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.
September 12 - 14, 2006
Atlanta, Georgia
The Coordinating Center for Health Promotion (CoCHP) will sponsor this conference at the Atlanta Hilton and Towers. This conference will bring together over 2,000 health professionals representing the Office of Genomics and Disease Prevention (OGDP), the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), and the National Center for Birth Defects and Developmental Disabilities (NCBDDD) as well as their partners. Matt Sones, Acting Enterprise Communications Officer for CoCHP, will provide the leadership, assisted by Beth Patterson who will serve as the conference manager. The executive committee will consist of representatives from each CIO. The committee representatives are Denae Ottmann and Melanie Myers from the Office of Genomics and Disease Prevention, Barbara Kilbourne from the National Center on Birth Defects and Developmental Disabilities, and Claudia Brogan, Stacey Mattison, and John Korn from the National Center for Chronic Disease Prevention and Health Promotion. The members of the executive committee will be working closely with both internal coordinating center staff and external partners to ensure the success of this event.
Website: http://www.cdc.gov/cochp/conference/
Contact: 770-488-2875 or chronicconf@cdc.gov?subject=2006 National Health Promotion Conference Inquiry
September 12, 2006, in Detroit, Michigan
September 13, 2006, in Foster City, California
September 15, 2006, in Seattle, Washington
8:30 a.m. - 4:15 p.m.
In order to help US companies prepare for REACH and move beyond the law toward sustainable chemicals management, the Lowell Center for Sustainable Production is organizing a series of one-day training workshops. These workshops will explain the key features of REACH, giving participants a chance to ask experts about how REACH will affect their companies. The LCSP will also provide training in the Globally Harmonized System of Classification and Labeling (GHS), the use of sustainable chemicals management, green chemistry, and cleaner production approaches, and how they can help businesses turn REACH around from a challenge to an opportunity. Andrew Fasey, one of the key authors of REACH and the GHS, will be the lead trainer in the workshops, along with LCSP senior staff. The new REACH system will put much more responsibility on companies to collect data on most chemicals on the market, assess the risk of these chemicals, and define safe use down the supply chain. It will also create a new system for dealing with the most hazardous chemicals, in which companies will have to justify continued use of chemicals of very high concern. Any company that exports chemicals or chemical mixtures into the EU, that competes in Europe, the US, or elsewhere with products meeting European standards, or that exports finished products to Europe, will be affected.
Website: http://www.chemicalspolicy.org/registration.shtml
September 14 - 15, 2006
Washington, DC
at the National Academy of Sciences Auditorium, 2101 Constitution Avenue, NW
Recognizing significant progress has been made on a number of exposures over the last 30 years, this workshop will challenge the field to focus on a broader array of exposures, and importantly, to better understand the linkages along the continuum from exposure to disease outcome. Such linkages are needed to improve risk assessment, to increase the validity of epidemiology studies, to enable the identification of genetic and environmental interactions and to increase the utility of exposure information in clinical settings. In addition to toxicity of a substance, factors such as the type of exposure, length of exposure, genetic polymorphisms, and age of an individual, determine whether an exposure will lead to a disease outcome. In an effort to increase our knowledge and understanding of the interface between environmental agents and human disease, this workshop will discuss the current state of knowledge along the exposure-disease continuum, the current exposure challenges for the future, and the research and policy strategies to inform the science. The workshop will draw from the scientific advances in genomics, proteomics, and biomarkers in order to discuss opportunities to provide insight into the exposure-disease linkages and build on increased knowledge in nutrition and stress research, and improved computer modeling to examine ways to make better linkages across the continuum. The workshop is free and open to the public, but does require advance registration.
Website: http://www.iom.edu/?id=36630
Contact: 202-334-2548
September 16, 2006
Cedar Creek, Texas
at the McKinney Roughs Nature Center
This symposium will focus on the National Children's Study, the largest long-term study of human health ever conducted in the United States. Study researchers will follow 100,000 children from before birth to age 21, hoping to better understand how children's genes and their environments interact to affect their health and development. In the study, "environment" includes factors like air, water, food and house dust, as well as how children are cared for, the safety of their neighborhoods, and how often they see a doctor. Keynote speaker will be Dr. Alan Fleischman, chair of the National Children's Study Federal Advisory Committee. Plenary speaker will be Gail D.A. Vitorri, co-coordinator of a National Environmental Health Agenda for the Built Environment with the Healthy Building Network.
Website: http://www.cehi.org/
Contact: Janie Fields (CEHI's Executive Director), Janie.Fields@cehi.org
September 17 - 21, 2006
Little Rock, Arkansas
at the Doubletree Hotel
Website: http://www.neurotoxicology.com/conference.htm
Contact: Dr. Joan Cranmer, Conference Chair, 501-364-2986 or CranmerJoanM@uams.edu
September 18, 2006
3:30 p.m.
Sacramento, California
at Byron Sher Auditorium, Cal/EPA Headquarters Building, 1001 I Street, 2nd Floor
During the workshop, DTSC representatives will present the approach used to develop the threshold, outline the basis for the assumptions and parameter selections, and discuss anticipated impacts. As part of the workshop, DTSC would like participants at both sites to provide input regarding the selection of the model, the assumptions regarding exposure, the selected parameters, potential outcomes and impacts associated with the revised threshold and any other concerns or positions about the proposal. Specific suggestions for changes and data regarding impacts are most useful. Attendees at the remote videoconference sites in Glendale and Berkeley will view the workshop on a live closed-circuit television monitor and will be able to participate through the videoconference connection. All interested parties are invited to participate in this public workshop. Please confirm your interest in attending the workshop by sending an e-mail notice indicating which workshop location you will be attending.
Website: http://www.calepa.ca.gov/broadcast/default.asp?FIRSTTIMEIN=1
Contact: David Miura, 916-322-0348 or DMiura@dtsc.ca.gov
September 19 - 21, 2006
Vail, Colorado
at the Vail Cascade Resort and Spa
The theme for this year's Children's Environmental Health Summit is "Children's Health and Their Environments: Making the Connection." Goals are to 1) increase the ability of health, environmental, and education professionals to identify, prevent, and reduce environmental health threats to children; 2) share information, resources, "best practices", and emerging science regarding the protection of children's health from environmental hazards; 3) encourage coordination and information sharing across government agencies, health organizations, health care providers, educators, and the general public in addressing children's environmental health issues; 4) identify actions that can be implemented throughout the region to protect children from environmental health threats; and 5) provide public health professionals with an opportunity to identify/implement effective children's health strategies in advance of Children's Health Month in October. Online registration is now available.
Website: http://www.epa.gov/region8/humanhealth/children/2006summit.html
September 24 - October 1, 2006
simultaneous events will take place in the Northeast, the Southeast and the West Coast
The tour theme is "Environmental Justice for All; Reclaiming our Health and Communities Tour '06." The purpose of EJ Tour '06 is to bear witness to the casualties of our failed economic and environmental policies and how our addiction to oil and chemicals is causing Americans -- especially infants and children, workers, indigenous peoples, and communities near industrial facilities -- to bear the heavy burden of chemical contamination. Buses with environmental and health specialists will roll from city to city to work with local communities to highlight their toxic contamination problems. Each visit will include a public event or teach in about local problems and solutions, and will generate public attention and media coverage. The effect of the tour as a whole will be to build stronger links with local environmental justice organizations and raise the profile of environmental justice and health concerns nationally.
Website: http://ej4all.org/
Contact: Virginia Giordano, National Director, 212-598-2181 or vgpnyc@aol.com
edited by Howard Frumkin, Robert J. Geller, I. Leslie Rubin and Janice Nodvin
submitted to this bulletin by Healthy Schools Network
Millions of children and adults across the nation spend their days in school buildings, and they need safe, healthy environments to thrive, learn and succeed. This book explores the school environment using the methods and perspectives of environmental health science. Though environmental health has long been understood to be an important factor in workplaces, homes, and communities, this is the first book to address the same basic concerns in schools. The editors are physicians and educators trained in pediatrics, occupational and environmental medicine and medical toxicology, and the authors are experts in their fields drawn from across the United States and abroad. Each section of the book addresses a different concern facing schools today. In the first six sections, the various aspects of the school environment are examined. Chapters include the physical environment of the school, air quality issues, pest control, cleaning methods, food safety, safe designs of playgrounds and sports fields, crime and violence prevention and transportation. In the last two sections, recommendations are made for school administrators on how to maximize the health of their schools. Appropriately evaluating the school environment, implementing strategies to address children and adults with disabilities, emphasizing health services, infectious disease prevention and recognition and occupational health for faculty and staff are all addressed. The entire book is evidence-based, readable, generously illustrated and practical. An indispensable resource for parents, school staff, administrators, government officials and health professionals, this book is for anyone who cares about the health of our schools.
For more information please visit http://www.oup.com/us/catalog/general/subject/Medicine/PublicHealth/?view=usa&ci=9780195179477
by Liv Osby, Greenville [South Carolina] News
September 5, 2006
http://www.greenvillenews.com/apps/pbcs.dll/article?AID=/20060904/NEWS01/609040314&SearchID=73255933033093
Late at night as the Upstate slumbers, trucks chug through neighborhoods, fogging for mosquitoes that cause West Nile virus. And while knowing that may help some sleep more peacefully, the spray may not be doing any good, according to researchers at the Harvard School of Public Health. They counted the number of mosquito eggs before ground spraying in the suburbs of Boston and then counted the eggs again afterward. They found little difference. "We tested the method under a variety of circumstances and made every attempt to optimize conditions, yet none of our treatments had any demonstrable impact," the researchers wrote in a recent issue of the Journal of Vector-Borne and Zoonotic Diseases. "We conclude that insecticidal aerosols dispersed from the road may not effectively reduce the force of transmission of West Nile virus."
Nearly 3,000 people got West Nile virus last year, and 116 of them died from it, according to the U.S. Centers for Disease Control and Prevention. So far this year, 901 cases, including 31 deaths, have been reported nationwide, with four birds and 10 mosquito pools infected in South Carolina. But peak West Nile season has just started, and recent rains are likely to mean more mosquitoes as well as more calls for spraying from worried residents. So if ground fogging produces few results, as the researchers contend, are taxpayers throwing money away on their spraying programs? "I think it is money well spent," said Paula Gucker, assistant Greenville County administrator for public works.
The county provides fogging services to residents of Greenville, Simpsonville, Travelers Rest and unincorporated areas of the county from June through September, she said, with preventive treatments in May for major mosquito populations. The program costs $25,000 a year, she said. "We get a lot of calls on an annual basis," she said. "People seem pleased with it." And Greer Public Services Director Wesley Wagner said he's always thought spraying did a good job, too.
In Mauldin, which spends between $16,000 and $19,000 a year on its program, acting administrator Tom Lynn said it's a case of something being better than nothing. In his own "unscientific" counts of mosquitoes, he said, the fogging has a 40 percent to 60 percent kill rate, depending on the weather and the density of the housing. And that helps make outdoor events more bearable, he said. "The success rate is not as good as we would like," Lynn said. "We would like to kill all of them, but at least we're killing half of them, so it's tolerable. If we did not spray, it would be horrible."
