agony. 'It was terrifying to watch,' says Sue. The problems seemed to be caused by a blockage in the stent. During the children's week-long stay in hospital, doctors had to reposition the catheter four times as on each occasion their pain only intensified.
The boys were not allowed to leave hospital until they could pass water without the catheter. But when they tried urinating naturally their parents were shocked by what she saw. 'When Charlie tried, the urine came out of five tiny holes near the end of his penis. When Henry did the same it came out of three holes. It sounds crude but it was like looking at a hosepipe with tiny puncture marks in it. 'Though we were assured these would heal naturally we were horrified. Their penises looked grotesque too. From thinking that this was just a routine operation I wondered if they would ever function normally.'
Hypospadias is technically difficult to correct and the Phipps sought a second opinion. They consulted Aivar Bracka, a consultant genito-urethral surgeon who specialises in hypospadias, at Wordsley Hospital in Stowbridge. He suggested a six-week wait to allow the children to recover from their trauma before carrying out corrective surgery -- one-third of his caseload comprises similar repair work. The 'salvage' operation took an hour. 'This time, thankfully, there were no tears or pain,' says Sue. 'Within a week their catheters were taken out and the boys healed quickly and were back at school within three weeks. 'The boys now have a check-up every two years and will do so until the age of 18.'
Although the boys have put the surgery behind them, Sue cannot but be concerned about what might lie ahead. Studies have shown that boys with the condition tend to have a slightly lower sperm count which could lead to problems conceiving. There is also an increased risk of testicular cancer. 'They haven't been offered any fertility tests and to be honest don't intend to pursue this unless it becomes an issue,' says Sue. 'Of course it is at the back of my mind, but I don't dwell on it.'
So what can be done to protect future children from such abnormalities. Later this month the EU parliament will vote on replacing hazardous chemicals in everyday products with safer alternatives. In the meantime, Prof Sharpe suggests that pregnant women try to minimise chemical exposure where they can. 'One new study has shown how rapidly the skin absorbs phthalates because it has such a large surface area. So it is best for pregnant women to try to avoid applying body creams and cosmetics.' For Sue the message is clear. 'I would urge all women who are thinking of having babies to be aware of the chemicals in everyday life. We need to raise awareness about the potential dangers.'
by Jeff Mason, Reuters
October 9, 2006
http://today.reuters.co.uk/news/CrisesArticle.aspx?storyId=L1065344&WTmodLoc=World-R5-Alertnet-2
BRUSSELS -- Companies seeking to produce or import hazardous chemicals in the European Union will have to use safer alternative substances when available under rules expected to be endorsed by EU lawmakers on Tuesday. Substituting safe chemicals for more dangerous ones is the most divisive issue between industry and environmentalists in a draft law called REACH (Registration, Evaluation and Authorisation of Chemicals), which faces a vote in the European Parliament's environment committee. The bill was designed to protect the public from the adverse effects of chemicals found in a wide range of products such as paint, detergents, cars and computers. Chemical makers would have to register the properties of substances in a central EU database. Those of highest concern, such as carcinogens, would require authorisation to be used.
The authorisation process has become the chief point of contention as the bill nears the end of the EU's long legislative process. Guido Sacconi, the parliament member chiefly responsible for steering the bill, proposed an amendment that would deny approval for dangerous chemicals if suitable alternatives exists. Companies seeking authorisation would also have to prove the social and economic advantages of a hazardous chemical "outweigh the risks to human health or the environment which arise from the substance", according to the text of the amendment. His proposals are expected to be endorsed by the committee, although that does not guarantee backing from the full parliament, which votes next, a parliament official said.
Industry vs environment
Business group UNICE urged lawmakers to ease the tougher rules to avoid chemicals being taken off the market. "The European Parliament's opinion on authorisation and substitution of chemicals of high concern ... is still seen as highly problematic to European companies," UNICE said in a letter to committee members. "It could lead to a complete ban of certain substances even though there is a clear socio-economic benefit and no alternative available." The group urged lawmakers to follow the position of EU governments, which would authorise dangerous chemicals if companies prove they can be adequately controlled.
But environmental group WWF urged lawmakers to push for safer substances. "If there is a safer available alternative, there is no reason to allow the continued use of chemicals that we know to be carcinogenic or toxic to reproduction," said WWF programme officer Justin Wilkes. He said the principle of substitution would apply only to roughly 1,500 chemicals deemed to be of high concern for which industry would need authorisation.
