The predominantly black and low-income communities living near the back-to-back petrochemical refineries of Louisiana’s “cancer alley” have long suffered compromised immune systems and high rates of disease. Now, the state’s fast-growing COVID-19 outbreak is poised to hit them especially hard. <Read more>
Author: Stephen Lester
Categories
The Coronavirus Outbreak
This blog was recently published by Hesperian Health Guides.
Coronavirus is all over the news and people are looking for how-to, actionable information on surviving the pandemic. But limiting advice and actions to improving individual or community hygiene is only washing our hands of the problem. To successfully defeat the looming epidemic, we have to change a health system that places profit over health. We have to recognize and address the political, social and economic factors –the social determinants of health — that govern how health or illness moves through our communities.
Most of what to do immediately about Coronavirus (or COVID-19) is already known: Wash your hands; don’t touch your face so often; stay home if you are sick. Clean surfaces often that are touched by multiple people. Since the virus is mostly transmitted by respiration, cough or sneeze into your elbow, wear a mask if you are sick or around sick people, or stay about 6 feet away from people you speak with if you think the virus is active in your area. (See our COVID-19 Fact Sheet for more details.)
While individual action is important, it will not stop an epidemic, only collective action will. We have to start acting like the connections among us are not routes to transmit disease, but the channels through which we can defeat it. There are many actions and policies we can demand to lower the possibility that COVID-19 becomes epidemic in the United States:
1) Guaranteed income for people affected by the virus.
Most of us live paycheck to paycheck and cannot afford to stay home from work without pay. Quarantines are difficult enough for people without making them worse by causing financial disaster.
The federal government has refused to require employers to pay sick leave, and even states that do — California requires only 3 days a year – would not cover the time necessary for your quarantine, much less if your quarantine is because someone else in your household is sick. And how would people with the lowest wages survive, those in service or production jobs who cannot telecommute (as our health advisors so blithely suggest), if their employers shut down? If schools are closed to prevent disease from spreading, how will adults stay home with children and not lose their jobs or income?
In places like the Bay Area, where housing costs take the lion’s share of monthly expenses, it may also be necessary to declare mortgage holidays and a moratorium on evictions.
2) Free access to testing and treatment.
The cost of health care already stops people from getting timely testing and treatment for health problems. With coronavirus, our health system is a prescription for an epidemic.
The CDC bungled producing testing kits for COVID-19, and hospitals still have a shortage. People who have been tested are being charged thousands of dollars. When asked about treatment costs, HHS Secretary Azar refused to say treatment would be affordable: “We can’t control that price because we need the private sector to invest.”
If the US continues on the health-care–for-profit path, it insures the epidemic will be more widespread and more severe. Free access to testing and treatment for coronavirus is essential, as it is for other health conditions. Demand access to care now and in November don’t vote for anyone who doesn’t support Medicare for All – they’re basically telling you that saving your life is too expensive.
3) Prioritize reaching the most vulnerable communities
People of color and low-income communities have more exposure to disease and less access to health care facilities. We can’t perpetuate this injustice in our coronavirus response.
People already sick, especially those with breathing problems, have a higher chance of getting severely ill and dying from COVID-19. Environmental racism places factories and freeways disproportionately in poor communities of color, leading, for example, to 20% more asthma among African Americans. By prioritizing reaching communities marginalized by the medical system with necessary supplies, testing and treatment, we can slow the epidemic and begin to undo the deadly relationship of ill health, inequity and injustice.
These are all achievable demands. To win them, we have to organize pressure on our local, state and national governments from our neighborhood organizations, unions, churches, professional groups, and within the political parties that are contending for our votes this election year.
We can also organize locally to care for each other:
–Reorient your Neighborhood Watch or Earthquake Preparedness group to check up on your neighbors. Find out who is sick and who needs help.
–Expand the reach of Meals on Wheels and other such programs to feed those in quarantine.
–Volunteer and train others to be community health outreach workers to help answer questions and prepare your neighborhood for the coronavirus.
–Compensate “gig workers” who are the human backbone of food and supplies order and delivery apps for the time and disinfection supplies they need to safely support people stuck at home in quarantine.
