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Using Blood Lead Levels to Set Cleanup Goals

Lead smelter in Kellogg, ID.The creativity of our government regulators never ceases to amaze me. I’ve seen a lot of incredibly stupid and callous decisions in my time, but this one is right up at the top. The US environmental Protection Agency (EPA) Region 10 and the Idaho Department of Environmental Quality somehow thought it was a good idea to use Blood Lead Levels in children to establish a remedial action objective (RAO) at the Bunker Hill Superfund site in Kellogg, ID. According to a recent peer reviewed paper published in the American Journal of Public Health, this decision is codified in EPA’s 1991 Record of Decision for the Bunker Hill site (1).

According to the authors, “the 1991 ROD for the Bunker Hill mine defined the EPA RAOs for child blood lead levels and stipulated the following criteria measures: (1) less than 5% of tested children should have blood lead levels greater than 10 micrograms per deciliter and (2) less than 1% of tested children should have blood lead levels greater than 15 micrograms per deciliter.” You got that. As long as no more than 5% of the children in Kellogg have blood lead levels greater than 10 micrograms per deciliter (ug/dl) and no more than 1% had levels great than 15 ug/dl, then the site cleanup efforts could be considered “successful” (1).

What was EPA thinking when they decided to use lead levels in children to define the effectiveness of a cleanup? And then, to accept that some children will have blood lead levels that exceed the recommended criteria is unconscionable. Even if this factor was not the sole criterion used to make decisions about the effectiveness of the cleanup, it is still unethical to use the children of Kellogg in this way.

The adverse health outcomes of exposure to lead are well understood. Earlier this year the Centers for Disease Control (CDC) revised its guidelines for lead lowering the blood lead level for protecting children’s health from 10 to 5 ug/dl. At the time CDC’s Advisory Committee for Childhood Lead Poisoning Prevention whose recommendations led to this change made it clear that no safe blood lead level in children has been identified.

Lead was mined at the Bunker Hill site for more than 100 years and at one time this was the home of the largest lead smelter in the United States. When the mine shut down in 1981, it left behind a toxic legacy of huge waste piles and residual contamination everywhere. Blood lead testing in children as earlier as 1976 found that 99% of Kellogg children living within 1 mile of the smelter who were tested had blood lead levels greater than 40 ug/dl (2). Today it is much less clear what the blood lead levels are because so few children are tested.

It is an injustice for EPA to treat the residents of Kellogg in this way. The residents In Kellogg have suffered disproportionately not only from lead exposure which continues to this day, but also from social disparities that include unemployment, poverty, and limited educational opportunity. Although there has been substantial cleanup at the site, it remains unclear whether there has been a corresponding improvement in community health and wellbeing. So much more needs to be done. This of course will never be achieved in communities like Kellogg, so long as decision makers think there’s nothing wrong with using the children as canaries in the mine fields.

1. Moodie, SM and Evans, EL. Ethical Issues in Using Children’s Blood Lead levels as a Remedial Action Objective. American J Public Health 2011 101(S1): S156-S160.

2. Landrigan PJ, Baker EL Jr, Feldman RG, et al. Increased lead absorption with anemia and slowed nerve conduction in children near a lead smelter. J Pediatrics 1976 89(6):904-910.

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Backyard Talk

BPA in Receipts – The chemical that’s everywhere, or so it seems

It’s very likely that you’ve heard of a chemical called BPA or bisphenol A. It’s been in the news because it’s an endocrine disrupting chemical used in making plastic products and in the lining of metal cans. The problem is that BPA leaches out of plastic bottles, canned foods and other products and gets into the food and drink. Trace amounts of BPA have been found in the urine of at least 90% of Americans.  BPA mimics the hormone estrogen in the body and has been linked to reproductive and developmental abnormalities as well as other adverse health effects.

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Source: American Chemical Society

Concerns about these adverse health effects led Canada to define BPA as a toxic substance and 11 states to ban its use in baby bottles and sippy cups. The FDA followed suit in July of this year. Concerns remain however about BPA leaching into infant formula, food and beverages. Approximately eight billion pounds of BPA are used each year worldwide.