But Clemson University extension pesticide coordinator Robert Bellinger said the research makes sense. "Their conclusions are probably correct. Effectiveness is going to vary," said Bellinger, adding the pesticide is sprayed in a fine mist, so it can stay suspended in the air, making it harder to hit the target. The researchers said spraying was ineffective largely because the pesticide has to hit a mosquito to kill it. And in suburban settings, obstacles such as shrubbery can limit the reach of the spray. "We were concerned about the distribution of the spray in the affected area -- were we getting even coverage," said one of the study's authors, Andrew Spielman, professor of tropical public health at Harvard.
The concentration of foliage and arrangement of homes are among factors that affected efficacy, he said. And spray trucks only get the front yard if they're lucky, adds Dr. Sheldon Krimsky, professor of urban and environmental policy and planning at Tufts University, who says the pesticides can be harmful to some people. This study tells you that you cannot just assume that by spraying a pesticide you're going to achieve the results you want to achieve," he said.
The researchers said an earlier study of spraying in a community with large expanses of unobstructed land and even building patterns appeared to reduce mosquitoes by 80 percent. So whether ground fogging works may depend on the neighborhood. "With all the money that's being spent, there's not a lot of emphasis on whether it's working," says Eileen Gunn, project director for the environmental group Beyond Pesticides.
But while Bellinger says the findings seem logical, Christopher Evans, medical entomologist with the state Department of Health and Environmental Control's Bureau of Laboratories, said the study results could be skewed by a number of factors. For instance, he said, egg-laying depends on a mosquito's nutrition, health and other issues, so counting eggs may not be a reliable way to monitor populations. Also, he said, because of the time of spraying, the researchers could have missed mosquitoes. And more than one application may be necessary. "Too many variables in this study could cloud the interpretation made by these authors," he said. "The jury is still out."
And Eric Benson, extension entomologist at Clemson, said the study reached a conclusion about spraying in the Boston suburbs, but results may differ in other areas. "You've got to be careful drawing broad conclusions," he said, adding that similar studies are needed in the Greenville area to determine whether spraying is effective here. Joe Andrews, a vector industry specialist with Univar USA, which distributes pest control products, agreed, saying programs that incorporate integrated pest management -- a system that uses the most appropriate pesticides and applications for the situation -- are most likely to have effective spraying.
In the case of mosquitoes, he said, IPM means first eliminating breeding areas, increasing public awareness, using special chemicals called larvicides to kill the insect larva in ponds and other waterways, and then fogging for adults under optimum conditions. But Bellinger said there's another concern about spraying, too -- the impact of pesticides in the environment. "If these pesticides were totally innocuous, with no potential effects on children, the elderly, immunocompromised people, sensitized people, it wouldn't matter," he said. "If it doesn't work, it doesn't work. You haven't lost anything except for some money."
Still, Bellinger says one study is no reason for everyone to stop spraying. "The take-home message is communities need to evaluate more closely the effectiveness of their fogging in the different types of situations," he said. "If you're not getting effectiveness, you're throwing money away."
by Sandra G. Boodman, Washington Post
September 5, 2006
http://www.washingtonpost.com/wp-dyn/content/article/2006/09/03/AR2006090300590.html
Virtually no one opposes the goal of the mandatory new federal program governing the use of Accutane: to prevent pregnant women from taking the potent acne drug, approved in 1982, because it causes serious birth defects. That is where the consensus about the unusually restrictive six-month-old program known as iPledge ends. The program requires registration of all parties: wholesalers who sell it, pharmacists who dispense it, doctors who prescribe it and, above all, patients who take the drug. Public health officials say such strict regulation is necessary because years of progressively stronger voluntary programs failed to prevent pregnancy in users of the medicine, a treatment of last resort for severe scarring acne. Most of the estimated 200,000 Americans who take the drug generically known as isotretinoin each year are under 30; half are female.
Others -- including Rep. Bart Stupak (D-Mich.), whose teenage son shot himself to death in 2000 while taking Accutane and who has addressed a congressional hearing on the drug's safety -- have long advocated tight controls, or a ban, on the drug because of its possible link to psychiatric problems.
But patients and their dermatologists complain that the rules of iPledge are onerous and unworkable and that the program is rife with problems that have disrupted and delayed treatment for thousands who have no other viable options. Some doctors say they have spent hours on hold trying to reach the iPledge call center to straighten out problems with a patient's prescription. And some patients and their parents say they were given misinformation by program staff that prevented them from registering for the program, or encountered days of delay obtaining a password necessary to access its Web site.
Last week the 15,000-member American Academy of Dermatology (AAD) released a survey it commissioned bolstering those claims. The telephone poll conducted last month found that 90 percent of 378 physicians are having problems with the program, which is expected to cost the drug's four manufacturers at least $80 million for the initial phase. Nearly 52 percent said patients' treatments had been delayed because they were unable to pick up a prescription within seven days while 39 percent said their patients encountered technical problems using the Web site.
In June, after a torrent of complaints, eight senators led by Judd Gregg (R-N.H.) and Dick Durbin (D-Ill.) appealed to acting Food and Drug Administration (FDA) commissioner Andrew von Eschenbach to "address the procedural barriers plaguing the operation of the program." "Every single one of my patients has had a problem" said Washington dermatologist Sandra Read, a member of the AAD board. "I don't care how smart you are -- this is an extremely confusing program with a very steep learning curve." Read said she has fielded calls from other dermatologists asking her to take over their patients because they had decided to stop prescribing the drug. Dermatologists estimate that Accutane costs about $600 per month and is usually covered by insurance.
Between 1982 and 2005, 2,796 pregnancies among women who used Accutane were reported to the FDA, according to Sandra Kweder, the agency's deputy director of new drugs. Most ended in abortion or miscarriage, but the birth of 194 babies with defects caused by the drug were reported to the FDA. The actual numbers are believed to be far higher, Kweder said, because pregnancies and birth defects among users are underreported. Each year approximately 120,000 American babies are born with birth defects that result from genetic, environmental or, most often, unknown causes, federal officials say. The most common include cleft lip or palate (6,800) and Down syndrome (5,500), while tens of thousands of infants are born with signs of permanent damage caused by prenatal exposure to alcohol.
IPledge supporters acknowledge problems with the mechanics of the program, but say it serves an essential purpose. "Acne is not a life-threatening disease," said Nancy Green, medical director of the March of Dimes, who called isotretinoin "a vanity drug" that has been over-prescribed for mild cases. Even though the program is, in her words, "cumbersome, laborious and flawed," she said it is critically important because of the drug's potential risks to a fetus.
Accutane and Amnesteem, Sotret and Claravis -- the trio of generics approved in the last four years -- are the only effective treatment for severe recalcitrant nodular acne, or cystic acne, the worst and most painful form of the skin condition, characterized by inflamed, pus-filled lumps that can approach the size of a quarter. In some cases, doctors prescribed the drug to patients with moderate acne that had not improved with other treatments. For about 80 percent of those who take it an average of five months, the results are remarkable. Their skin clears dramatically and often permanently. "It has made a big difference in his self-esteem and he's got beautiful skin now," said Maureen Distad of Bowie of her 16-year-old son, who took the drug earlier this year. "I really didn't want him to take it," said Distad, who was worried about the widely publicized but unsubstantiated link to the risk of suicide in users, "but [his acne] had gotten to the point where the dermatologist said he was starting to scar and he said, 'I can't do this anymore.' "
Since the advent of the drug, dermatologists say, there have been substantially fewer cases of disfiguring acne, which can leave scars that are both physical and psychological. "Anyone who says this drug is not lifesaving doesn't know what they're talking about," said pediatric dermatologist Robert Silverman, who practices in Fairfax and Washington. "I've treated at least half a dozen kids over the years who wouldn't leave their house because their acne was so bad, or who were suicidal because of how they looked."
Out of Patience
Dermatologist Susan Walker, director of the FDA's Division of Dermatology and Dental Products, says the program is working and that her agency is seeking to achieve "a critical balance of maintaining access to the drug and ensuring its safe use," in an effort to keep a "uniquely effective" drug on the market. The FDA, she said, is "doing everything we can to maximize the efficiency of the program" by working with the sponsors. Walker declined to discuss possible modifications to iPledge.
Laurene Isip, a spokeswoman for Covance, the New Jersey drug development firm hired by the manufacturers to help design and administer the program, acknowledged in an e-mail that problems had occurred. But she said the situation has improved significantly. Since March 1, when the program began, she said, approximately 165,000 patients, 25,000 physicians and more than 51,000 pharmacies have registered. "Overall we have made progress with the iPledge program," she wrote, adding that Covance has "worked diligently to rectify the situation by increasing telephone staffing and making the Web site more user friendly.
"It is important to note," she added, that the program is "unprecedented in size and scope." Some dermatologists and patients say more fundamental changes are needed. "Just this week I had two patients who were locked out of the system" because they failed to pick up prescriptions before the seven-day deadline, Silverman said. "One man just gave up." Although Silverman said response time has improved, "I just don't have time to sit on the phone for five or 10 minutes, which still happens routinely." Silverman said he has no choice other than the call center: The Web site of iPledge is accessible only via an Internet Explorer browser that he cannot run on his office's Macintosh computer.
Holly Fenske said her 14-year-old daughter, Megan, was denied the drug for a month in the midst of treatment because the doctor made a clerical error on the girl's prescription. "It was hell," said Fenske, who lives near Sacramento. The girl, who had spent four years battling one of the worst cases of acne her dermatologist said she had ever seen, told her mother "she was still ugly, still disfigured and felt like she wanted to die," recalled Fenske. "She felt she had just started to make some progress and it was being taken away from her."
Singling Out Accutane
FDA officials say the decision to implement what Kweder calls an "extraordinary" program in terms of its restrictiveness was made on the advice of an advisory committee in 2004, after a previous program called SMART failed to prevent an increase in pregnancies. Between April 2001 and March 2002, the year before SMART took effect, 150 pregnancies were reported to the FDA; during its first year, the number rose to 183.
In that two-year period, 325 Accutane users became pregnant, according to statistics compiled by the FDA; the outcome of 160 of those cases is known. Twenty-nine babies were born to Accutane users: 20 had no discernable problems, seven had birth defects consistent with the drug and the status of the other two infants was unknown. Between Dec. 31, 2005, when enrollment for iPledge opened, and March 31, 2006, four weeks after the program became mandatory, no pregnancies were reported, said Walker, citing the most recent data available. "That's good news for doctors and patients," she said.
Some doctors say they are concerned about reports that frustrated patients are buying the drug online from abroad or going to Canada or Mexico to obtain it, skirting all regulation. The FDA Web site explicitly warns against buying Accutane online.
And leading dermatologists ask why the agency hasn't imposed similar restrictions on other drugs known to cause birth defects. Among them are anti-seizure drugs approved for epilepsy that are now widely prescribed mostly off-label for depression and other psychiatric problems; the psoriasis drugs Soriatane and Tegison (which the FDA labels Category X -- never safe during pregnancy -- as it does Accutane); and over-the-counter vitamin A supplements, which in high doses can cause cleft palate, low IQ and heart defects, the same birth defects associated with isotretinoin. "Putting isotretinoin but not all teratogens [drugs that cause birth defects] into a mandatory, restricted distribution program is arguably selective and discriminatory," wrote former AAD president Clay J. Cockerell and Diane Thiboutot, chairman of the AAD isotretinoin task force, in an article last month on Virtual Mentor, an online publication of the American Medical Association.