What really stands out in the face of an epidemic like coronavirus is our leaders’ antagonism to the concept of “the public good” — unless it’s profitable, it just shouldn’t exist. Our public health systems have been weakened by millions of dollars of budget cuts, an opposition to regulation of both pollution and greed, and the refusal to build or maintain common infrastructure. If we are going to survive coronavirus with a minimum of deaths, we need to replace our health-for-profit system with one that recognizes that health is a human right.
Not too long ago, a local leader in a community in Nevada asked if I could review a set of water testing data. The sample was taken from a water storage tank that provides drinking water to the town where she lives. The town had painted the inside of the storage tank, but now the water has a strong chemical odor and four volatile chemicals were found in the water sample.
The concentration of all four chemicals in the water was below the federal drinking water standards and as far as the town was concerned, the conversation was over. The water was safe to drink. But is it really? What’s the basis for saying this?
Federal drinking water standards are based on exposure to a single substance in isolation of any other risks and reflect only a limited exposure, typically one day, from a single route of exposure, ingestion. But this is not how people are typically exposed which is to multiple chemicals at the same time. The federal standards do not address the cumulative risks posed by exposure to multiple chemicals over time. Further, these standards fail to address potential synergistic effects which are adverse health effects that are greater than would be predicted or expected based on exposure to individual chemicals alone or in combination.
Consequently, estimating risks posed by exposure to multiple chemicals in drinking water using federal drinking water standards underestimates the true risks people face drinking and using this water on a regular basis. Scientifically, we do not know how much these other factors add to the risks a person faces when drinking water with multiple contaminants. Even though each of the four chemicals in this example were found at concentrations below the federal drinking water standards, this does not mean that there is no risk when consuming or using this water. It does mean that science cannot inform this question.
Yet you hear all time when tests results are interpreted by government agencies that there is no cause for alarm. The standards are used like the proverbial line in the sand. On the one side, people are safe, and on the other, there’s endless debate over what the numbers mean. In truth, it’s not that simple.
In this case, each of the four chemicals found in the water affect the central nervous system and the liver. This means that these organ systems are all targeted simultaneously by each of these four substances. The health impact on the central nervous system (CNS) and the liver resulting from exposure to all four of these substances at the same time is difficult to judge because there is little or no information on exposure to multiple chemicals simultaneously. In addition to these targeted effects on the nervous system and the liver, these chemicals pose other specific health risks whether its skin irritation, the ability of the body to fight infection, or damage to the kidney or the heart. In many cases, some chemicals are considered carcinogens, that is, exposure increases the risk of developing cancer. The EPA’s health goal for exposure to all suspect carcinogens in drinking water is “zero” indicating that any exposure to this substance increases the risk of developing cancer over time. But EPA adjusts the health goal to reflect the realities of setting a drinking water standard at a concentration of “zero.”
In addition, because all these substances are volatile, they will evaporate into the air when a person takes a shower. One study compared the risk posed by taking a 15-minute shower versus normal consumption of drinking water and found that the risk of taking a 15-minute shower was greater than drinking the water (https://www.sciencedirect.com/science/article/pii/0048969785903493?via%3Dihub). This risk is not included the federal drinking water standard.
While the concentration of these substances in the water may be below the federal drinking water standards, there is significant uncertainty about the cumulative risks posed by simultaneous exposure to these four volatile chemicals in drinking water, especially over time.
This is just one example of how difficult it is to interpret the results of water testing. This situation is quite common, whether it’s contaminants in drinking water, chemicals in ambient air or contaminants in soil. Interpreting air and soil testing is even more difficult because there are no federal standards that define what levels are acceptable and what are not. Instead, EPA uses guideline values that are not enforceable and subject to political whims.
CHEJ can you interpret the results of any testing results you’re concerned about. Contact us if you have test results you need help interpreting.
A unique collaboration between university and community led to an important study evaluating the human health risks posed by airborne polychlorinated biphenyls (PCBs) coming from sediment in the New Bedford Harbor in Massachusetts. Researchers from Boston University found that the harbor, the home of one of the largest PCBs Superfund sites in the country, is the primary source of PCBs in the air around the harbor. They described the harbor as the “largest reported continuous source of airborne PCBs from natural waters in North America.”
