I have made some connections with the EPA, Dr. Maryann Suero for one, and got first word of this good news on triclosan Friday.
FDA issues final rule on safety and effectiveness of antibacterial soaps
Rule removes triclosan and triclocarban from over-the-counter antibacterial hand and body washes
FDA News Release:
“The U.S. Food and Drug Administration today issued a final rule establishing that over-the-counter (OTC) consumer antiseptic wash products containing certain active ingredients can no longer be marketed. Companies will no longer be able to market antibacterial washes with these ingredients because manufacturers did not demonstrate that the ingredients are both safe for long-term daily use and more effective than plain soap and water in preventing illness and the spread of certain infections. Some manufacturers have already started removing these ingredients from their products…”
“Consumers may think antibacterial washes are more effective at preventing the spread of germs, but we have no scientific evidence that they are any better than plain soap and water,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research (CDER). “In fact, some data suggests that antibacterial ingredients may do more harm than good over the long-term.”
Here is the pre-publication notice- the list of 19 (which includes triclosan and triclocarban) begins on page 15:
Have you heard about the family suing Terminix because they were permanently disabled by illegal exposure to methyl bromide? Not, mind you, that methyl bromide has been outlawed, because pesticides are presumed innocent even with irrefutable proof of human health harms. It’s just the way it was applied that was illegal. There is an irony in hearing that the settlement may amount to $87 million. Not that it’s not deserved. The two sons could have died, remaining in comas for weeks, and six months later, the father and sons still struggle to “eat, walk, and sit up on their own.” They are trapped in a “neurological torture chamber.”
The story is similar to that of a Florida boy who was poisoned when his house was fumigated for termites. He has suffered a “catastrophic brain injury” that requires around-the-clock care.
So what is the irony in reading these tragic stories? Whereas they may seem like unfortunate, rare accidents, I and my family suffered many of the same symptoms from reckless use of pesticides, as do countless Americans every year, even if they are not able to so definitely identify the source of their illnesses. Katherine died as a result, and my son and I endure lasting health effects. Prosecution is appallingly rare compared to the damage caused. As Philip Landrigan has said, we are suffering a “silent pandemic” of neurological problems because of our widespread use of pesticides and other toxic chemicals (Grandjean & Landrigan 2006). A recent study linked mosquito spraying with a 25% increased rate of autism.
The first time I was poisoned, we were living in a basement apartment in a large complex while attending graduate school at the University of Michigan. It was only after the mandatory treatment for roaches that I realized my severe asthmatic symptoms and general malaise were a result of having wiped the toxic yellow fluid up off the counter, to avoid it getting in our food. Too late I obtained the MSDS for chlorpyrifos, an acutely toxic organophosphate that causes difficulty breathing and the neurological symptoms that are all too common with pesticide exposure. In addition, a single use conveys a doubled risk for childhood leukemia, even when the mother is exposed in the year BEFORE pregnancy, as I was (Ma et al. 2002; Eskenazi 2007; Engel et al. 2011). It took months for the symptoms to dissipate. I kept some of the clothing drenched in my closet for evidence — but to what end? Lawsuits like these are only very rarely successful. We would have been hard-pressed to prove that the application was done illegally; chlorpyrifos was approved for just such indoor use. We were never warned about the toxicity — and that would have been the only basis for a suit.
The second time I was poisoned unaware was when I was pregnant for the second time, with David. This time, it was city-wide mosquito spraying, and it was only long afterwards that we realized that my symptoms were likely tied to those exposures. We were never notified so that we could close the windows. Although we can never be sure, we think it very likely he suffered cognitive losses as a result. Research shows that children with the top quintile of organophosphates in their cord blood are 7 IQ points lower than those children in the bottom quintile, which is not zero (Bourchard et al. 2011; Rauh et al 2011). Not only that, but the pesticides I was exposed to would have continued to reach him through breast milk (Anderson & Wolff 2000). A mother’s exposure truly becomes her child’s, just when that child is most unprotected.
The third notable time we were poisoned, and I say notable because we doubtless experienced continual low-level poisoning from our city mosquito abatement program, was the Fall we pulled up carpets in our house, unknowingly exposing our children to the pesticide dust that must have accumulated there. Both three-year-old Katherine and baby David were acutely ill with organophosphate poisoning, misdiagnosed as asthma. They could scarcely breathe and had to get albuterol treatments and steroids just to get through it. Both had horrible dark circles under their eyes, and David had rampant canker sores, likely because of a depressed immune system. Katherine never recovered from her dark circles, she steadily paled and lost weight, and by Spring I was taking her to the doctor every couple of weeks for her constant low-grade fever, every night, 101 degrees. I was thought a hypochondriac, or guilty of Munchausen by proxy. Finally, after Katherine struggled just to play at the park, where huge purple bruises bloomed on her shins, I demanded a CBC to decide if it were leukemia or anemia. I hoped I was wrong. I wasn’t.