There's little doubt the drug responsible for the largest number of preventable birth defects is alcohol: An estimated 40,000 babies annually are born with symptoms of fetal alcohol exposure, which causes brain damage, facial deformities and mental retardation. "We don't regulate alcohol," said the FDA's Kweder. She noted that Accutane causes birth defects at a rate approaching 30 percent -- far higher than epilepsy drugs and comparable to thalidomide, a drug once given to pregnant women to treat nausea. Thalidomide, banned in the United States in the 1960s, is now used to treat cancer under regulations similar to those for isotretinoin. And that, said Green of the March of Dimes, is the purpose of regulation. Public health officials, she said, have a "social responsibility to protect against major high-risk outcomes. What's wrong with that?"
by Tammy Webber, Indianapolis Star
September 5, 2006
http://www.indystar.com/apps/pbcs.dll/article?AID=/20060905/NEWS01/609050435
The 3-year-old boy's blood-lead level was among the highest Marion County health officials had seen in years -- and no one knew why. After several months and two courses of aggressive chemical treatment to try to purge the lead from his blood, they finally found the cause: He had swallowed a metal charm. Doctors removed the charm, likely saving the boy's life, but the suspected damage to his brain will never be reversed.
Lead poisoning, largely eliminated as a childhood health issue decades after it was banned from paint and gasoline, is once again creating anxiety among parents and health officials. The metal is showing up in an alarming range of imported consumer products, posing an often-unrecognized danger to children.
Last month, Indiana officials discovered lead in bendable animal toys given away by public libraries. In the past few years, it has shown up in everything from Reebok charms and Disney necklaces to vending machine jewelry and other everyday items such as computer cords, vinyl mini-blinds and pottery. In Indiana, jewelry, decorative key chains, pottery and Mexican candy have poisoned children.
Deaths are rare, though a 4-year-old Minnesota boy died this year after swallowing a charm Reebok gave away with some of its shoes. Lead poisoning still poses the greatest threat to poor, urban children who live in houses with old lead-based paint. Most known lead-poisoning cases still are caused by ingesting paint chips and dust. "The list of (lead) sources is really unbelievable," said Jo Rhodes, health educator for the Indiana State Department of Health's lead program. "You can't say there are any children not at risk because it's in so many consumer products."
Many physicians and parents, however, are unaware of the dangers that can affect children of any income level. "Lead is an equal-opportunity menace," David McCormick, head of the Marion County Health Department's lead program. Last year, 548 Indiana children were confirmed to have suffered from lead poisoning, though that number is almost certainly much higher, state and local health officials said. No exact numbers on children poisoned by lead in consumer products exist because government testing targets only the poor, who are more likely to live in older houses where lead-based paints were used. Under federal law, children receiving Medicaid, the government health-care program for the poor, must be tested for lead because they are more likely to live in those older houses. But most of those children are not being tested, sometimes because doctors don't realize it's a requirement, health officials said.
The state Department of Health has been asked by a lead-poisoning task force subcommittee to consider recommending that all Indiana children be tested for lead poisoning. But state Health Commissioner Dr. Judith Monroe said she doubts wider testing would work, because physicians and parents largely ignored similar recommendations in the past. Instead, she said the best approach would be to eliminate lead in consumer products.
But if parents are concerned, Rhodes said, it wouldn't hurt to have their children tested for lead. "A lot of parents . . . don't realize it's still a threat. They think it's kind of like polio or whooping cough -- that it's not an issue anymore," she said. "That's a barrier we're trying to break down not just with parents, but with physicians as well."
Source not always clear
George and Kim Bergan never imagined their 8-year-old daughter might be exposed to lead. But that was before Ellen Bergan got a toy from the Monroe County Public Library this summer that was recalled as a lead hazard. "When you think of (lead), you generally think of old homes and kids chewing on windowsills," said George Bergan, whose family lives in Ellettsville, near Bloomington. "You'd never think with something clearly going to children that you'd have to worry about that. Unfortunately, that's not the case."
In the past two years alone, the U.S. Consumer Product Safety Commission has issued more than 20 lead-related recalls for everything from jewelry and animal flashlights to painted toys and sidewalk chalk. The most recent recall, for 340,000 bendable plastic cat and dog toys given out by libraries nationwide this summer, was issued last month after Indiana health officials found lead in them. Monroe County Public Library gave away almost 900 of the toys to children before a Bloomington Hospital nurse warned children's librarian Stephanie Holman that the toys might contain lead.
by Shankar Vedantam, Washington Post
September 5, 2006
http://www.washingtonpost.com/wp-dyn/content/article/2006/09/04/AR2006090400513.html
Children born to fathers of advancing age are at significantly higher risk of developing autism compared with children born to younger fathers, according a comprehensive study published yesterday that offers surprising new insight into one of the most feared disorders of the brain. The finding comes at a time of great controversy over autism in the United States, as a recent surge in diagnoses has fueled speculations about various possible causes of the disorder. For scientists, both the origins of and potential treatments for the disorder remain a mystery.
With every decade of advancing age starting with men in their teens and twenties, the new study found, older fathers pose a growing risk to their children when it comes to autism -- unhappy evidence that the medical risks associated with late parenthood are not just the province of older mothers, as much previous research has suggested. Of special concern is the finding that the risk for autism not only increases with paternal age but also appears to accelerate. When fathers are in their thirties, children have about 1 1/2 times the risk of developing autism of children of fathers in their teens and twenties. Compared with the offspring of the youngest fathers, children of fathers in their forties have more than five times the risk of developing autism, and children of fathers in their fifties have more than nine times the risk.
Autism is a developmental disorder that is often characterized by social and verbal problems. It becomes manifest early in childhood and is associated with learning deficits and other problems. Many cases are diagnosed shortly after children enter school, where differences among kids become too obvious to ignore. A wide variety of interventions are increasingly available for autistic children, and early behavioral interventions have been said to help with outcomes and functioning. There is, however, no cure for the disorder, and scientists are not sure about its biological roots.
The new study presents an intriguing new avenue for research, because it suggests that genetic traits passed along by fathers, as opposed to mothers, may play some significant role in creating susceptibility to autism. Several other studies have suggested that older parents of both sexes are at greater risk of having children with developmental disorders. Three earlier studies looking at the relationship between paternal age and autism have produced mixed results; the new study is the most rigorous analysis conducted to date.
The study was based on an enormous sample of 17-year-olds -- nearly all the male and three-quarters of the female subjects of that age found over a six-year period in Israel, as they came of draft age. In all, data from 378,891 people were analyzed. Since all Israeli citizens have a unique identification number, and the draft process routinely calls for listing the identification numbers of parents, researchers were able to develop a large-scale map that allowed them to determine the age of both parents for 132,271 draft candidates. They then compared that information against medical evaluations conducted by the draft board for autism and other disorders for those same candidates.
Abraham Reichenberg at the Mount Sinai School of Medicine in New York, along with several others at research institutions in the United States and Israel, found a significant relationship between paternal age and autism, even after accounting for other factors, such as mothers' age and socioeconomic status. Children of fathers who were 15 to 29 years of age had a risk of about six in 10,000 of developing autism. Children of fathers in their thirties had a risk of nine in 10,000. Children of fathers in their forties had a risk of 32 in 10,000, and children of fathers who were older than 50 had a risk of 52 in 10,000.
In a paper published yesterday in the Archives of General Psychiatry, the researchers said that the number of cases of autism among families with the oldest dads was too small to lead to definitive conclusions about that group, but that there was little doubt about the overall trend. The only question, they said, is whether the risk accumulates at an accelerating rate with advancing paternal age, as the numbers in this study suggest.
Scientists in the United States are increasingly thinking about autism in terms of a spectrum of problems, which is why they have coined the term "autism spectrum disorders." The federal government estimates that the risk for autism spectrum disorders in the United States is around 3.4 for every 1,000 children between the ages of 3 and 10. Whether that number is on the rise has been hotly contested; better outreach and diagnostic efforts may be finding children who would previously have gone undetected. Enduring disparities in access to health care complicate the picture. While the medical complexities of autism are present in Israel, concern over disparities is mitigated to some extent because Israel has universal health insurance, which guarantees equal access to care.
The Israeli military draft board's medical diagnostic system does not differentiate among conditions on the autism spectrum, which includes autism, Asperger's syndrome, Rett syndrome and what are known as pervasive developmental disorders. Autistic people can be unresponsive in social situations, or focused intently on a single task or object for long periods. While some parents recognize that their babies seem different from a very young age, U.S. government researchers also say that sometimes engaging and babbling babies can suddenly turn "silent, withdrawn, self-abusive, or indifferent to social overtures."
In recent years, concern and controversy have grown -- despite a lack of conclusive evidence -- that mercury in children's vaccines produces toxicity that leads to autism. While the link between older fathers and autistic children is likely to be genetic, the researchers who conducted the new study also acknowledged the possibility that unknown other factors could simultaneously be causing men to delay parenthood while independently increasing autism rates.
by James Bruggers, Louisville Courier-Journal
September 5, 2006
http://www.courier-journal.com/apps/pbcs.dll/article?AID=/20060905/NEWS01/609050392
Researchers studying railroad workers have documented that cleaning solvents used in their jobs caused brain damage, shrinking the vital bridge that helps one side of the brain communicate with the other. The results of the study by researchers from West Virginia University, the University of Pittsburgh and Johns Hopkins University, which was funded by the federal government, bolster evidence that powerful degreasers can damage the brain. They also lend further credence to claims by hundreds of railroad workers, many from Kentucky and some from Indiana, diagnosed with brain damage after cleaning locomotives with solvents from the 1950s through the early 1990s. "We were able to identify a change to the structure of the brain," said lead author Marc Haut, a professor in the departments of behavioral medicine and psychiatry, neurology and radiology at the West Virginia University School of Medicine in Morgantown.
The researchers sought funding for the study after numerous railroad workers with the same symptoms began showing up in the researchers' clinics, Haut said. "Those railroad workers with more exposure or severe exposure had a greater loss of (brain) volume," Haut said. He said they found a correlation between brain loss and workers' performance on tests that evaluate such mental performance as processing speed, attention and concentration.
The new report is the first connected with the nation's first large, independently funded study that seeks to explain how railroad workers may have been affected by solvents like 1,1,1-trichloroethane, trichloroethylene and perchlorethylene. Workers who participated in the study came from railroad shops in Cumberland, Md., and Huntington, W.Va. "It is no surprise to me," Deanna Bowerman said of the study's findings. Her late husband, Dale, was a CSX railroad machinist in Louisville and Corbin, Ky., and was diagnosed with toxic encephalopathy -- characterized by chronic depression, loss of short-term memory and hair-trigger temper. Although Dale Bowerman was not part of the West Virginia study, Deanna Bowerman, of Harrison County, Ind., said doctors told the couple years ago that her husband had suffered permanent brain damage.
Effect of solvents
In a 10-month investigation in 2000 and 2001, The Courier-Journal learned that Bowerman and more than 600 other U.S. railroad employees had been diagnosed with toxic encephalopathy after spending years in workplaces where solvents were widely used with little or no protection. The newspaper found that the debate within the medical community about whether exposure to solvents in the workplace caused brain damage had diminished in the 1990s.