Although diet is the primary route of exposure to BPA, research has shown that it can also be absorbed though the skin in a less familiar way – the handling of receipts of all kinds. BPA is the primary chemical used in cash register and thermal receipts commonly used in stores, ATM machines, gas stations, various tickets, and many other uses. BPA is used as a color developer for the printing dye. It’s applied as powder coating that acts in the presence of heat to produce an image without ink. The problem here is that the chemical is not bound to the paper, so it rubs off when you handle the receipt. It gets on your fingers and quickly gets into your blood stream. If you handle receipts every day, and it accumulates in the body, you increase your risk. This is especially a concern for workers who handle receipts all day long, or for pregnant women.

While there’s no way to tell if a receipt contains BPA or not, a number of studies have tested receipts for BPA. One study reported in the New York Times of 103 thermal receipts collected from cities in the U.S., Japan, South Korea and Vietnam in 2010 and 2011 found 94% of the receipts to contain BPA. All of the receipts in the U.S. had traces of BPA, even some marked as BPA-free. A study by researchers in Boston found 8 of 10 cash register receipts had BPA, and a study by the Environmental Working Group in 2010 found 14 of 36 receipts collected from fast food restaurants, retailers, grocery stores, gas stations and post offices tested positive for BPA.

Although studies in animals have found that very low concentrations of BPA can produce adverse effects, it’s unclear what level of exposure in people can produce adverse effects. It’s also unclear how much exposure from thermal receipts contributes to a person’s total exposure to BPA. Diet remains the primary route of exposure. It is clear, however, that there are readily available alternatives to BPA and this is another source of chemical contamination that can easily be eliminated. It’s also easy to say “no thank you,” when asked if you want your receipt.

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Identifying Disease Clusters – What Comes Next?

It’s hard to say how many disease clusters have been identified. The website of the National Disease Cluster Alliance (NDCA) which held a national conference last week has a map that identifies 73 clusters. Several people attending the meeting pointed out that their cluster was not on the map and there are no doubt many others not on the map. While identifying clusters is an important step, knowing how to respond and what steps to take once a disease cluster (even a suspected disease cluster) has been identified is, perhaps, more important. This and other questions about disease clusters were discussed at a National Disease Cluster Conference held in Washington, DC last week by the NDCA.

It was clear from several presentations that no guidelines exist for what action steps a government agency should take once a disease cluster has been identified. This is a big problem, especially since most health agencies typically close their investigation once a cluster has been identified, concluding that they could not determine the cause of the cluster. This is not the time to walk away from a community that is struggling to determine not just whether a disease cluster exists, but what‘s causing it as well.

There are plenty of examples of communities where a disease cluster was identified. There is the cleft palate cluster in Dickson, TN, increase cancers in Clyde, OH, and childhood cancers in Toms River, NJ, Sierra Vista, AZ and Fallon, NV to name a few (see NDCA map). There are few examples, however, of agencies being able to identify the cause of the cluster. Woburn, MA is the exception as the state health department was able to identify contaminated drinking water wells as the cause of a childhood leukemia cluster.

No doubt determining the cause of a disease cluster is a difficult question to answer. It took the MA state health department over 10 years to conclude that the contaminated drinking water wells were the cause of the cluster in Woburn. But because it’s difficult is not reason enough for public health agencies to walk away. This is unconscionable and irresponsible. Public health agencies need to come up with an action plan for how to follow-up the finding of a cluster. Part of the response needs to include an environmental investigation into what may be causing the cluster. In addition, the community would likely benefit from the distribution of educational materials about the disease in question and the methods used to investigate clusters and their causes. Whatever follow-up occurs, the government needs to include from the very beginning of the process the affected community as part of the planning group directing the investigation.