After the environment committee vote, Sacconi will seek a compromise with representatives of EU member states before bringing the bill before the full parliament for a vote. Both parliament and EU member states will have to approve REACH before it can become law.
by Alison Hawkes, Uniontown [Pennsylvania] Herald-Standard
October 8, 2006
http://www.heraldstandard.com/site/news.cfm?newsid=17298480&BRD=2280&PAG=461&dept_id=480247&rfi=6
HARRISBURG -- Despite strong protests from state lawmakers and industry groups, the state's environmental protection agency is moving forward with final regulatory approval on two controversial measures to curb automobile pollutants and mercury emissions from power plants. Environmentalists say the new regulations would be among their most important victories in recent years. And if the regulations get final clearance, they expect Pennsylvania could start tipping the scales nationwide in favor of environmental issues. "We're getting a lot of attention nationally for both of these proposals," said Nathan Willcox, a spokesman for PennEnvironment. "Pennsylvania has a large population. Politically other states look to Pennsylvania as a bellwether state on environmental issues. It's not like Massachusetts or California passing something because environmental regulations come about much more slowly in Pennsylvania."
The proposed regulations would buck the federal government's standards in favor of stricter state emissions controls. On mercury, the state Department of Environmental Protection (DEP) has designed a state plan that's supposed to achieve faster and more substantial reductions in levels of the developmental neurotoxin than the federal plan. It also wouldn't allow the federal plan's market-based trade of mercury emissions credits out of concern that Pennsylvania, with its sizable power industry, would be a net importer of those credits bringing about areas of concentrated mercury "hot spots."
On auto emissions, the DEP is seeking a two-year extension to implementing California's smog-reduction standards. But many see the move as the DEP's affirmation in favor of California over the federal government's higher allowable levels, a move the DEP believes will allow it to better conform to Clear Air Act requirements. "We have federal air quality requirements we have to meet and the federal (emissions) standard isn't strict enough to help us get there," said DEP spokesman Kurt Knaus.
Both regulations still must clear a lengthy regulatory process in the next two months, involving approval from the 20-member Environmental Quality Board and review from the five-member Independent Regulatory Review Commission. Both of them are composed, in part, of legislative appointments. There's a potential either measure might be still derailed along the way. For some lawmakers, that would be a blessing.
Backed by industry groups and the United Mine Workers of America, Senate members of the Environmental Resources and Energy Committee have been mounting formidable offenses to the measures. On the car emissions, they say they fear Pennsylvania would be abdicating its authority to the California Air Resources Board, which sets emissions standards for California and nine other participating states. On mercury, opponents have questioned the extent to which mercury emissions are a public health issue and the costliness to Pennsylvania power companies, and thus consumers, in meeting the standards. They have harangued DEP Secretary Kathy McGinty at hearings this spring, wading through fairly technical and scientific issues on how mercury from coal-fired power plants disperses.
Upset at their lack of traction with the DEP, opposing senators pushed bills through their chamber that would revert to the federal standards; both have been bottled up in House committees. With the legislative approach stalled, opposing senators led by committee Chairwoman Mary Jo White, a Venango County Republican, are now looking into ways to use the regulatory process to their favor. According to Patrick Henderson, executive director of the Senate environmental committee, opposing senators are considering filing legislative resolutions against the measures. The only apparent way those resolutions would survive a gubernatorial veto is with a subsequent legislative override. A legislative override of a regulation has rarely, if ever, happened, according to several sources. "It makes it unlikely for that to occur but it's a possibility," said Henderson. "At a minimum we can delay finalization of the regulation."
Besides differences of opinion with the DEP, senators have been particularly perturbed that they've been shut out of drafting major environmental policy. "My boss (White) has been insistent that especially on mercury these underlying policy decisions should be made by elected officials and not by a bureaucratic agency," said Henderson. "The thing with legislation is you can find a middle ground and put it in there."
But Rep. William Adolph, a Delaware County Republican who chairs the House Environmental Resources and Energy Committee, said the DEP has been taking his feedback on the mercury standards. "We have been working, negotiating, offering ideas, different versions than what's been introduced and we'll see what happens," Adolph said. He said he doesn't plan on letting the Senate's mercury bill out of his committee.