But studies of railroad workers were less common, and some that were funded by CSX Transportation had found no link between solvent exposure and the illness. The newspaper found that CSX, the railroad company with the largest number of claims, had paid out nearly $35 million to more than 460 current or former workers diagnosed with the illness. Railroads began phasing the chemicals out of their shops in the early 1990s.
CSX has both won and lost jury verdicts in chemical exposure cases that have gone to trial. It has argued that its workers' problems could be explained by other factors, such as drinking alcohol, side effects from prescribed medication, or illnesses such as depression or diabetes. Gary Sease, a spokesman for CSX, said the company continues to believe there is no credible and conclusive scientific basis to support claims that solvent exposure harmed company workers.
Joe Satterley, a Louisville attorney who represents railroad workers, said he's aware of at least 100 pending lawsuits in Kentucky and elsewhere that were filed in the last few years. The study, he said, "substantiates everything we've been saying all along."
Brain images compared
The findings of eight researchers were published in June in the Journal of Occupational and Environmental Medicine. They are based on comparing images of the brains of 31 railroad workers who were exposed to solvents over a period of at least 10 years to 31 people who were not. Any workers involved in pending litigation with the railroad were excluded, as were those with current substance abuse, a history of serious medical illness, or a diagnosis of mental illness before solvent exposure, Haut said. The researchers also factored out potential effects from high blood pressure and diabetes, which can cause the brain to shrink.
With funding from the National Institute for Occupational Safety and Health, the researchers found that the size of the corpus callosum -- a bridge between the left and right hemispheres of the brain that allows communication between the sides -- was significantly smaller in the railroad workers. And the part most affected, they found, was the genu, a section of the corpus callosum that connects the frontal lobes, which are associated with decision making, problem solving and emotions. The researchers also concluded that psychiatric conditions, such as depression, could not have caused the physical changes in workers' brains.
As another part of the study, the researchers are analyzing images that compare brain function while participants take certain mental tests. Haut said the research will help professionals better understand the medical problems of people in other industries exposed to solvents. Dr. Alan Ducatman, a co-author of the study and chair of the department of community medicine at West Virginia University's medical school, has diagnosed more than 100 railroad workers with the illness. He said there are also implications for anyone who is a heavy drinker of alcohol, which is also considered a solvent. "For all of the intoxicants, the problem ... is knowing the threshold before safety is breached," he said.
by Amanda Spake, Los Angeles Times
September 4, 2006
http://www.latimes.com/features/health/la-he-fish4sep04,0,3015878.story?page=1&coll=la-home-health
BY the time Weems W. Duvall Jr., hit 45, he was close to 300 pounds, his cholesterol was sky high and his blood pressure was out of control. "I was pretty much a walking heart attack," he says. Diet books advised him that adding fish to his meals would help him reduce calories and take advantage of a hefty dose of heart-friendly fats called omega-3 fatty acids. He began replacing his red meat with fish and felt better -- and lost weight. As Duvall likes to put it, "I was hooked."
For years, media reports have depicted fish as a dietary dream come true -- a high-protein, low-calorie super food that protects against heart attacks, strokes and some cancers. Newer studies have even linked eating fish to lower rates of Alzheimer's disease, degenerative eye disorders, diabetes and other illnesses. Since 2002, the American Heart Assn. has recommended that healthy adults eat at least two servings of fish a week to protect their health. "Calorie for calorie, the benefits of fish oil exceed any other nutrient in the diet," says Dr. Dariush Mozaffarian, a cardiologist at Harvard's Brigham and Women's Hospital in Boston who researches the heart benefits of fish.
But in the last few years, a battle over safety has erupted, confusing many consumers about the benefits and risks of eating fish. All fish contain low levels of contaminants (ingested from water or by eating smaller, contaminated fish), notably polychlorinated biphenyls (PCBs), cancer-causing industrial chemicals banned in 1976; and mercury, a heavy metal found in lakes, streams and oceans. Environmentalists and consumer groups argue that toxic contaminants in some popular types of fish, such as tuna, put the public's health at risk and that the federal government is doing little to solve the problem.
Physicians and nutrition researchers, on the other hand, fear that all the talk about the dangers of fish scares people away from a food that most of medical science generally agrees offers significant benefits. "For adults in this country, the main problem is that people don't eat enough fish," says Dr. Eliseo Guallar, associate professor of epidemiology and medicine at the Johns Hopkins School of Public Health. Indeed, Americans are not big fish eaters. The U.S. Department of Agriculture estimates that people eat about 3.4 ounces a week, with Californians and other Pacific coast residents eating a bit more: about 3.7 ounces. By comparison, the USDA estimates that per capita red meat consumption totals nearly 21 ounces. "Yet fish is healthier," Guallar says.
Benefits not without risk
Scientists now think that the healthful effects of fish are largely due to substances called omega-3 fatty acids, especially two known as DHA and EPA, which are plentiful in oily fish such as salmon, trout and herring. But the long list of possible benefits doesn't translate to a blanket endorsement of all fish, any fish. Fish in fish sticks, for example, is generally low in omega-3s. Fish in fast food restaurants is often high in the unhealthful trans fats used to cook it. These factors can neutralize the benefits of fish. In an investigation known as the Cardiovascular Health Study, in which 4,775 adults older than 65 were tracked for many years, those who ate baked or broiled fish one to four times each week had 27% fewer strokes than those who ate fish less than once a month. People who ate fried fish or fish sandwiches more than once a week had 44% more strokes. "Before I did this research, I might have considered a fish sandwich at a fast food restaurant or fish sticks a 'fish meal,'" says Harvard's Mozaffarian, lead author of this work.
Another complication is that not all of the studies on fish-eating have been positive -- possibly, scientists say, because of the effect of contaminants. A study of 1,833 men in Finland, for example, reported that those who ate mercury-contaminated freshwater fish (and who ended up with higher mercury blood levels) suffered twice the rate of heart attacks and deaths from strokes as those who did not eat contaminated fish. This raises the possibility that the presence of mercury in fish may reduce or eliminate its cardiac benefits, says Guallar of Johns Hopkins, who has conducted studies that indicate similar results. "It's concerning," he says.
Mercury originates from natural sources and air pollution. In water, it's transformed by bacteria into methylmercury, which is toxic to the brain, heart and nervous system and especially damaging to the neurological development of infants and young children. It was not until 2004 that the Food and Drug Administration and the Environmental Protection Agency advised pregnant and nursing women, women of child-bearing age, and children to avoid certain fish because of the mercury content. These fish -- swordfish, king mackerel, tilefish, and shark -- are all large, long-lived predatory fish that concentrate mercury in their bodies throughout their lives through eating smaller fish that also contain mercury.
Tuna, another large, long-lived fish and the nation's most popular seafood, was not on the original list. The agencies later added a recommendation that vulnerable groups eat no more than 6 ounces, or one can, of white or albacore tuna a week. FDA tests had shown that canned albacore tuna, as well as fresh or frozen tuna steaks, contained significantly more mercury, because they came from larger tuna species, than did chunk light tuna, often canned from the smaller skipjack tuna. The advisory also recommended that vulnerable groups limit their total fish consumption to 12 ounces a week.
The advisory does not mean pregnant women should not eat fish; omega-3s are critical to an infant's developing brain. A Harvard study released last year found that pregnant women who ate fish every week during pregnancy had offspring with intelligence scores 4 points higher for every additional serving of fish over the average of one serving. But there lies the conundrum: The finding only held if the mothers' blood mercury levels remained low. Women with the highest blood mercury levels had offspring with intelligence scores 9.3 points lower than those from mothers with an average amount of mercury, or less.
The government's fish advisory, which reflects the "reference dose" or "safe limit" of mercury for vulnerable groups set by the EPA, may not protect women who are not careful about how much fish, or what kind, they eat, says Kathryn Mahaffey, an EPA scientist. She examined the mercury levels of American women of child-bearing age recorded in a large federal health survey and found that as many as 10% of such women may be eating enough fish to have blood mercury levels over the reference dose. That, she calculated, exposed somewhere between 300,000 and 630,000 newborn infants annually to methylmercury concentrations that may put them at risk of neurodevelopmental defects. "Some people eat a lot of fish, and many don't eat fish at all," she says. "Neither extreme is good."
People do eat a lot of tuna. Some 26% of all fish consumed in 2004 was canned tuna, according to the USDA. Environmental and consumer groups say the warnings regarding mercury in tuna are too weak. They note that canned light tuna, which is listed on the FDA's website as low in mercury, contains about 20 micrograms of mercury, whereas a 6-ounce serving of salmon has only about 1.6 micrograms. "We're in favor of eating fish, as long as it's low-mercury fish," says Jackie Savitz, a senior scientist with Oceana, a national environmental organization concerned with the effects of ocean pollution. "But we need to solve the mercury problem."
In July, three national environmental groups led by the Defenders of Wildlife released the first comprehensive study on the amount of mercury in chunk light tuna from various countries. (Imports of canned tuna now total about 51% of all canned tuna sold in this country, though not all is labeled by country of origin.) They reported that more than a third of the cans that were tested by an independent lab had mercury levels above the level deemed safe by the EPA for vulnerable groups. Nearly one can in 20 contained so much mercury that the FDA regulations would allow the agency to pull it from the supermarket shelves.
For its part, the tuna industry says that the mercury categories the FDA chooses for different fish, and the advisory regarding tuna, are adequate. "The health benefits of eating canned tuna far outweigh the risk from trace amounts of mercury," says Anne Forristall Luke, president of the U.S. Tuna Foundation.
Yet even physicians who are strong proponents of eating two or more servings of fish each week worry about tuna. "Tuna is just so popular and so easy for people. For elderly people, and busy people -- just open a can of tuna," says Dr. Walter Willett, professor of epidemiology and nutrition at the Harvard School of Public Health. "There really is a chance some people can get too much mercury from tuna. As a result, I think people probably should not be having tuna fish more than twice a week."
How much is too much?
Perhaps if Michelle Bekey, 48, had followed Willett's advice she would not have ended up with a high blood mercury level. "Fish was my primary source of protein," says the West L.A. communications consultant. She typically ate tuna salad for lunch and swordfish, sea bass or tuna steak for dinner. "Basically, I was eating all the higher-mercury fish. I'd been aware that mercury is a hazard for pregnant women and children. But I hadn't seen warnings for anyone else."
Indeed, there are none, nor does the FDA believe there needs to be. "Based on the science, no," says Dr. David Acheson, chief medical officer in the FDA's Center for Food Safety and Applied Nutrition. "Yes, you have to be cognizant of mercury in the type of fish you eat. If you are in those vulnerable groups of women, or for children, you have to be more cognizant of it. But with regard to the general population: eat fish."
Bekey did just that. Over time, she began to feel increasingly lethargic and to suffer from numbness in her hands. One day she came across a story in a magazine about an actress who had eaten so much fish she developed mercury poisoning -- and her symptoms sounded so familiar that Bekey had her blood tested. Her mercury level was eight times the safe reference dose set by EPA. She's a small woman, only 110 pounds, and because the level of mercury people can tolerate is based on weight, Bekey can safely eat about 35 micrograms of mercury each week. One 4-ounce tuna steak would put her over her limit -- and she was eating several every week. Bekey is convinced that her physical problems were the result of eating too much mercury, but as with most environmentally related symptoms, cause and effect is seldom proven. She stopped eating fish a year ago and, she says, her symptoms have improved.