The study found that PCB levels in the ambient air were highest closest to the harbor and that changes in thyroid levels are more likely to occur among people who live near the harbor compared to residents who live further away. These researchers focused on the non-cancer risks posed by exposure to PCBs rather than the cancer risks which EPA used to drive its decisions on the cleanup of the harbor which has been ongoing since the 1990s. So far, more than 425,000 cubic yards of PCB-contaminated sediment has been removed from the harbor as of December 2017 according to the EPA. Much of this waste has been placed in a constructed landfill in the harbor. The local group, Hands Across the River, has been fighting to stop the agency from doing this for years.
In response to requests from residents to monitor the ambient outdoor air for PCBs in places where they live, researchers from Boston University partnered with the Toxic Action Center, the University of Iowa and local residents to identify locations and design a monitoring program to meet community needs. In contrast, EPA selected monitoring locations for convenience or where concentrations were expected to be the highest.
The researchers modeled the data they collected and for the first time were able to estimate residential exposures and health risks for residents living around the harbor. They chose the thyroid as a target of PCB toxicity based on strong evidence in human and animal studies in the scientific literature. They compared thyroid changes in residents and PCB levels in the ambient air near and distant from the harbor and were able to show potential health risks associated with proximity to the PCB contaminated Superfund site in the New Bedford Harbor.
EPA’s response to these findings in part was to say that “the measured levels of airborne PCBs have never exceeded EPA’s health-based criteria.” This of course misses the point that this study identified new health risks beyond what the agency had previously considered. EPA’s standard risk procedures do not capture all health risks. Their focus was on cancer risk. This study focused on non-cancer health risks.
It has long been suspected that PCBs in the sediment of rivers and waterways will evaporate to some degree and eventually become airborne, but industry and government have pushed back arguing that PCBs do not substantially volatilize and if they did, their impact would be insignificant. This study puts that argument to rest.
This study is a remarkable example of what scientists and researchers can do together to address community needs. Scientific information is a powerful tool when university expertise and resources are focused on responding to community concerns. In this collaboration, new risks were identified that EPA had not previously considered. More of these collaborations are needed.
Categories
Limiting Science in Government
Just before the Thanksgiving Holiday, the New York Times ran a story about EPA’s plan to limit the studies and information that would be used by the agency in evaluating public health risks when setting regulations. The original proposal called, Strengthening Transparency in Regulatory Science, was proposed in April of 2018 and would require scientists and researchers to disclose their raw data including confidential medical records before the agency would consider a study’s conclusions. The findings of researchers who did not comply with this rule would be not be considered by EPA when reviewing and setting standards.
The original proposal released during Scott Pruitt’s term as administrator at EPA, was met with huge outcry from the scientific and medical community. According to the Times article, nearly 600,000 comments were submitted, the vast majority of which opposed the proposal including some of the leading scientific organizations in the country such as the American Association for the Advancement of Science (AAAS).
The prime opposition to the proposed requirements is that many studies linking disease outcomes with pollution and chemical exposures are based on personal health information protected by confidentiality agreements. For example, a critically important study linking mortality and premature deaths to exposure to particulates in the air of urban areas relied on personal health information provided by people who signed confidentiality agreements. The researchers would not have been able to do this study without obtaining these agreements. This research design is standard accepted procedure that has been in place in the scientific community for many years. Under the proposed rule, the results of studies involving the use of personal health information would not be considered by EPA when setting related rules and regulations unless the researchers were willing to break their confidentiality agreements.
Despite enormous opposition from some of the leading scientific and medical organizations and institutions in the country, EPA seems bent on going forward with this plan. In a scathing rebuttal to the Times article, the agency stated that it “still intends to issue a final rule in 2020.
This incredibly bad proposal is consistent with the Trump Administration’s efforts to undermine and ignore standard science that does not meet political objectives. If finalized, many legitimate scientific findings will be ignored for political advantage and that’s not only bad science, but it’s bad policy.
Categories
Busting Stereotypes: Outdoor Afro
Earlier this month, the Heinz Foundation honored 5 remarkable people who reflect the accomplishments and spirit the late U.S. Senator John Heinz. These awards recognize the extraordinary contributions of individuals in the areas of greatest importance to the late senator.
The Environmental Award went to Rue Mapp, founder and CEO of the nonprofit organization Outdoor Afro, who was recognized for inspiring African Americans to reconnect with nature and for championing diversity in conservation leadership.