The DEP, too, says it's received quite a bit of public support on both measures. It received the highest number of public comments ever on its mercury proposal, nearly 11,000 comments. All but three dozen were supportive. Its second highest response ever was for the car emissions standard at 4,800 comments. Fewer than two dozen were opposed, according to DEP spokesman Kurt Knaus. Still, Knaus said he doesn't believe the agency is in the clear on these regulations yet. The Clean Vehicles program goes before the Independent Regulatory Review Commission Nov 2. The Environmental Quality Board must approve the new mercury standards on Oct. 17 and in time for a Nov. 17 federal deadline to submit a state-specific plan. If the DEP fails to meet that deadline, Pennsylvania must default to the federal standard. "We are fast approaching the Nov. 17 deadline," said Knaus. "If we don't meet that none of the other things matter."
Charles Territo, spokesman for the Alliance of Automobile Manufacturers, said he's not throwing in the towel yet on derailing the DEP's car emissions plan. That plan requires car manufacturers to sell different vehicles to the Pennsylvania market with changes to their catalytic converters. Territo said the changes aren't supposed to cost consumers more, but requires manufacturers to produce two different cars for the U.S. market: ones that meet federal standards and those meeting the California standards. "It's a very important issue for the auto industry," he said.
by Ricardo Alonso-Zaldivar, Los Angeles Times
October 7, 2006
http://www.latimes.com/news/printedition/front/la-na-fda7oct07,1,7169046.story
WASHINGTON -- When scientific advisors urged the Food and Drug Administration in February to put a strong warning about suspected cardiovascular risks on attention-deficit drugs taken by millions of children and adults, agency officials said more clinical evidence was needed. Now, the FDA-funded study meant to authoritatively answer questions about the drugs for attention-deficit hyperactivity disorder may be halted in midstream. The reason: The agency doesn't have the money to finish it.
The threat to the study, as revealed in documents and interviews, stems from chronic shortchanging of the nation's drug safety program. It is one symptom of a federal agency increasingly constrained by a budget that has failed to keep up with costs. This crunch is even more dire in the food division, which tries to keep tainted foodstuffs from supermarket shelves. Even as concerns grow, the agency has budgeted only $1.6 million for such safety studies of medications already on the market, and that number is scheduled to drop to $900,000 in the coming year. Outside experts estimate that the agency needs $20 million to $100 million a year to conduct such studies.
Recently, three former secretaries of Health and Human Services sounded a public alarm about what they saw as a dangerous squeeze on the overall FDA budget. Tommy G. Thompson, who served in President Bush's first term; Donna Shalala, who served under President Clinton; and Louis W. Sullivan, who served under President George H.W. Bush, joined consumer and industry groups in calling on the administration to substantially boost -- perhaps double -- the agency's $1.5-billion annual budget, which has increased only modestly in recent years.
FDA officials declined to discuss problems with funding for drug safety, saying the issue was under internal review. In a statement, the agency acknowledged that more money was needed for safety and noted that funding to complete the ADHD study had "not yet been identified." A special fact-finding panel of the Institute of Medicine recently put the troubles in blunt terms in a report that called for significant FDA changes. Funding for drug safety is "especially inadequate [and] resource limitations have hobbled the agency's ability to improve and expand this essential component of its mission," the panel concluded.
FDA officials estimate the study of ADHD medications, including such well-known brands as Ritalin and Adderall, will cost $2 million to $3 million. About $1 million has been committed. By analyzing the records of thousands of individuals, outside medical researchers have been trying to determine whether the medications predispose patients to heart attacks and sudden death. Most ADHD drugs are derived from powerful stimulants. They help patients concentrate, but they also raise blood pressure, a major risk factor for heart disease and stroke. The medications, once given primarily to children, are increasingly prescribed for adults -- a population more susceptible to heart problems. About 2.5 million children and 1.5 million adults now take such medications. "If the FDA lacks the resources to complete the study of cardiovascular risks of ADHD drugs, the consequences can have a profound adverse impact on public health," said Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic. "The makers of these agents have no incentive to study the hazards of their own drugs. Therefore, the FDA will likely represent the only entity capable of objectively assessing the safety of the ADHD drugs."
The ADHD study is not the only example of a patchwork system. The FDA bought -- at a cost of $500,000 a year -- a British database that is considered a state-of-the-art tool for drug safety research. The General Practice Research Database contains complete medical records on 4 million patients that can be mined for information on reactions to drugs. But the FDA has acknowledged that its drug safety office doesn't have enough professionals -- epidemiologists, biostatisticians and computer programmers -- to take full advantage of the database.