Based on stories like Bekey's, some nutrition researchers and activists feel the general public is not well enough informed about the amount of mercury in different types of fish and that the federal health agencies have a responsibility to provide clearer direction to all consumers. In early July, the nutrition advocacy group Center for Science in the Public Interest urged the FDA to require mercury warnings on packaged fish. (In California, supermarkets and restaurants post such warnings.)
The organization noted that although average mercury levels of many fish are posted on the websites of the FDA and EPA, only 1 in 5 consumers it surveyed could correctly identify the fish highest in mercury -- swordfish, shark, tilefish and king mackerel. More than 21% said salmon was high in mercury, when it is among the fish with the lowest mercury content.
So, to eat fish, or not? And what kind, and how much? Nutrition researchers, federal agencies and consumer groups all agree that most adult Americans need to eat low-mercury fish, and a lot more of it. When people add fish to their diet, they tend to cut down on the extra saturated fat and calories found in beef, pork, lamb and even chicken. That's one key reason the American Heart Assn. and the government's dietary guidelines say healthy adults should eat two servings of low-mercury fish a week. For people who've been diagnosed with heart disease, the AHA recommends eating more -- enough fish or fish oil capsules to total 1 gram of omega-3s a day.
But knowing which fish offers the most rewards may seem like something of a puzzle to consumers. To help parse the puzzle, Cathy Levenson, associate professor of nutrition at Florida State University, recently coauthored a research paper weighing the costs and benefits of eating different types of fish. "It may not be enough to simply tell people to eat fish low in mercury," she says. For one thing, mercury is only part of the equation: The omega-3 content in each type of fish is also important. This, like the level of mercury, varies widely depending upon the fish. Shellfish, for example, tends to be very low in mercury, but it's also, with the exception of oysters, low in omega-3s. Shrimp, second only to tuna in popularity, has no detectable mercury. But to consume 1 gram of omega-3s, you'll need to eat 11 ounces of shrimp.
Luckily, many popular commercial fish -- including salmon, trout, herring, flounder -- are rich in omega-3s and do not have high levels of mercury. Only about 4.5 ounces of salmon, 3 ounces of rainbow trout and 2 ounces of herring contain a full gram of omega-3s. Topping the list in Levenson's analysis (in the March issue of the journal Nutrition Reviews) was wild-caught salmon, a very low-mercury fish with among the highest amount of omega-3s.
Wild salmon trumped farmed salmon because of the risk of another kind of contamination, that of PCBs. In 2004, a study published in Science reported that farmed Atlantic salmon, particularly fish from Iceland, Norway and Scotland, contained PCB levels as much as seven times higher than those found in wild, caught salmon. (More than 80% of the fresh salmon eaten in the U.S. is farmed and imported from the north Atlantic, Canada, Chile and elsewhere.) Although the levels didn't exceed the FDA standards for PCBs in commercial fish, they were above the safe limits set by the EPA for sport fish caught and eaten by anglers. Farmed fish contain higher levels of PCBs because the fish meal and fish oil they're fed is high in these contaminants. The global salmon farming industry is investigating ways to reduce PCBs in farmed fish by substituting soybean oil in place of some of the fish oil in the feed.
In the meantime, country-of-origin labeling, required for two years now on fish sold in supermarkets and other retail stores, may help guide careful consumers. The least-contaminated fish among the 2 metric tons of salmon purchased by the Science researchers came from farms in Chile. Salmon from Washington state and Canada was also cleaner than that from the north Atlantic. Another tip: In farmed salmon, the chemicals tend to concentrate under the skin and the layer of fat beneath the skin -- and thus, removing the skin and underlying fat before or after cooking will reduce the PCB content of the fish.
Figuring out how to weigh the mercury and PCB risks versus the benefits of omega-3s may become clearer with the release of a study by the National Academy of Science's Institute of Medicine, due out in the next month or so. But for some eager fish consumers, just knowing a little more about the mercury content in fish can lead to safer choices. Weems W. Duvall, for example, ate tuna every day when he first switched to fish. Today, he's a great deal more discerning. "I'm limiting tuna now, because of the mercury," he says. "I still eat tuna, but I've come to really like that imitation crab…. And my favorite food now is salmon." Duvall is the first to admit that he can't prove that eating fish is enhancing his health. "But I've lost some weight, my cholesterol is lower and I feel better," the Maryland attorney says. "For me, that's all the proof I need."
by Jeffrey Kluger, Time
September 3, 2006
http://www.time.com/time/magazine/article/0,9171,1531326,00.html
Environmental poisons never play by the rules. Just when you think you've got them figured out and rounded up, they give you the slip. Get the lead out of gasoline, and it comes at you through aging pipes. Bury waste and toxins in landfills, and they seep into groundwater. Mercury, at least, we thought we understood. For all its toxic power, as long as we avoided certain kinds of fish in which contamination levels were particularly high, we'd be fine. And not even everyone had to be careful, just children and women of childbearing age.
But mercury is famously slippery stuff, and a series of recent studies and surveys suggests that the potentially deadly metal is nearly everywhere -- and more dangerous than most of us appreciated. Researchers testing birds in the Northeast have found creeping mercury levels in the blood of more than 175 once clean species. Others have found the metal for the first time in polar bears, bats, mink, otters, panthers and more.
Just as alarming are new discoveries about unexpected sources of mercury contamination. While coal-fired power plants and chemical factories are familiar culprits, a recent study reveals that wetlands are mercury time bombs; if hit by wildfire, they release centuries' worth of accumulated toxin in a single, sudden blaze. In addition, there's a growing body of research that reveals the extent to which medium to high levels of exposure to the metal can harm adults as well as children, causing a wide range of ills -- including fatigue, tremors, vision disorders and brain, kidney and circulatory damage. All told, "the breadth of the problem has expanded greatly," says biologist David Evers of the BioDiversity Research Institute in Gorham, Maine. "It's far more prevalent and at higher levels than considered even a couple years ago."
Mercury has to work hard to do all the damage it does. In its pure state, it is only moderately toxic because it passes quickly through the body, leaving little to be absorbed. Not so the mercury we pump into the skies. Smokestack mercury exists in either particle form -- which falls relatively quickly back to earth -- or aerosol form, which can travel anywhere around the globe. Either way, when it lands, trouble begins. On the ground or especially in the low-oxygen environment of the oceans, mercury is consumed by bacteria that add a bit of carbon to convert it to methylmercury, a metabolically stickier form that stays in the body a long time. That is bad news for the food chain, since every time a bigger animal eats a smaller animal, it consumes a heavy dose of its prey's mercury load. That's why such large predatory fish as shark, swordfish, mackerel, tilefish and albacore tuna are so heavily contaminated. Less publicized but still problematic is toxic mercury vapor, which can be odorlessly emitted from factories and dumps where batteries, fluorescent lamps, jewelry, paints, electrical switches and other mercury-containing products are manufactured or discarded.
All that has been known for a while, but the game changer was the recent study of Northeastern songbirds. A group headed by Evers had been worried for some time that mercury's reach was greater than it seemed, particularly in the Northeast, which is downwind from the power plants of the Midwest and Canada. Mercury from those plants' smokestacks could find plenty of bacteria in water, leaves and sod to make the toxic conversion to methylmercury. Netting 178 species of songbirds and testing their blood and feathers, Evers found that all of them were indeed contaminated, some in concentrations exceeding 0.1 parts per million. That doesn't sound like much, but it's a lot higher than it ought to be, and it's surely on the rise. So far, the toxin hasn't disrupted the birds' reproductive cycle, but researchers fear that it will before long. What's more, if the birds are contaminated, so are other animals that eat the same diet -- not to mention predators that eat the birds. Says Evers: "It creeps up the food chain and continues to biomagnify as it goes."
The wetlands study darkened the picture further. Marshes in Alaska and northern Canada are natural sinks for mercury, which chemically adheres to damp peat and readily converts to the methyl form. That is not a problem as long as the mercury stays put. But increasingly frequent droughts -- a likely consequence of global warming -- have led to increasingly frequent wildfires, causing wetlands to release centuries' worth of collected mercury in one toxic breath. "There's mercury that's been accumulating since the dawn of the Industrial Revolution," says ecosystems ecologist Merritt Turetsky of Michigan State University, who has been studying the problem. "During droughts, you get a meter-thick carpet of dry peat in some places, and all you need then is a match. Lightning usually provides that."
As global mercury levels rise, more and more species are being affected. A recent study by investigators at Denmark's Natural Environmental Research Institute showed that mercury measurable in the fur of Greenland polar bears is 11 times higher than it was in baseline pelts preserved from as early as the 14th century. This fall the National Wildlife Federation will release a survey of more than 65 recently published studies showing elevated mercury in more than 40 species, many of which had been thought to be in little danger. Some, including common loons and bald eagles, are already showing signs of behavioral and reproductive changes associated with mercury poisoning.
Cleaning up the mess is the responsibility of the species that made it, and that job starts with coal. The 440 coal-fired power plants in the U.S. produce about 48 tons of mercury a year -- 40% of the nation's total output, by some estimates. The Clinton Administration did not attack the problem until its final year, when it issued a proposal that would have required a 90% cut in power-plant mercury by 2008. President George W. Bush has discarded the Clinton rule in favor of a looser standard that would result in only a 70% reduction by as late as 2025. What's more, Bush weakened the Clean Air Act's new-source-review rule, which requires power-plant owners to install the best available pollution controls when they make major upgrades that result in increased emissions.
Lately, however, the courts have been pushing back. In March a federal circuit court in Washington strengthened the new-source-review requirements by refusing to sanction a loophole that the Environmental Protection Agency (EPA) had introduced, and last month a circuit court in Chicago forbade a move by the Cinergy power corporation to measure its pollution output hour to hour rather than year to year, because the hourly standard often produces a lower, less accurate reading of emissions. In November the U.S. Supreme Court will address the same measurement question in a case out of North Carolina. All those battles technically address smog and soot, not mercury, but where the first two go, the third follows. "Power plants are the 800-lb. gorilla," says John Walke, a project director with the National Resource Defense Council and a former attorney for the EPA. "Their [mercury] output is extraordinary."
But while much of the environmental mercury in the U.S. comes from power plants, the other dominant source is chlor-alkali plants, which manufacture chemicals used in soaps, detergents and other products. More than 25% of the U.S. total blows in from overseas, particularly from coal-gobbling countries like China. Illinois Senator Barack Obama has proposed two bills to address those problems. One requires the eight chlor-alkali plants in the U.S. that still use mercury to convert to a less toxic alternative by 2012. The other calls for a ban on U.S. exports of mercury starting in 2010 -- a significant move, since the U.S. sells as much as 300 tons of the metal a year, or 8% of the world's total. More than a dozen state governments across the U.S. are getting ahead of Washington with mercury controls of their own. Foreign governments have also acted. "Europe, Canada, Australia and Japan have been reducing their use of mercury for five to 10 years," says Linda Greer, a member of the EPA's science advisory board.