Started as a blog in 2009, Outdoor Afro has grown into a national network with more than 35,000 participants and nearly 80 volunteer leaders in 30 states around the country. Outdoor Afro has become the nation’s leading, cutting edge network that celebrates and inspires African American connections and leadership in nature. As stated on their website, “We help people take better care of themselves, our communities, and our planet!” Outdoor Afro connects thousands of people to outdoor experiences and is changing the face of conservation.
Developing African American leaders in the fields of conservation and outdoor activity and management is a key component of Outdoor Afro’s programming. Leadership training summits are held annually, with attendees learning about conservation efforts and how to advocate for natural resources; the health benefits of nature; trip planning; leave-no-trace principles; proper clothing and gear; and community organizing approaches. Once trained, leaders volunteer to organize local “meet ups” in their home regions for local outdoor excursions, as well as larger destination trips to national parks and historical sites.
Mapp acknowledges that historical racism has undermined the connection black people have with nature through race-related crimes frequently executed in local woodlands and Jim Crow laws that barred African Americans from using public outdoor facilities such as beaches and pools.
Outdoor Afro’s mission is to overcome these narratives and use nature as a vehicle to help black communities address the violence in their past and present. As an example, the group has organized “healing hikes” that provide opportunities for people to find solace in nature.
As part of her work challenging traditional conservation organizations to be more inclusive, Rue Mapp consults with the outdoor industry, environmental nonprofits, and the national park system, as well as national and state administrations, and has been instrumental in helping shape national leaders’ understanding of how federal public land policies affect people of color.
Outdoor Afro has inspired Black people from all walks of life to step up and become leaders in the outdoors and in the community. Their volunteer leaders plan, scout and lead nearly a thousand events annually, connecting Black people all across the U.S. with positive and meaningful experiences in the outdoors. As described on their website, these activities not only help participants learn new skills and discover hidden gems in their cities, but they also carve out a unique space in which participants are able to embrace the joy of the outdoors.
For more about the Heinz awards see http://www.heinzawards.net/2019-recipients/
On September 20th more than 4 million people around the world took to the streets to join the global climate strike movement. People of all ages from across the globe came together to share a message: The planet is in a climate emergency, and we will not sit by and do nothing. A recap of many of these strikes was put together by the Earth Day Network: “Change is coming, whether they like it or not:” Youth climate strikes break records worldwide
On Saturday September 21st, the United Nations hosted its first-ever Youth Climate Summit in New York City bringing together hundreds of youth climate leaders from around the world to discuss climate solutions for the future. The Earth Day Network prepared a summary of this event and included several notable quotes. “Change rarely happens from the top down,” climate activist Bruno Rodriguez said at the summit. “It happens when millions of people demand change.” Youth student climate leader Greta Thunberg from Sweden said, “Together and united, we are unstoppable. This is what people power looks like. We will rise to the challenge.”
The Summit was part of a weekend of events leading up to the U.N. Secretary-General’s Climate Action Summit on Monday September 23rd. The summit was a call to action in the face of the worsening climate crisis. On its website, the UN defined climate change as the “defining issue of our time and now is the defining moment to do something about it.”
Leaders from 65 counties attended the summit and more than 100 business leaders were there. The UN prepared a summary of the commitments and actions taken by the attendees. In closing the meeting, UN Secretary-General António Guterres, said “You have delivered a boost in momentum, cooperation and ambition. But we have a long way to go.”
Youth leaders urged action not more promises.
Perhaps the most powerful statement at the summit was delivered by youth activist Greta Thunberg.
“The eyes of all future generations are upon you. And if you choose to fail us, we will never forgive you. We will not let you get away with this. Right here, right now, is where we draw the line.”
Listen to Greta’s full statement here.
The way scientists think about how chemicals cause their toxic effects is changing. Recent scientific research tells us that the traditional notion of how chemicals act is being replaced by a better understanding of the actual features of exposures to environmental chemicals. These features include the timing and vulnerability of exposures, exposures to mixtures, effects at low doses and genetic alterations called epigenetics.
Traditional thinking tells us that how much of a chemical you are exposed to (the dose) determines the effect. This principle assumes that chemicals act by overwhelming the body’s defenses at high doses. We’re learning now that this principle is not always accurate and its place in evaluating risks needs to be reconsidered. What we now know is that some chemicals cause their adverse effects at low exposure levels that are not predicted by classic toxicology.
Recent research has shown that environmental chemicals like dioxin or bisphenol A can alter genetic make-up, dramatically in some cases. These changes are so powerful that they can alter the genetic material in eggs and sperm and pass along new traits in a single generation, essentially by-passing evolution.