The fourth time we were poisoned — and not the last because pesticides are ubiquitous, unavoidable, no matter how hard we have tried — was the terrible time we realized what had caused our many illnesses. We realized that Katherine would likely die as a result of her re-exposure. She had just successfully weathered her first bone marrow transplant, her last chance at survival. But I knew as I lay on the kitchen floor. As much as the neurotoxins coursing through my body, I was paralyzed by the knowledge that the mosquito spraying had caused her cancer and relapse and that this new exposure would likely depress her immune system enough to allow the cancer to come back. By then, I had done the research and figured my initial exposure had caused her leukemia. I could not believe it when Clarke Environmental (yes — horrible name) sent over the MSDS and we found that this, too, was chlorpyrifos.
Like the children affected in these recent exposures, I struggled to sleep or eat. Food wouldn’t stay down, and I lost all appetite. My hands shook, and I felt oddly weak. I woke at 5 every morning with my heart racing. While that certainly would have been consistent with the emotional stress, it is also a distinctive symptom of organophosphate poisoning. My heart skipped beats, as it had after my first poisoning. After that, I could always tell when I had been exposed. Worst of all, my children manifested with the asthmatic symptoms (a result of acetylcholinesterase reuptake inhibition) and dark circles under their eyes. They too were obviously suffering symptoms. I struggled to get people to take me seriously — all except Katherine’s oncologists, who were all too familiar with the literature linking childhood cancer with pesticides and other environmental chemicals. A lawsuit was ruled out because “there were not enough sick and dead children.”
There is absolutely no debate left: we are constantly poisoning our children, not just in these rare instances where a dramatic effect is definitely linked to a certain exposure. We are causing higher rates of childhood cancer, autism, ADHD, lowered IQs, endocrine disruption, birth defects, diabetes, obesity, and autoimmune disease (PANNA 2013, Roberts & Carr 2012). When are we going to decide that the cost is too high, that companies making and using pesticides and other toxic chemicals should not be presumed innocent at the expense of the real innocents — our children.
Anderson HA, Wolff MS. Environmental contaminants in human milk. 2000. J Expo Anal Environ Epidemiol 10 Suppl 6:755-760.
Bouchard MF, Chevrier J, Harley KG, Kogut K, Vedar M, Calderon N, Trujillo C, Johnson C, Bradman A, Barr DB, Eskenazi B. 2011 Aug. Prenatal exposure to organophosphate pesticides and IQ in 7-year-old children. Environ Health Perspect 119(8): 1189-1195.
Engel SM, Wetmur J, Chen J, Zhu C, Barr DB, Canfield RL, et al. 2011. Prenatal exposure to organophosphates, paraoxonase 1 and cognitive development in childhood. Environ Health Perspect 119:1182-1188.
Eskenazi B, Marks AR, Bradman A, Harley K, Barr DB, Johnson C, et al. 2007. Organophosphate pesticide exposure and neurodevelopment in young Mexican-American children. Environ Health Persp 115(5):792-8.
Grandjean P, Landrigan PJ. 2006. Developmental neurotoxicity of industrial chemicals: A silent pandemic. Lancet 368:2167-2178.Landrigan PJ, Sonawane B, Mattison D, McCally M, Garg A. 2002. Chemical Contaminants in Breast Milk and Their Impacts on Children’s Health: An Overview. Environ Health Perspect110(6):A313-A315.
Ma X, Buffler PA, Gunier RB, Dahl G, Smith MT, Reinier K, Reynolds P. 2002. Critical windows of exposure to household pesticides and risk of childhood leukemia. Environ Health Perspec110(9):955-960.
Pesticide Action Network North America (PANNA). 2013. A generation in jeopardy. PANNA. Retrieved from http://www.panna.org/resources/publication-report/report-generation-jeopardy
Rauh V, Arundjadai S, Horton M, Perera F, Hoepner L, Barr DB, et al. 2011. Seven-year neurodevelopmental scores and prenatal exposure to chlorpyrifos, a common agricultural pesticide. Environ Health Perspect 119:1196-1201.
Roberts JR, Carr CJ. 2012. Policy statement: Pesticide exposure in children. American Academy of Pediatrics 130(6):e1757-1763.
This from the Environmental Working Group:
Americans are exposed daily to these chemicals found in consumer products
THURSDAY, JULY 21, 2016
“WASHINGTON –The nation’s new chemical safety law promises to give the EPA expanded authority to regulate hazardous chemicals in consumer products. But of the tens of thousands of chemicals on the market, most of which were never tested for safety, which should the EPA tackle first?
“Today the Environmental Working Group released a list of high-priority chemicals the EPA should act on quickly. It includes chemicals in products Americans use every day – detergents and household cleaners, clothes, mattresses, furniture, toys and even kids’ jewelry.