One example highlighted at the conference was the work of Dr. Paul Sheppard from the University of Arizona who conducted an environmental investigation following the identification a childhood leukemia cluster in Fallon, NV. Between 1997 and 2004, 17 children living in Fallon were identified with leukemia, three of them died. For three years Sheppard studied heavy metals in air, especially tungsten which had been identified as increased in Fallon. Sheppard used tree leaves and tree rings to measure tungsten and found a high concentration of tungsten in the center of Fallon, the home to a tungsten refinery and a tungsten plant since the 1960s.

Although Sheppard was unable to prove that exposure to tungsten caused the increase in leukemia, his work has clearly related the two. His work provides a model for how to follow-up finding a disease cluster. Investigating environmental exposures in a community with a cluster makes perfect sense. Now we need to convince the public health agencies that they need to include this step in as part of their responsibilities. For more about the conference, see www.clusteralliance.org.

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Backyard Talk

What the Chemical Industry Doesn’t Want You To Know!

The American people will panic if they find out there is dangerous levels of dioxin in their food. That’s the argument the chemical and food industries are using to stop the release of the Environmental Protection Agency’s (EPA) scientific report on dioxin.   Really. . . do they really think people will panic rather than take steps to protect their families?  The American people didn’t panic and not place their children in vehicles when they learned that more kids are injured in auto collisions than in any other type of accident. Parents installed safety seats.

The EPA’s dioxin report has been meticulously peer reviewed and is scientifically sound.  Yet, the power of the corporations that are responsible for dioxin in our environment and food has kept this critical scientific information (over 20 years of study) from reaching the public.  Consequently, the public is unable to make personal decisions about what foods they’ll eat and how best to reduce their families’ risks.

Dioxin, a known cancer causing and endocrine-disruptor chemical, is a byproduct of combustion and various industrial processes and is found everywhere in the environment. Chlorinated dioxins are released into the air and travel great distances landing on fields, pastures and waterways from waste incineration, burning household waste and a variety of industrial processes, including smelting, chlorine paper bleaching, PVC plastics and pesticide manufacturing. When animals graze in the pastures or eat feed that has animal byproducts, they ingest dioxin which is then stored in their fat.  So when little Joey drinks his whole milk, he also ingests dioxin contained in the milk’s fat.

Ninety percent of the public’s body burden of dioxin comes primarily from animal fat in the food supply.  The Environmental Working Group has found that the amount of dioxin a nursing infant ingests daily is up to 77 times higher than the level EPA has proposed to protect the endocrine and immune systems. The fact that both breast milk and infant formula are contaminated with dioxin highlights the urgent need for EPA to release its report.  For cancer risk, the situation is also concerning because the general public is exposed to up to 1,200 times more dioxin than regulatory agencies typically consider safe.

Parents place bike helmets on their children, fasten their seat belts, and take their babies for regular checkups because they understand the risks of not taking these steps.  However, everyone is being kept in the dark when it comes to dioxin in our food.  For example, breast milk contains fairly high levels of dioxin.  Nevertheless breast milk is still the healthiest food for baby.  EPA must release this information to new mothers so they know that nursing is the healthiest option.

Whose protection is our public agencies’ priority?

Recently, there has been an increased lobbying effort by various industries to stop the release of the EPA’s dioxin report. The International Dairy Foods Association, for example, wrote EPA a letter stating, “Animal products, such as milk and dairy foods, have the highest concentrations of dioxins, albeit at levels that are only in the parts-per-million and clearly below levels that have been determined to be unsafe. However, EPA’s proposed values for evaluating dioxin, if translated publicly to a “reference dose,” would scare consumers away from our products, and this would be contrary to the government’s own dietary guidance to consume three servings of low-fat or fat-free dairy each day in order to get essential nutrients found in milk and dairy.”

Releasing the EPA’s dioxin report will help consumers make choices in food products that are low in fat content (as recommended by government’s dietary guidance) and could educate the dairy lobbyists as well since they got it wrong in their letter. Low fat and fat free products are not the big problem, because dioxin is carried into food products through the fat content.

Consumers should call their federal representatives and urge them to support the release of the EPA’s dioxin report so they can make their own decisions about what is safe.  It is time to stop assuming the American people will not understand and give them the scientific information.