Meanwhile, the 90-person drug safety office is reeling from a surge in reports on medication side effects. The number of such "adverse event" reports jumped from about 250,000 in 2000 to more than 450,000 in 2005. The trend reflects greater use of prescription drugs, growing awareness of their risks and improvements in the reporting system. "We have to do difficult triage about which ones we are going to follow up on," said an FDA official closely involved with the agency's budget who asked not to be identified because of the sensitivity of discussions within the Bush administration. "Our funding is just not robust enough for scientific research." Fully funding the ADHD risk study would mean "we wouldn't be able to do too many other studies," the official added.
The FDA's budget crunch has also hurt its ability to safeguard fresh produce, some critics say. That has become an issue in the aftermath of the E. coli outbreak traced to California spinach. The number of inspectors and field office staffers has been cut from 2,217 in 2003 to about 1,960. "The agency is like a fire department running around with a little fire extinguisher," said Michael Jacobson, director of the Center for Science in the Public Interest, a nutrition advocacy group. "The money situation for foods is probably worse than it's ever been."
Earlier this year, the FDA's food division announced that budget pressures had forced cuts in its headquarters workforce from 950 in 2003 to fewer than 850, with further reductions expected. The FDA has "been presented with unique challenges, and we will not be able to take on the same large number of objectives we have identified in previous years," Robert E. Brackett, director of the food division, wrote in an unusually candid letter to consumer and industry groups. "The challenges are likely to continue [in 2007] and beyond for domestic agencies in the federal government."
The agency's budget challenge has three facets, outside experts and agency officials say. First, modest annual increases for the FDA have not kept up with escalating salaries for its doctors, pharmacologists, epidemiologists and other professionals. For example, experts in the FDA's Center for Drug Evaluation and Research made an average of $70,000 in 1997, but now command salaries of $140,000 to keep up with industry. A recent internal FDA analysis estimated that the 2006 budget would have needed to be $2.2 billion -- not $1.5 billion -- just to keep pace with increases in personnel costs.
Second, the post-market drug safety program -- with a few exceptions -- is not allowed to tap into user fees that pharmaceutical companies pay the agency for the review of proposed new drugs. The user fees add about $400 million a year to the FDA's $1.5-billion budget.
Finally, compared with funding for the National Institutes of Health, which sponsors cutting-edge medical research, securing more money for the FDA has been a low priority for the administration and Congress. The NIH budget has increased from $20.5 billion in 2001 to $28.6 billion. "There has been a dramatic increase in the attention focused on NIH, and we believe similar attention needs to be given to the FDA," said Sheila Burke, chairwoman of the Institute of Medicine panel that recently reported on drug safety. "The center of that effort has to be an increase in resources. There is no question that it needs to be done."
Meanwhile, despite the uncertainty over funding for the ADHD study, researchers are continuing work on it. They plan to use several medical databases to try to address three key issues: whether there is a link between ADHD drugs and higher rates of heart attack and sudden death in children; whether such a risk exists for adults; and whether there is a link between ADHD drugs and heart-rhythm abnormalities in children. They have designed the study, but without more money won't be able to determine whether these popular drugs can lead to heart attacks. "That's a very important question," said Laurel Habel, an epidemiologist at the Kaiser Foundation Research Institute in Oakland, which is participating in the study. "These drugs are being prescribed for a large and growing number of children, and they are also being prescribed to a growing number of adults. And, in general, they are medications that are taken for the long term."
by Martin Mittelstaedt, Toronto Globe and Mail
October 5, 2006
http://www.theglobeandmail.com/servlet/story/RTGAM.20061005.wxpesticide05/BNStory/National/home
According to the Canadian Food Inspection Agency, fresh fruits and vegetables on Canadian store shelves are remarkably free of pesticides, with bug- and weed-killer residues on only 10 per cent of the thousands of samples it checks every year. But a new report from an environmental think tank contends the federal food safety watchdog is seriously underestimating these residues because U.S. regulators, checking the same types of fresh foods, find pesticides on 76 per cent of them. British food safety regulators find them on 40 per cent. "It is difficult to believe that fruits and vegetables in Canada are so much cleaner than produce in the U.S. or the U.K, especially when a substantial proportion of Canadian produce is imported from the U.S.," said the report by the Vancouver-based David Suzuki Foundation.
The report, being released today, called on the federal government to investigate these "glaring inconsistencies" to find out why the Canadian tests are so out of line. The foundation's report, one of the most comprehensive comparisons among advanced countries on the regulations covering pesticides, concluded that Canadian safety standards are some of the weakest, in part because they allow the continued use of dozens of weed, bug and fungus killers banned elsewhere. "Canada is really light years behind other industrialized nations in addressing the health threats posed by pesticides," said report author David Boyd, an adjunct professor of environmental management at Simon Fraser University.