“After decades of stagnation, the EPA can now ban or restrict the use of toxic chemicals, and order companies to conduct safety testing when more information is needed,” said EWG Senior Scientist David Andrews. “It’s important that the agency act promptly to eliminate or reduce Americans’ exposure to industrial compounds linked to cancer, birth defects, hormone disruption and other health problems.”
“For many chemicals on the list, action is long overdue. For example, many Americans believe asbestos – a carcinogen that claims 12,000 to 15,000 lives each year – was banned decades ago, as 55 other nations have done. But U.S. industry still imports, uses and sells asbestos and asbestos products, including automobile brake pads and clutches, vinyl tile, and roofing materials.
“With so many hazardous chemicals in use, any list of those posing the greatest risks would be subjective and incomplete. But the vast catalog of chemicals that have never been evaluated for safety make it urgent for the EPA to move quickly to tackle the backlog. The agency put 90 chemicals known to pose health risks on a list called the TSCA Work Plan.
“The Work Plan list represents opportunities for assessment and regulation where EPA action is overdue,” said EWG Senior Scientist Johanna Congleton. “In some cases, such as with some kinds of flame retardants, the initial EPA review was hindered by the lack of safety and exposure data. The EPA must now use its expanded authority to fill in these critical information gaps.”
“EWG scientists scrutinized the chemicals on the Work Plan, analyzed studies by U.S. and international researchers and consulted fellow experts in environmental health. They considered each chemical’s health risks, how widely Americans are exposed to it and the likelihood of EPA action under the new law.
“Here are the 10 chemicals EWG urges the EPA to thoroughly review and regulate as soon as possible:
- Asbestos. The cancer-causing substance is still found in automobile brake pads and clutches, vinyl tiles, and roofing materials. While some uses have been banned since 1989, no new risk assessment is scheduled.
- PERC. This probable carcinogen appears in dry-cleaning fluid, spot removers and water repellents.
- Phthalates. These chemicals are linked to early puberty in girls and other reproductive harms. They show up in PVC plastic, toys and plastic wrap.
- BPA. This carcinogen is linked to infertility, developmental risks and diabetes. BPA is used in food cans and other food containers, as well as cash register receipts.
- Chlorinated phosphate fire retardants. These chemicals turn up in upholstered furniture, foam cushions, baby car seats and insulation. They are linked to possible nerve and brain damage.
- TBBPA and related chemicals. This potential carcinogen and endocrine disruptor is seen in electronics, auto parts and appliances.
- Brominated phthalate fire retardants. These chemicals are linked to developmental toxicity, and appear in polyurethane foam for furniture and baby products.
- 1-Bromopropane. This probable carcinogen is used in aerosol cleaners and adhesives, and is linked to reproductive harm.
- DEHA. This probable carcinogen is found in plastic wrap and PVC plastic. It is also linked to developmental toxicity.
- P-dichlorobenzene. This probable carcinogen is detected in moth balls and deodorant blocks. It is linked to liver and nerve damage.
Police aggression is not the only arena in which Whites and Blacks are treated differently. In environmental health, too, there are systematic and significant differences. Asthma, caused primarily by air pollution, is one of the most common chronic diseases among children. The mortality rate for African American children is 500% greater than Caucasian children. One in five Puerto Rican and Filipino children have asthma, and the overall cost to the U.S. economy was $19.7 billion in 2007 (EPA 2016). Lead likewise shows disparities by income and race, particularly for Black non-Hispanic children (EPA 2016). Poor housing contributes, and poor housing is higher in Cook County than elsewhere (County Rankings, 2016). Within the county, the West Side of Chicago, which is predominantly non-White (CityData, 2016), showed some of the highest levels of any region (Oyana et al., 2010). There may be no better example of health disparities than the environmental racism shown in examples like the Flint, Michigan water crisis. While there are some individual choices that can be made to avoid common environmental health hazards, the largest sources of such hazards are societal. Once the air has been polluted, it is very difficult for any citizen in a polluted area to mitigate their risk. If you live in a house painted with lead paint, with soil that has been contaminated for decades by emissions from leaded fuel, you can do a few things to protect your children – cover the soil, clean the dust in your house, and avoid anything that will disrupt the lead – but much of the exposure is out of your control, even though you had nothing to do with the lead being there. Reducing lead is often acknowledged an important environmental health goal, including in Healthy People 2020 (2016; Bennett et al., 2016).