The good news is, once mercury is removed from circulation, it needn't trouble us again. As long as it's held in double-hulled containers and kept relatively cool to prevent evaporation, it is largely inert. "It's my favorite chemical for what you can finally do with it," says Greer. "It will sit placidly in a warehouse at under 70 degrees." It's a remarkably quiet end for a remarkably dangerous metal -- an end that can't be too soon in coming.
by Phil Ferolito, Yakima Herald-Republic
September 3, 2006
http://www.yakima-herald.com/page/dis/286945814445983
Yakama tribal member Johnny Jackson figures he eats fish at least twice a day. Maybe more. While mercury and other toxins found in Columbia River fish may be putting him at risk, he refuses to abandon tribal tradition. "I think my people will always be eating salmon," said Jackson, chief of the Cascade band of the Yakamas. "It's the first food on the table. It's No. 1 in our culture."
Mercury, a long-lasting chemical that accumulates in the food chain, can cause neurological damage, learning disabilities and memory loss. But its effects on tribal members -- some of whom eat fish up to 10 times more than non-Indians -- remains unknown. "My fear is that one of these times, none of our traditional foods is going to be safe to eat," said tribal fisherman Wilbur Slockish Jr., hereditary chief of the Klickitat band of the Yakamas. "A lot of development isn't geared toward health; it's geared toward economic benefit. Health is the least concern."
Much more than just food to the Yakamas, salmon are a sacred tie to the land. According to Yakama belief, the salmon offered itself as food so that man could live on earth. The fish is honored at many ceremonies throughout the year.
How much is too much?
Although Northwest Indians consume anywhere from four to 10 times more fish than non-Indians, Indians who strictly follow tradition eat even more, said Dana Davoli, a health risk assessor with the federal Environmental Protection Agency in Seattle. "There are tribal members eating a lot more than that," she said. Indians eat, on average, 2 to 13.7 ounces of fish daily compared with 0.6 ounces for non-Indians, according to a study by the Columbia River Inter-Tribal Fish Commission. For that reason, they may be more at risk from mercury in the fish.
Mercury can come from a variety of sources. The biggest emitters near the Columbia River are Portland General Electric's coal-fired plant in Boardman in Eastern Oregon and Ash Grove Cement Co. in Durkee, about 10 miles south of Baker City, Ore. Initially airborne, the mercury eventually ends up in waterways. It's not clear if the two plants are the leading source of the mercury in the river. But most mercury in salmon and steelhead is suspected to have come from the Pacific Ocean, where high concentrations have been found in tuna and swordfish, said Oregon state public health toxicologist Dave Stone. "We know it's there. We know it's in the fish," said David Bray, EPA assistant director of airway and toxins in Seattle. "But where (it's) coming from is still a question."
The highest concentrations of mercury in Columbia River Basin fish are found in bass and northern pikeminnow, he said. The Oregon Department of Health Services warns fishermen to limit consumption of those fish from the Willamette River, and has also issued warnings on crayfish and shellfish on the lower Columbia River. Washington has issued similar warnings on bass statewide, and on walleye from Lake Roosevelt.
Of all Columbia River Basin fish, salmon and steelhead appear to have the lowest concentrations of toxins, including mercury, Stone said. But that's of little comfort for tribal members who consume significant amounts of those fish. Mercury levels in salmon and steelhead vary greatly in the Columbia Basin. Levels in most of those fish fall within federally acceptable limits -- but not always. Among the highest measurements were spring chinook on the Klickitat River, where some fish were discovered with concentrations as high as 0.51 parts per million, exceeding EPA's consumption advisory level of 0.30 parts per million.
Stone said the health benefits of eating salmon and steelhead outweigh the risk. But others say the federal limits for mercury -- as well as other toxins, such as pesticides and other metals -- are based on average consumption rates and don't account for those eating significant amounts of the fish. "What EPA said is a safe level is a level based on people eating less fish," said Oregon Environmental Council program director Laura Wise. "If you're protecting people, which ones are you going to protect?"
During a water quality summit last week in Pendleton, Ore., leaders from the Yakama, Nez Perce, Umatilla and Warm Springs tribes told EPA officials that calculations for the average fish consumption rate need to be increased before contaminant issues could be accurately assessed. It wasn't the first time Yakama tribal leaders have asked the EPA to research possible health effects of Columbia Basin contaminants on tribal members, said Russell Jim, manager of the tribe's Environmental Restoration and Waste Management program. "Basically, they said they didn't have any money," he said.
Setting new standards
New federal law promises to decrease airborne mercury from the nation's coal-fired power plants from roughly 48 tons to 15 tons by the year 2018. But Northwest tribes, including the Yakamas, and a host of environmental groups want it done faster. The law applies only to coal-fired plants, which are considered one of the largest single sources of mercury. Requirements are still being hammered out for cement manufacturers, another major source of airborne mercury.
Portland General Electric's coal-fired plant emits about 180 to 220 pounds of mercury annually, said company spokesman Steve Corson. Of that, about 10 to 15 percent ends up in the river, said Jerry Ebersole, hazardous air pollutant analyst with the Oregon state Department of Environmental Quality. There's no estimate on how much of the cement plant's mercury reaches the river, he said.
A global problem
Getting a handle on mercury, which is more of a global problem, isn't going to be easy, Corson said. Studies indicate that much of it is wind-blown from Asia, and work is still being done to determine whether the mercury in the Columbia River is from local or global sources, he said. "The question is where does it actually fall out of the sky and end up in the food chain," Bray said.
Either way, the Yakamas support a proposal to drastically reduce emissions by 2010. "It's a way of getting around being responsible," said the tribe's Columbia River environmental program coordinator, Rebecca Elwood. "I think the heart of this thing is environmental justice."
Mercury isn't the only concern, Jim said. Numerous contaminants from pesticides to dirty storm water and even radioisotopes from the Hanford nuclear facility are making their way into the river. "If there is damage to resources, then there has to be damage to people, especially the indigenous people that rely on the natural resources, foods and medicines," Jim said. "There are numerous issues tied to this."
by Mark Magnier, Los Angeles Times
September 3, 2006
http://www.latimes.com/news/nationworld/world/la-fg-enviro3sep03,1,687961.story?page=2&coll=la-headlines-world
HUASHUI, China -- The tents are gone, the protesters have dispersed and the police have retreated to the shadows. But villagers remain in jail, local women are still tending deformed babies, and rage burns beneath the surface. With the spread of pollution-related unrest, a contagious source of instability in the world's most populous country, Huashui stands out as a benchmark more than a year after farmers drew a line in the once-fertile earth. Not only was it one of the largest known protests, with an estimated 10,000 police officers and desperate villagers battling in April 2005, but it also proved a rare case in which citizen outrage prevailed over deeply vested interests. A few months ago, the last of the area's 13 poison-spewing factories was shuttered. "Without the riot, nothing would have changed," said Wang Xiaofang, a 43-year-old farmer. "People here finally reached their breaking point."
China's pollution has long been a focus of international criticism as clouds of toxic air waft over California and polluted rivers empty into the Pacific Ocean. Increasingly, however, China's own people are taking to the streets to demand an end to the birth defects, Technicolor water, dead crops and murky air that are robbing them of their livelihoods and lives. "Environmental problems are increasingly a flash point of rising unrest in China," said Nicholas Bequelin, China researcher with Human Rights Watch. "You're not talking about the size of some woodland or whether to cut old-growth trees. You're talking about life-and-death issues for villagers."
In Huashui, villagers may have forced out the factories, but they have paid a price. Nearly a dozen farmers, including Wang's 40-year-old brother, Wang Liangping, have been sent to prison for as long as five years. Several say they have been tortured. "We're not the troublemakers," Wang said. "It's the government and the factories that poisoned us. They created the problems, but we're the ones sent to jail."
And local authorities using spies, wiretaps, intimidation and close surveillance keep a tight grip on the area. As villagers spoke with a reporter in Wang's farmhouse, 10 police officers and local officials arrived, tipped off either by tapped cellphones or, as they later claimed, a "patriotic farmer" reporting the "illegal" gathering. The reporter, along with a villager, was interrogated at the Dongyang police station for nearly three hours, his bags searched, cellphone records examined, notes confiscated and digital photographs deleted before he was made to sign a "self-confession." Two local foreign affairs representatives remained with the reporter for the next 15 hours before delivering him to the airport.
China saw 50,000 environment-related riots, protests and disputes last year, an increase of nearly 30%, according to the state-run China Daily. Many were closely linked to other divisive and equally sensitive social issues, including the nation's growing wealth gap and illegal land seizures by local officials as new developments gobble up the countryside. "This environmental problem has become one of the main factors that affect national safety and social stability," said Pan Yue, deputy director of the State Environmental Protection Administration.
Analysts blame a top-down single-party system obsessed with economic growth in which officials are promoted for fulfilling five-year plans, not for listening to citizens. Structural problems also are a factor. Pan's environmental bureau is weak and easily dominated by muscular economic ministries with bigger budgets and more clout. And the salaries of its local representatives are paid by the pro-growth governments they're supposed to be regulating. "Many in government worry about instability if economic growth is not very fast," said Daniel C. Esty, head of Yale's Center for Environmental Law and Policy. "But I think instability is a far greater threat from people who find they're being poisoned by the environment."
A government study released in mid-July found that 81% of the nation's chemical plants were dangerously near population centers and sources of drinking water. Aware of the problem and the fury it engenders, Beijing recently promised to spend $175 billion on environmental protection over the next five years. There are small signs of change. A few groups have started challenging polluters in court, with modest success. "We're winning more cases," said Xu Kezhu, deputy director of the Center for Legal Assistance to Pollution Victims, which helps farmers file environmental lawsuits. "But it's not easy."
Villagers here say they originally cooperated with the government. The first chemical factories, which sprang up around 2001, were welcomed as a source of jobs and economic growth. That view started to change, however, as stillbirths increased and more children were born with deformed limbs or with learning disabilities. As more chemical factories moved in, residents saw a "death zone" expand around the industrial area, killing trees and crops as far away as six miles. "If you ate the rice immediately after harvest, you got a stomachache," said Jiang Yonggen, 44, a farmer. "And vegetables wouldn't grow at all." They also noticed that the foul-smelling gas clouds emitted by the factories at night left their children's eyes glued shut in the morning.
But when they raised their concerns with government and factory officials, with their yellow shriveled cornstalks in hand, they were told they must have used too much fertilizer. After four years of excuses, and word that still more chemical factories would be moving in, the farmers settled on a new tack. On March 20, 2005, they blocked the main road leading to the factories with homemade bamboo tents and mounted slogans on the factory walls that read: "Give us back our land" and "We want to survive." They recruited retirees to keep watch on the tents around the clock, telling them to set off fireworks to alert other villagers if local officials showed up.
Three weeks later, in the wee hours of April 10, thousands of villagers heard the firecracker warning and came running to defend the barricades. Facing off against them, witnesses say, were an estimated 3,000 police officers and government supporters. Villagers say police threw stones at them from a nearby elementary school in a battle that lasted for hours. Initially, villagers say, they forced the authorities back, overturning government cars and buses and injuring police officers. But police used a wedge maneuver to split and scatter the protesters before destroying the tents.