The CFIA couldn't immediately explain why its pesticide spot checks were so different from those in the other two countries. But Robert Charlebois, the agency's director of food safety, said the results might not be comparable because of differences in the way the products were sampled and tested in the countries.
Among its other findings, the report said Canada generally allows higher pesticide residues on food than in Europe or Australia. In one case, for the insecticide methoxychlor, Health Canada considers safe residues a staggering 1,400 times the European limit. In a comparison between Canada and Europe of residue standards on 40 food and pesticide combinations, the report said Canadian limits were weaker in 30 cases, and stronger in none. In a comparison with Australia, Canadian standards were weaker in 21 cases, and stronger in four.
Health Canada's chief of pesticide registration, Richard Aucoin, defended Canadian residue limits because more than 90 per cent are either the same as in the United States or stricter. He said Canada has a "very, very rigorous risk assessment for pesticides." According to the report, Canadian regulations frequently label as safe food with pesticide residues of around one part per million, but it said new research has found some of these chemicals are biologically active at far lower concentrations, raising concerns that the amounts to which Canadians are exposed could be a health risk.
The report also said that Health Canada allows Canadian farmers to use 60 pesticides no longer permitted in other countries because of bans or product withdrawals from the market. Mr. Aucoin said Health Canada is currently looking at the accuracy of the list compiled by the foundation. However, he said "virtually all" of the chemicals identified by the foundation will be re-evaluated by Health Canada under a previously announced program of looking at the safety of pesticides in long-term commercial use.
by Cheryl Hogue, Chemical & Engineering News
October 5, 2006
http://pubs.acs.org/cen/news/84/i41/8441EPA.html
Three members of a panel that advises EPA on the management of commercial chemicals resigned as a bloc effective Oct. 4. The National Pollution Prevention & Toxics Advisory Committee "has been unable or unwilling to consider systematic, structural problems" with EPA's assessment and management of chemicals under the Toxic Substances Control Act, they said in an Oct. 2 resignation letter to the agency. Leaving the 15-member panel are Richard A. Denison, senior scientist for Environmental Defense; Joseph H. Guth, executive director of the California League for Environmental Enforcement Now; and Joel Tickner, assistant professor in the Department of Community Health & Sustainability at the University of Massachusetts, Lowell.
The three said EPA has been reluctant to acknowledge and confront limitations in its approaches for assessing and managing chemicals. Also, the agency has "repeatedly cited EPA's budgetary constraint as a barrier even to considering changes." In addition, the advisory panel is "numerically weighted excessively toward industry," they said. This has allowed some industry members to put off the panel's discussion of broader issues and limit its agenda to "narrow, short-term issues" that do not warrant the time and expense to EPA of having the advisory committee, the three wrote.
Industry members include representatives of the American Chemistry Council, the Synthetic Organic Chemical Manufacturers Association, the American Petroleum Institute, Dow Chemical, Procter & Gamble, and GE Advanced Materials. Chairing the committee is Harry Gregori Jr., the vice president of Environmental Solutions, an environmental consulting firm. Other members of the panel are a retired executive director of the Risk Science Institute at the International Life Sciences Institute, a representative of the National Center for Healthy Housing, and officials from two state agencies and one from a Native American tribe.
The committee was scheduled to meet in a public session on Oct. 4-5, but EPA abruptly cancelled the meeting on Oct. 2, providing no explanation. Calls from C&EN to EPA on the issue were not returned by deadline.
by Marla Cone, Los Angeles Times
October 5, 2006
http://www.latimes.com/news/printedition/asection/la-me-perchlorate5oct05,1,7438204.story
Many women exposed to perchlorate, the rocket fuel chemical that has contaminated hundreds of Southern California water wells, have suppressed thyroid function, which can lead to health problems in them and abnormal brain development in their offspring, according to a study by the Centers for Disease Control and Prevention published Wednesday. The study is the first research that links reduced thyroid hormones in people with the low amounts of perchlorate routinely found in the bodies of Americans nationwide. Women with low iodine levels -- more than one-third of U.S. women -- were most at risk from the chemical, according to the report.
Perchlorate is particularly a pervasive threat in California, where more than 450 wells and other water sources operated by more than 100 agencies are contaminated, primarily in Los Angeles, Orange, Riverside, San Bernardino and Sacramento counties, according to the state health department. The chemical also is found in milk, cheese, lettuce and other food, as well as human breast milk and baby formula. Much of the contamination comes from military bases and aerospace plants, where perchlorate was used as the explosive component of solid rocket fuels.