It wasn’t too long ago that scientists believed that the DNA in our cells was set for life, that our genes would be passed on from one generation to the next, and that it would take generations to change our genetic makeup. That’s no longer the case.
This new field – called epigenetics – is perhaps the fastest growing field in toxicology and it’s changing the way we think about chemical exposures and the risks they pose. Epigenetics is the study of changes in DNA expression (the process of converting the instructions in DNA into a final product, such as blue eyes or brown hair) that are independent of the DNA sequence itself.
What researchers are learning is that the “packaging” of the DNA is just as important as a person’s genetic make-up in determining a person’s observable traits, such as blue eyes, or their susceptibility to diseases such as adult on-set diabetes, or to the development of lupus.
The environment is a critical factor in the control of these packaging processes. We may be born with our genes, but epigenetics changes occur because of environmental influences during development and throughout life. These influences include chemicals in the food we eat, the air we breathe, the water we drink, and they appear to contribute to the development of cancer and other diseases.
Epigenetics may explain certain scientific mysteries, such as why certain people develop diseases and others don’t, or why the person who smoked for 30 years never developed lung cancer. There is still much to learn, but an early lesson to take away from this emerging science is that we need to rethink our traditional ideas of how chemicals affect our health.
For more information see
https://www.healthandenvironment.org/environmental-health/social-context/gene-environment-interactions
This is the question that journalist Jim Daley raised recently in an article published in Scientific American. According to the article, the U.S. Environmental Protection Agency (EPA) is substantially changing the program that evaluates the toxicity of chemicals by shifting staff and program emphasis from the Integrated Risk Information System (IRIS) to duties related to implementation of the Toxic Substances Control Act (TSCA). Daley writes that “Former EPA officials contend that the shake-up takes chemical assessments out of the hands of career scientists, potentially to the detriment of public health.”
As evidence of this shift, Daley writes that that the agency has reduced the number of its ongoing chemical toxicity assessments from twenty to three.
The IRIS Program began in 1985 to support EPA’s mission to protect human health and the environment by identifying and characterizing the health hazards of chemicals found in the environment. The IRIS program has become the most respected scientific program in the agency. Its health assessments are the backbone of EPA risk analysis work and is the preferred source of toxicity information used by EPA to determine public health risks. It is also an important source of toxicity information used by state and local health agencies, other federal agencies, and international health organizations.
The TSCA program on the other has a much narrower focus which is primarily on reporting, record-keeping and testing requirements, and restrictions relating to chemical substances and/or mixtures, according to EPA’s website. Certain substances are not covered by TSCA including food, drugs, cosmetics and pesticides. While the 2016 amendment to TSCA greatly improved this regulation, it did not address its narrow focus. This shift began with the leadership of Andrew Wheeler who took over for a beleaguered Scott Pruitt as administrator of EPA in July 2018.
One EPA official who declined to be identified was quoted in the Daley article saying that IRIS and TSCA are “very different” in their approaches to evaluating the public health risks posed by exposure to chemicals. “One could make the argument that this is political interference, in that high-level people are saying which methodology we should be using to assess the safety of a chemical. “And the policy’s pretty clear that they’re not supposed to do that.”
Bernard Goldstein, Professor Emeritus at the University of Pittsburgh School of Public Health, who served as EPA Assistant Administrator of the Office of Research and Development (ORD) from 1983 to 1985, summed it up this way in the Daley article, “I really see this as part of a restructuring of EPA in such a way that science will have very little to do with what EPA is basing its regulation on, and that we will end up with much weaker regulations in terms of protecting public health. “It’s troubling, in large part because it’s very consistent with an overall approach – a very astute approach – to take out the inconvenient facts.” Also cited in the same article was a comment by Thomas Burke from the Johns Hopkins Bloomberg School of Public Health, a former EPA lead scientist adviser and Deputy Administrator of ORD from 2015 to 2017, “’any reduction’ of the number of IRIS chemical assessments ‘is a loss for public health and, unfortunately, puts populations who are exposed at risk.’”
Read the full article here.
Jayne DePotter spent almost a decade making her Michigan jewelry studio a second home for young artists seeking direction, seniors looking to exercise their hands and minds and new immigrants in search of community. <Read more>.