Villagers say at least two elderly people died. In a country where information is carefully controlled, the claims are difficult to verify. The government says that the villagers attacked first, that no one died and that most of the injuries were on its side. When the dust cleared, the police fingered a few "troublemakers," a centuries-old tactic of making scapegoats, villagers say, quoting a Chinese proverb: "killing one to scare 100." Wang's brother was sentenced to 15 months in jail. He is mentally disabled and has an extremely gentle disposition, Wang says, and wasn't even at the tents when the alleged assault supposedly took place. She says he's been beaten repeatedly in police custody.
A police officer at Dongyang station, who declined to be identified, acknowledged that the government had not always been responsive to environmental problems. "The farmers assaulted the police, who didn't fight back, and many police suffered broken bones, stab wounds and poked eyes," he said. "While Wang Liangping may be a gentle man, gentle people can also become violent."
Jiang Yinsheng, Huashui's Communist Party secretary, who was named to the post after the riots, says that he has no direct evidence of police misconduct and that the existence of birth problems is not conclusive. "I don't believe the villagers were tortured," he said. "And some farmers aren't well-educated and take medicines during pregnancy, so we can't be sure deformed or stillborn babies result from pollution."
Jiang, the 44-year-old farmer, shifts his maimed hip. He says he can barely walk, go to the bathroom by himself or sit for more than a few minutes, the result of near-continual torture sessions during his 117 days in Dongyang jail. Jiang says he was hit in the face with a shoe more than 30 times, and other prisoners were encouraged to hit him as well or face the same punishment. His buttocks were hit repeatedly with a wooden stick, leaving deep bruises that lasted for weeks. The pain was so terrible that he considered committing suicide, he says. "Even the doctors were merciless."
Villagers say a few people in China are getting rich by destroying the environment. "This whole system is unfair," said Liu Maotian, a farmer whose 31-year-old son is serving a five-year term on charges of stabbing a police officer during the uprising. Liu says his son kicked the officer in the melee but didn't stab anyone. "They're getting wealthy on the backs of poor people like us," he said. "If there was the least bit of concern for ordinary people, this riot never would have happened."
by Peter Calamai, Toronto Star
September 2, 2006
http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&c=Article&cid=1157147419130&call_pageid=968332188774
The green credentials of the Harper government are going to be severely tested even before the House of Commons resumes Sept. 18. Four days earlier, officials in the federal environment and health departments are to reveal which among 23,000 chemical compounds used for years in Canada pose the biggest toxic danger to people or ecosystems. Some of the hundreds of candidates for the danger list are found in everyday items, such as lip balm and water bottles. "These are the worst of the worst of the worst," says Rick Smith, executive director of Environmental Defence, a Toronto-based activist group known for measuring chemical residues in prominent Canadians.
The danger list results from an exhaustive seven-year scientific survey of the 23,000 chemical compounds, not including pesticides, thought to be already in use when Parliament updated the Canadian Environmental Protection Act in 1999. While any new substances introduced into the country had to pass a toxicity check starting in the late 1980s, the updated law set a seven-year deadline for government officials to investigate those already on the market.
Environment department officials first determine if the substances are "inherently toxic" to fish, the test animal, and also if they are either persistent (don't break down chemically) or accumulate in fish. If those boxes are ticked off, officials check whether the compound is still in use and rate the chances of exposure to toxic levels. Health department officials look for compounds inherently toxic to humans and carrying the greatest risk of exposure. Government sources say this investigation produced a list of about 4,000 suspect substances with 500 tagged as high-priority. About 400 of those pose potential ecological risks and 100 health risks but as many as 200 overall may no longer be in widespread use.
"If the Conservatives don't have an action plan ready to deal with this on Sept. 14, they're going to look like idiots," says Smith. Undefined action on toxic chemicals is included in the first phase of the Harper government's Green Plan II, which is scheduled to be revealed between now and spring in a kind of slow political strip-tease. (The original, highly lauded Green Plan was hatched by Brian Mulroney's government.) Yet the Tories want to train the initial public spotlight on a new Clean Air Act, said to be combining strong measures to curb urban smog with a minimal response to the greenhouse gases responsible for global warming.
Senior federal officials have held closed-door briefings with cities, business and environment groups in the past two weeks. Only a vague outline of Green Plan II has emerged, and aides to Environment Minister Rona Ambrose are tight-lipped. Here are some tentative highlights of Green Plan II, pieced together through interviews with environmentalists who were briefed and with federal officials speaking on a promise of anonymity:
Sources say the rough price tag for all this came in at about $2.4 billion, about $400 million more than the government initially allotted. The clean energy program costs the most. At the core of Green Plan II lies a heavy emphasis on tough regulation rather than the kind of voluntary compliance typically followed by the federal environment department. Ambrose is said to favour the U.S. approach of administrative fines and other penalties as opposed to drawn-out court proceedings.
Says Bea Olivastri, who heads the Canadian office of Friends of the Earth: "The talk on compliance, enforcement and accountability is stronger language politically than we've heard for some time." Such tough talk only increases the expectation the Harper government will take real action on the several hundred high-priority toxic chemicals in wide use. Yet severe budget cuts by the Chrétien and Martin cabinets crippled the ability of the environment department to move rapidly on deciding which chemicals should face the "virtual elimination" specified under the 1999 federal law. One estimate is that checking out and managing all 4,000 suspect chemicals might take a decade. "In Europe and the U.S. many of these chemicals are in the process of being banned," says Rick Smith. "Do we really want Canadians exposed to chemicals that even the Bush administration is eliminating?"
by Andrew Bridges, Associated Press, Newsday
September 1, 2006
http://www.http://www.newsday.com/news/health/ats-ap_health10sep01,0,3564324.story?coll=ny-leadhealthnews-headlines
WASHINGTON -- Silver fillings used to patch cavities aren't dangerous even though they expose dental patients to the toxic metal mercury, federal health researchers said Friday. The Food and Drug Administration reviewed 34 recent research studies and found "no significant new information" that would change its determination that mercury-based fillings don't harm patients, except in rare cases where they have allergic reactions. The FDA released a draft of its review ahead of a two-day meeting next week to discuss the safety of mercury used in dentistry.
Consumer groups opposed to its use disputed the FDA's conclusions. The groups plan to petition the agency for an immediate ban on use of the cavity-filler in pregnant women. "The science is over. There is no safe level of exposure," said Charles Brown, a lawyer for one of the groups, Consumers for Dental Choice. "The only thing standing between this and a ban is politics. They are still pretending it is a scientific question, but it isn't."
Amalgam fillings, also called silver fillings, by weight are about 50 percent mercury, joined with silver, copper and tin. Dentists have used amalgam to fill cavities since the 1800s. Today, tens of millions of Americans receive mercury fillings each year. Amalgam use has begun to decline, however, with many doctors switching to resin composite fillings, considered more appealing since they blend better with the natural coloring of teeth. With amalgam fillings, mercury vapor is released through tooth-brushing and chewing. In general, significant levels of mercury exposure can permanently damage the brain and kidneys. Fetuses and children are especially sensitive to its harmful effects.
Scientists have found that mercury levels in the blood, urine and body tissues rise the more mercury fillings a person has. However, even among people with numerous fillings, exposure levels are well below those known to be harmful, the report said. "If substantial scientific evidence showed that dental amalgam posed a threat to the health of dental patients, we would advise dentists to stop using it. But the best and latest available scientific evidence indicates that dental amalgam is safe," Dr. Ronald Zentz, senior director of the American Dental Association's council on scientific affairs, said in prepared remarks to be delivered Wednesday to the joint meeting of FDA experts on dental products and neurology.
Among those expected to address the joint panel is Rep. Diane Watson, D-Calif., who has introduced legislation that would effectively ban the use of mercury in dental fillings by 2008. Watson will press the FDA for a ban and call on the agency to study the environmental impact of dental mercury, spokesman Bert Hammond said. Also on the legislative front, Sen. Mike Enzi, R-Wyo., and other Senate colleagues have asked President Bush's nominee to head the FDA about the safety of mercury fillings. An Enzi spokesman said the lawmaker has yet to receive Dr. Andrew von Eschenbach's answers to those questions.
Meanwhile, representatives of the National Multiple Sclerosis Society and Alzheimer's Association are expected to testify that there is no known scientific evidence to connect mercury fillings and the two diseases that are the focus of their respective groups. And Swedish and Canadian experts are to discuss how their countries regulate amalgam fillings. The meeting likely won't be the last word in the drawn-out fight over mercury fillings. As early as the 1840s, dentists were squabbling over whether gold or mercury-silver fillings were better -- a feud that led to the disbanding of the first national dental society in the United States, according to a March article in the Journal of the California Dental Association.
by Verity Edwards, Sydney Australian
August 31, 2006
http://www.theaustralian.news.com.au/story/0,20867,20310702-23289,00.html
WORLD Health Organisation guidelines for safe levels of lead in blood could be too high to protect children. Adelaide University scientist Peter Baghurst, who has a federal grant to study the brain development of children in the industrial cities of Port Pirie and Broken Hill, said the "safe" level of 10 micrograms per decilitre of blood had been set because it was seen as an achievable target. However, he warned there was evidence to prove that exposure to smaller concentrations of lead could also be harmful. "There are now controversial claims in the research literature that there may be larger effects occurring between one and 10 micrograms of lead per decilitre of blood than previously thought," Dr Baghurst said.
"That figure of 10 was chosen not so much on us having information on what was going on below 10, but it was thought to be a pragmatic level." Up to 60 per cent of children aged under five in Port Pirie, 230km north of Adelaide, have unsafe lead levels. The city is home to the world's biggest lead smelter, owned by Zinifex.
International scientists criticised the South Australian Government earlier this year for failing to curb dangerous emissions from Zinifex's smelter. More than $30 million has been spent on a lead decontamination program in the city since 1984, with levels dropping significantly. But the smelter still emitted close to 47 tonnes of contaminated lead dust in 2003-04.
The American Academy of Pediatrics and the US Centres for Disease Control have previously called for further research amid concerns that the 10mcg limit is too high. The state Government is closely watching Dr Baghurst's study. His Adelaide University research team will study 300 children aged seven or eight by the end of 2008, including interviewing parents and testing blood lead levels. Dr Baghurst said the removal of leaded petrol was the most significant action taken to reduce exposure to non-lethal amounts of lead.
The experienced lead researcher said questions were first raised about the WHO target after blood lead levels in children dropped as a result of taking the petrol off the market. "Having taken the lead out of petrol we're now seeing levels that are way below 10 around the country," he said. "We're revisiting an old problem based on studies that find that (lead levels below 10mcg) can still do pretty nasty things."
Dr Baghurst said his team had chosen the two communities because they had previously been involved in blood lead level studies and the population of children with high levels could be easily monitored. It is hoped that contemporary tests will provide clearer indications of which aspects of brain function were affected by lead exposure. The tests will also look at the IQ levels of children, cognitive ability, emotional behaviour and whether the child's home environment has an effect on lead levels.
by Stephen Smith, Boston Globe
August 30, 2006
http://www.boston.com/yourlife/health/other/articles/2006/08/30/cigarettes_pack_more_nicotine/
Even as measures to discourage smoking grew more stringent in recent years, a new report indicates that the nicotine content of cigarettes rose, making it tougher for smokers to quit. From 1998 to 2004, the amount of nicotine that could be inhaled from cigarettes increased an average of 10 percent, the study by the state Department of Public Health found. Nicotine is the chemical that causes cigarettes to be addictive, and the study, released yesterday, found higher levels in all classes of cigarettes, including those branded "light."