The findings could provide major evidence for the U.S. Environmental Protection Agency, which for years has been reviewing whether it should set a national standard for perchlorate in drinking water. The CDC team analyzed thyroid hormones and perchlorate levels of 1,111 women and found a relationship between them, particularly in those with low iodine levels. Women with moderate to high perchlorate exposure had fewer T4, or thyroxine, hormones -- on average, a reduction equivalent to 8% to 33% of the normal range for the hormone. "For women overall, perchlorate was a significant predictor" of two important thyroid hormones, T4 and TSH, or thyroid-stimulating hormone, according to the study, published Wednesday in the online version of the journal Environmental Health Perspectives. The research was led by Benjamin C. Blount of the CDC's National Center for Environmental Health in Atlanta.
Prolonged reductions in thyroid hormones, often caused by insufficient iodine intake, can lead to hypothyroidism, a metabolic disorder, in adults, and mental impairment in fetuses and infants. The most pronounced reductions in the thyroid hormones were in women with iodine levels of less than 100 micrograms per liter, the minimum level suggested by the World Health Organization. No drops in the hormones were seen in men, possibly because women are more at risk due to the thyroid effects of estrogen and pregnancy.
Last year, a panel of the National Academy of Sciences concluded that perchlorate can affect the thyroid's ability to absorb iodine and suppress its hormones. But it also determined, based on the science at the time, that effects would occur at high levels of exposure. In the new study, the reductions in thyroid hormones were seen "at perchlorate exposure levels unanticipated based on previous studies." Based on the average perchlorate levels in their urine -- 2.9 parts per billion -- the women were ingesting almost 10 times less than the dose the EPA has considered safe based on the national academy panel's recommendations.
In a report accompanying the new study, Environmental Health Perspectives called the reductions in thyroid hormones "significant" and said they "indicate that even small increases in perchlorate exposure may inhibit the thyroid's ability to absorb iodine." The CDC researchers reported that nearly all of the previous studies that found no thyroid effects analyzed men, not women. Only two previous studies included women, and they had normal iodine levels so they were less vulnerable to effects. "Our study is the first to target and separately analyze results for women with lower levels of urinary iodine, a potentially susceptible population," they said.
While the EPA reviews whether to impose a drinking water standard, it has set an interim goal -- not an enforceable limit -- for industrial cleanups. The Pentagon and its contractors, including Aerojet and Lockheed Martin, have been lobbying against a stringent drinking water standard, saying there are no proven health effects and that cleaning up perchlorate could cost billions of dollars.
In August, California proposed its own drinking water standard of 6 parts per billion. The state health agency will hold a hearing on its proposed regulation Oct. 30 in Sacramento. Comments from the public will be accepted until Nov. 3. Massachusetts is the only state with a mandatory limit in place: 2 parts per billion. Perchlorate has been detected in the public drinking water supplies of more than 11 million people in 26 states at concentrations of at least 4 ppb, according to the 2005 National Academies of Science report.
by Jodi Andes and Mark Ferenchik, Columbus Dispatch
October 4, 2006
http://www.columbusdispatch.com/news-story.php?story=dispatch/2006/10/04/20061004-A1-00.html
A paint company is suing Columbus for merely planning a lawsuit to recover damages caused by lead paint. Cleveland-based paint manufacturer Sherwin-Williams has filed a lawsuit against the city in U.S. District Court in Columbus asking the court to prohibit the city from suing paint companies over lead paint. Assistant City Attorney Glenn B. Redick said to his knowledge the paint company's lawsuit marks the first time Columbus has been sued over what the city might do. "We're not intimidated," Redick said.
In September, city officials announced they were considering legal action against paint companies after Rhode Island won a lawsuit against Sherwin Williams and two other companies that is potentially worth billions. Since then, Toledo and East Cleveland have sued Sherwin-Williams, Millennium Holdings and NL Industries -- the three defendants in the Rhode Island case. Sherwin-Williams also named those cities as defendants in its suit, along with cities that might file suit later, listed as John Doe cities. Rhode Island successfully claimed that paint companies continued putting lead pigment in paint even after studies showed it caused serious health problems in children. The federal government banned lead paint in 1978.
In the suit Sherwin-Williams filed last week, the company blames outside lawyers for lobbying cities to file suit so the lawyers can make piles of money. The Rhode Island cleanup costs have been estimated at $1.37 billion to $3.74 billion. In Columbus, outside law firms working for the city could receive up to one-third of any settlement or decision. "We think this suit is important to stop the trial lawyers from stirring up what we view to be baseless litigation," Sherwin-Williams spokesman Bob Wells said.
Sherwin-Williams says cities are going after its "deep pockets" instead of focusing attention on those who should be held responsible. "A relatively small number of private property owners ... have failed to maintain their properties and the lead-containing paint within them," the lawsuit says. "They are directly responsible for creating risk underlying the alleged public nuisance."
In the Rhode Island case, the state argued that Sherwin-Williams belonged to trade associations whose lobbyists fought lead-paint regulations. The company says that by threatening a similar lawsuit, Columbus is violating the company's First Amendment rights to association and to petition the government.
Normally such pre-emptive strikes are very difficult to win, said David Goldberger, a First Amendment expert with Ohio State University's Moritz College of Law. But he said companies such as Sherwin-Williams realize litigation can drain the city's resources. Still, he called the suit a potpourri of long shots. "There is every conceivable theory under the sun here."
On July 31, the Columbus City Council approved a contract with four law firms and two lawyers -- including some involved in the Rhode Island case -- to represent the city if it sues the paint companies. City Attorney Richard C. Pfeiffer Jr. called Sherwin-Williams' claims puzzling but not surprising. "It's the nature of the beast when you deal with folks at this level," he said. John P. Kennedy, a lawyer with Crabbe, Brown and James, which is working with Columbus on the possible lawsuit, said he thinks Sherwin-Williams' suit won't stop Columbus from proceeding.
Sherwin-Williams filed a similar lawsuit in Mississippi in 2001 after a school district filed suit against paint companies. A federal circuit court reinstated the company's case after a lower court dismissed it, but then the school district dropped its claim, said Charles Moellenberg, an attorney for Sherwin-Williams. In the past 10 years, more than 2,500 Columbus children have been diagnosed with lead poisoning. City officials are planning to use $1.75 million in federal money to remove lead paint from 226 homes.
by Laura Landro, Wall Street Journal
October 4, 2006
http://online.wsj.com/article/SB115991894763881827.html?
Hospitals play a pivotal role in protecting America's health. But they may also have a surprising unhealthy side -- inadvertently contributing to illness and pollution by exposing patients and staff to a witch's brew of toxins from building materials, medical waste, hospital supplies and cleaning products. Environmental health experts warn that materials that cover floors, walls and ceilings release hundreds of chemicals into hospital air, and chemicals used to clean and maintain hospitals add more. Volatile organic compounds such as formaldehyde, acetaldehyde, naphthalene and toluene are released into the air from particle board, carpets and other finish materials and are inhaled by patients and staff. Polyvinyl chloride (PVC), which releases the carcinogen dioxin during its manufacture, is widely used in the production of IV and blood bags, plastic tubing and other hospital products, as well as carpets. In addition, inadequate ventilation and generally high energy consumption have contributed to poor air quality and pollution, studies show, with effects ranging from longer patient recovery times to more sick days for staff.
Now, as the industry embarks on a $200 billion construction program over the next decade to replace or rebuild decaying facilities and meet growing demand from aging baby boomers, that is starting to change. Under pressure from local and state governments, as well as health-care architects and designers and their own environmentally conscious donors, hospitals are building more efficient, eco-friendly facilities with "sustainable" design features that conserve energy, use natural light and materials and reduce potentially dangerous emissions.
About a dozen pioneering groups, including Kaiser Permanente and Dartmouth-Hitchcock Medical Center in Lebanon, N.H., began the move to "green" hospital construction several years ago, and others are now following suit. According to the nonprofit Center for Health Design, which co-sponsored a conference in New Jersey last week to promote green design, more than 180 health-care facilities have been built or are being designed and constructed to standards such as those set by the Green Guide for Health Care (GGHC.org), modeled on a certification system developed by the U.S. Green Building Council, a coalition of builders, architects, government agencies and nonprofit groups.
When Kaiser Permanente's new medical center in Modesto, Calif., is completed in 2008, solar panels will cut energy costs, permeable pavement material will filter chemicals from rainwater runoff, floors will be covered with natural rubber, carpets will be backed with recycled safety glass -- even toilets will be fitted with special fixtures to conserve water. The new center is part of a $20 billion-plus facilities program at the Oakland, Calif.-based health-care giant that includes building or replacing 27 hospitals over the next nine years.