During the past decade, aggressive campaigns across the nation have aimed to curb smoking, the leading cause of preventable deaths. Cities and states, including Massachusetts, have banned smoking in public places, and the price of cigarettes has soared. Still, smoking rates among US adults stubbornly persist above 20 percent. "We in public health have tried to spend a lot of time figuring out why people don't stop smoking," said Lois Keithly , director of the Massachusetts Tobacco Control Program . "It is more difficult to quit when there is a higher amount of nicotine in the cigarette."
Representatives of the three major tobacco makers in the United States -- Lorillard Tobacco Co. , Philip Morris USA , and R.J. Reynolds Tobacco Co. -- declined to comment on the study and would not answer questions about the nicotine content of their products.
Tobacco control specialists not involved with the Massachusetts report described it as the first major study tracking nicotine in cigarettes in seven years. And those specialists said they believe that the findings reflect trends nationwide. Industry documents turned over during landmark litigation in the 1990s that led tobacco companies to settle with state governments for billions of dollars showed that the companies routinely spiked the nicotine content of their products so that cigarettes would be more pleasurable and addictive. The state study, tobacco control specialists said, suggests that practice has persisted. "Their efforts are focused on getting people addicted quickly and keeping them addicted," said Diane Pickles , executive director of Tobacco Free Massachusetts, an advocacy organization.
A 1996 state law required cigarette makers to test the nicotine content of their products using a method specified by the Department of Public Health and report the results annually. Most of the tests are conducted at an independent laboratory in Canada that uses a machine to simulate a typical smoker's puffing. Though the data in the report came from the tobacco industry, Sally Fogerty , an associate commissioner of public health, said her agency was confident the nicotine readings are reliable because it would not be in the companies' interest to report an increase.
Veterans of the decades-long fight against the tobacco industry said the rising nicotine levels show that companies will adopt strategies to get smokers addicted -- and to keep them hooked. "I'm always shocked at the new things the industry does," said Richard Daynard , chairman of the Tobacco Products Liability Project at Northeastern University . "This is sort of sleazy in a new and different way."
The industry is still absorbing the latest blow against it, a ruling this month by a federal judge in Washington, D.C., that the companies had conspired to deceive the public about the perils of smoking. The judge ordered cigarette makers to stop using monikers such as "ultra-light" and "low tar." The Federal Trade Commission for three decades regularly released reports on the nicotine and tar content of cigarettes -- reports that frequently came under criticism for failing to adequately reflect the amount of nicotine smokers inhale in actual use. The reports showed that nicotine levels on average had remained stable since 1980, after falling in the preceding decade. The last of those studies was released in September 1999, commission spokeswoman Claudia B. Farrell said yesterday. The Federal Trade Commission has continued collecting data on nicotine, but she did not know why they have not published reports on the findings.
The Massachusetts approach to measuring nicotine tries to address shortcomings of the Federal Trade Commission's methodology so that it more realistically reflects how people actually smoke, state specialists said. The state test assumes that half of the tiny holes that filter smoke will be blocked by a user's lips or hands, increasing the amount of smoke inhaled, while the federal reports assumed that all of the holes would be open. The Massachusetts study analyzed nicotine in 116 cigarette brands, finding that the amount of nicotine that can be inhaled by a typical smoker increased in 92 brands from 1998 to 2004. Only a dozen brands registered a decrease in nicotine. Twelve others remained constant. In 2004, Newport filtered cigarettes eclipsed Camel and had the highest level of inhalable nicotine, nearly 70 percent above the average. The brands with the lowest content were Doral Ultra-Light King soft pack and Winston Ultra-Light King soft pack.
After being inhaled, nicotine races to the brain in seconds, releasing a flood of chemicals associated with pleasure and motivation. Increasing the amount of nicotine, doctors said, presents a very real danger to smokers. "If people are getting accustomed to higher levels of nicotine when they smoke, when they stop smoking, I would expect they would have more withdrawal symptoms," said Dr. Nancy Rigotti , director of tobacco research and treatment at Massachusetts General Hospital . "And it would make it harder for them to quit smoking." It could make it harder, too, to treat smokers who want to quit, Rigotti and the state's Keithly said. Current formulations of nicotine patches and gums might be too weak to counteract the craving created by high-powered cigarettes.
Massachusetts once was a national leader in spending on tobacco control, but a statewide budget crisis caused funding to plummet to just $5 million a year, from a high of $48 million a few years ago. In July, the state expanded smoking cessation services for the poor and uninsured; about 40 percent of Massachusetts adults covered by government health plans smoke.
by Michael D. Shear, Washington Post
August 30, 2006
http://www.washingtonpost.com/wp-dyn/content/article/2006/08/29/AR2006082900896.html
RICHMOND, Aug. 29 -- Virginia Gov. Timothy M. Kaine (D) said Tuesday that he is "actively considering" ordering a ban on smoking in state government buildings and vehicles, a move that would affect 100,000 employees and inch the commonwealth closer to a growing national consensus about the dangers of secondhand smoke. Kaine's willingness to consider a smoking ban is especially symbolic in a state where tobacco has been king since it was first planted by colonists in 1609. Philip Morris, one of the state's top employers, makes nearly 470 million cigarettes a day at its Richmond plant.
Responding to questions from two Northern Virginia listeners on Washington Post Radio, Kaine said, "I was surprised to find out that there is no state smoking ban in state facilities, and that's something that I'm actively considering right now." The governor also reiterated his firm opposition to a government-imposed ban on smoking in private workplaces, calling it "too much of a reach for government. I just don't see government having to tell all these folks that if you allow the public in your place of business, you can't smoke in your own office," Kaine said.
That drew a sharp rebuke from state and national anti-smoking activists, who accused Kaine and other Virginia politicians of continuing to bow to the will of cigarette companies such as Philip Morris, which moved its headquarters to Virginia in 2004. "I hope when you talk to the governor you ask him to explain the difference between protecting state workers and protecting all workers," said Paul Billings, vice president for national policy at the American Lung Association. "There is still significant political power associated with the tobacco industry. That's what's driving some of this rhetoric."
Tobacco was the state's leading export for nearly 400 years until being displaced unceremoniously last year by computer memory chips. Altria, the parent company of Philip Morris USA, is one of the top political donors to state races in Virginia, having given $2.25 million during the past decade. The company gave $80,000 to Kaine's gubernatorial campaign and $50,000 to help stage his inauguration this year. A Philip Morris spokesman declined to comment on a possible ban in state offices. But he said the company does "understand and agree that people should be able to avoid being around secondhand smoke, particularly in places where they must go, such as public buildings."
Kaine spokesman Kevin Hall said political contributions had no impact on Kaine's long-standing position on smoking. He said Kaine believes the marketplace will pressure private businesses to go smoke-free and said a decision to ban smoking in state buildings could serve as a positive example. "The governor's position would allow an employer flexibility to devise a policy that works for employees and customers," Hall said.
That position puts Kaine at odds with many in his party and with the state Senate, which this year passed legislation that would have banned smoking in virtually all public and private businesses. The legislation died in the House of Delegates. Sen. J. Brandon Bell (R-Roanoke), who sponsored the Senate legislation, said he is pleased that Kaine might be willing to ban smoking in at least some places. "He's hearing from a lot of people. It's a broadly supported bill," Bell said. "I don't think he wants to be on the wrong side of that."
In Virginia, the decision to prohibit smoking in a state building is currently left to agency or facility managers, according to Hall, who said the result is "uneven" policies on smoking across the state. In Maryland, smoking in state buildings is prohibited under a 1992 executive order and is limited to sealed, ventilated smoking rooms in all private workplaces except restaurants and bars. In the District, a law that went into effect in April bans smoking in all workplaces and in restaurant dining rooms. In January, it will ban smoking in bars as well. Across the nation, 22 states, including West Virginia, ban smoking in state buildings, according to the American Lung Association.
The smoke-free movement is accelerating in part because of a June report by U.S. Surgeon General Richard H. Carmona, who found that secondhand smoke at any level is toxic and "not a mere annoyance. It is a serious health hazard that can lead to disease and premature death in children and nonsmoking adults." In November, Arizona and Ohio voters will decide on ballot initiatives that would ban smoking in workplaces. Smoking is barred in the capitol in North Carolina, a major tobacco-producing state.
But smokers have always had a haven in Virginia, where for many years signs invited visitors to the state Capitol to light up wherever they pleased. On the ceilings of the House and Senate chambers in the Capitol, which is currently under renovation, are pictures of tobacco leaves, a tribute to a crop that still generates hundreds of millions of dollars in valuable exports each year. Now, if Kaine gets his way, the sweet smell of tobacco leaves wafting across from the world's largest cigarette manufacturing plant may soon be the closest that state employees in Virginia's capital get to smoking on the job.
Kaine has said several times that he supports voluntary bans by private companies. The law firm where he worked in the mid-1980s did just that, he said again Tuesday. But he has said his opposition to government bans on smoking at private businesses stems from the memory of his father's ironworks business in the Kansas City, Mo., area, where five people -- including Kaine -- worked. He said again on the radio Tuesday that he cannot imagine the government banning smoking there. "What is the right role of government?" he asked, rhetorically. "That is the question."
by Marla Cone, Los Angeles Times
August 29, 2006
http://www.latimes.com/news/local/la-me-perchlorate29aug29,0,4030059.story?coll=la-headlines-california
Perchlorate, a toxic ingredient of solid rocket fuel that is contaminating hundreds of wells throughout Southern California, would be limited in drinking water under a new state standard proposed Monday. The California Department of Health Services plans to set a drinking water standard of 6 parts per billion, the same as a goal the state established two years ago. The standard, however, would be enforceable, whereas the existing goal is not.
The proposal allows the health department "to address a contaminant that, unfortunately, is quite common in certain areas of California," said state Public Health Officer Mark Horton. "Perchlorate's potential for harm is of concern to pregnant women and their developing fetuses, as well as children, so limiting exposure to this contaminant is important for protecting public health." Most of the water contamination comes from military bases and aerospace plants, where perchlorate was widely used as the explosive component of solid rocket propellants.
The U.S. Environmental Protection Agency earlier this year set a much higher interim cleanup goal for perchlorate -- 24.5 parts per billion. But the federal agency has not yet set an enforceable standard for drinking water. "The states are again acting in the face of inaction by federal EPA," said Bill Walker of the Environmental Working Group, an environmental health advocacy organization. "While we would have liked to have seen California's standard lower, and it could leave some Californians at risk, the big story is the difference between it and EPA's. This is another strong signal to EPA that its [goal] is much too high and that they need to stop the foot-dragging and move forward with a truly protective drinking water standard."
Massachusetts is the only state with a mandatory drinking water limit -- 2 parts per billion, which went into effect last month. Environmental groups had urged California to adopt a more stringent standard, from 1 to 2 parts per billion, but the Pentagon and its contractors objected that such a low standard would be unwarranted. Taxpayers and industry "will face staggering costs to meet requirements that could be set by California" or the U.S. EPA, according to a report by a water quality group funded by Lockheed Martin