To be sure, there is conflicting evidence about the harm caused by chemicals in hospitals, and some manufacturers say there is no direct evidence that PVC, for example, is harmful to humans. But the nonprofit advocacy group Healthcare Without Harm says hospitals have a responsibility to choose the safest course when evidence suggests harmful effects. The group cites studies that show hazardous additives in PVC are toxic to both the reproductive and neurological systems -- a particular concern for neonatal-intensive-care patients. The American Hospital Association signed a memorandum of understanding with the Environmental Protection Agency several years ago to phase out the use of mercury, which can affect the human nervous system, in things like thermometers and blood-pressure cuffs. At the same time, studies show that environmental improvements associated with sustainable buildings, such as bringing in more natural daylight, meditation areas and "healing gardens," can shorten patients' length of stay, reduce reliance on medication, and lessen mental and physical stress.
As hospitals move to make such changes, the challenge now is not only to build hospitals to rigid environmental standards, but also to operate them with the same principles in mind. "You can't build a green hospital and still have Styrofoam cups in the cafeteria," says health-care architect Robin Guenther, a co-coordinator of the Green Guide for Healthcare. Stiffer federal regulations governing emissions of chemicals and heavy metals like dioxin and mercury have driven some changes, in particular regarding incinerators used to dispose of medical waste. Since the mid 1990s, when regulators found that hospital incinerators were a major contributor to mercury and dioxin emissions, more than 5,000 medical-waste incinerators have closed, and hospitals have adopted safer waste-disposal and treatment technologies. "Hospitals didn't think of themselves as polluters, with spewing smokestacks and waste going out the back door," says Laura Brannen, executive director of the nonprofit Hospitals for a Healthy Environment (h2e-online.org), which helps hospitals devise improved environmental programs that also shave costs. Among them: separating hazardous waste, infectious waste and solid waste, which must be treated and disposed of differently, and recycling or reclaiming chemicals for medical use.
But Ms. Brannen cautions that many hospitals still send their waste to municipal incinerators that contribute to health threats. Wastewater from hospitals, she adds, still contains toxic lab and cleaning chemicals and pharmaceutical compounds, many of which aren't broken down in sewage-treatment plants. Hospitals are also scrambling to find substitutes for building and interior finish materials. And companies that supply the industry are under growing pressure to come up with green products, including latex-free examination gloves, greener cleaners without harsh chemicals and recyclable solvents. "In an era of rising construction costs, you don't have to pay extra money and use precious health-care dollars just to be green," says Christine Malcolm, Kaiser senior vice president of national facilities and hospitals. With the industry's purchasing power, "we can force suppliers to generate environmentally sensitive products."
Kaiser, for example, pressured carpet manufacturers to come up with a PVC-free product, which it will use in all its new facilities. Kaiser is also installing "dual-flush" toilets, which use more water for flushing solid waste and less for liquid, saving half a gallon of water for the latter. In the past five years the company says it has eliminated the purchase and disposal of 40 tons of hazardous chemicals, chosen "ecologically sustainable" materials for 30 million square feet in new construction, and saved more than $10 million a year through energy-conservation strategies. While many of the innovations cost more up front, they can actually reduce operating costs over time, says Gary Cohen, executive director of the Environmental Health Fund, a nonprofit group that works on chemical-safety issues. Rubber flooring is more expensive to install than PVC, for example, "but the hospital will save much more during the lifetime of the flooring due to the fact that you don't need to constantly strip the floor with toxic chemicals and rewax it," Mr. Cohen says.
Still, going green can be challenging for hospitals that have to rebuild or retrofit older facilities. To build the new Lacks Cancer Center, St. Mary's Health in Grand Rapids, Mich., had to tear down old buildings, remove asbestos from pipes, tear out linoleum tiles, and separate metals like steel and copper. But it recycled more than 90% of the materials, recrushing brick and cement for the new facility, and installed energy-saving devices like windows with self-cleaning coatings. "It may have cost us a few dollars more, but in the long run it will pay dividends," says St. Mary's President and Chief Executive Philip H. McCorkle Jr. Another incentive: A local benefactor made a major gift to the hospital contingent on sustainable design. The hospital also prepares food to order, which Mr. McCorkle says uses less energy, wastes less food, and makes patients happier than the traditional cafeteria model.
The University of Pittsburgh Medical Center, which is building a new children's hospital due for completion in 2009, is paying special attention to issues such as materials used to cover and clean floors, since its small patients "are closer to the floors and the source of chemicals," says President and CEO Roger Oxendale. But the hospital is also teaching medical interns about environmental health and reaching out to underserved populations to educate them about issues such as how second-hand smoke can harm their children.