It is worth saying that the fact that lead contamination continues to be a nightmare is so because paint and fuel companies vehemently insisted on the safety of lead even while knowing the contrary was true. Lead Wars documents the politics by which this was allowed to happen, as does the authors’ earlier book, Deceit and Denial, which was recommended to me by a Professor of Chemistry at Benedictine, Ed Ferroni. It is shocking to read about the National Lead and Sherwin-Williams discussing the dangers of lead paint to children among themselves in the 1920s, while maintaining a rigorous advertising campaign about safe and sanitary lead paint through the 1960s. All this came to light only because of lawsuits filed against the companies; otherwise, their duplicity may never have been known (Markowitz & Rosner, 2014, p. xii-xiii). There is a reason people do not trust corporate America; perhaps new technologies like GMO foods may prove not to be harmful, but given the guilty history of the chemical industry, one can hardly blame the public, often made unwitting guinea pigs, for having a skeptical attitude.
A quote from the more recent book, is, I think, completely illustrative of the premises of environmental health, environmental justice, and public health more generally, and is therefore worth quoting in full:
If the history of lead poisoning has taught us anything, it is that the worlds we as a society construct, or at least allow to be built in our name, to a large extent determine how we live and how we die. The social, economic, political, and physical environments humans create bring about specific diseases that are emblematic of these conditions. If poverty, for example, and great disparities of wealth result in those on the bottom of the social scale living in crowded conditions without access to pure water, adequate sanitation, or pure air, we can expect infectious and communicable diseases to predominate as they did in nineteenth-century American cities. If we systematically pollute our water and air, we can expect chronic diseases emblematic of the late twentieth century to predominate. (Markowitz & Rosner, 2014, p. xiv-xv)
Similar stories have played out with asbestos, tobacco, mercury, PCBs, and pesticides with terrible impacts on the health of all people, but particularly on those who are most vulnerable.
What causes health care disparities is a very complicated question, addressed by an entire field of study – Environmental Justice. But I would say that the answer ranges from out-and-out racism to economic forces based on externalized costs – costs that are put outside the economic calculus of the market: for instance, the cost of mentally handicapped children – which seem mostly to be borne by the least powerful and influential people in society. In reality, lead poisoning affects many people, but it does so disproportionately, allowing many people to selfishly live in denial that it will affect them.
The solution to the lead problem is fairly simple: safely remove the lead. If Public Health as a discipline were able to solve these problems – if they had had the will, the money, and the political power to do something about racial disparities and mass poisonings, they would have by now. It seems to me that this is a result of two far larger problems: one, societal tolerance for the systematic poisoning of our population for profit; and two, racism.
Sadly, we are reminded that Public Health officials are not always the solution; sometimes they are the problem, as seen in the tragic case of the Flint poisoning. In brief, the manager running the city of Flint, rather than paying higher fees for clean water, switched the city over to water from the Flint River, which is highly polluted. It is also acidic, which caused the lead pipes in the town to corrode, releasing high levels of lead into drinking water. Children were harmed – it’s hard to say how many or to what degree. Time will tell, but there were roughly 9000 children in Flint, and no amount of lead is considered safe. What is worse is that even after citizens complained, state and local officials, including Public Health officials, claimed that the water was fine. As Marc Edwards, the civil engineer from Virginia Tech who helped lay bare the scandal, has said, “In Flint the agencies paid to protect these people weren’t solving the problem, they were the problem. What faculty person out there is going to take on their state, the Michigan Department of Environmental Quality, and the U.S. Environmental Protection Agency?… If an environmental injustice is occurring, someone in a government agency is not doing their job” (Kolowich, 2016). Edwards argues that public science is broken, that scientists often pursue their own interests, publications and career advancement, rather than the interests of those they are pledged to serve, particularly those who are powerless.
Primary Prevention is obviously superior to secondary or tertiary, in that it is aimed at preventing disease from ever occurring. Primary Prevention is essential in lead poisoning because once a child has been exposed, there is very little that can be done to reduce the risk or mitigate the damage. Those children in Flint are likely harmed for life to varying degrees. Markowitz and Rosner discuss how at the beginning of the lawsuits against the lead industry, and the discussion of remediation, in the 1990s, the aim was to spend $15 billion fixing the problem and ending the epidemic of lead poisoning among children. Instead, because of the pressure of landlords, industry, and others, that plan was abandoned for weak, partial, and ineffective measures that continued to allow millions of children to be poisoned (Markowitz & Rosner 2014, p. 19-20). That said, I often use lead levels as a success story to demonstrate what can be done when policy is changed and prevailing narratives challenged. It is terrible to have to offer a partial success as one of the greatest ones, but this graph counters a prevailing narrative, promoted by the industry and its allies, that poisoning our children – in the many ways we do – is inevitable, almost natural.
Figure 1. Percentage of children 1-5 years old in the U.S. population
with elevated blood lead levels (≥ 10 μg/dL) (Jones et al. 2009).
The problem with this graph is that while we have made progress, recent research has shown that there is no safe level of lead exposure for children, and the action level has been moved down to ≥ 5 µg/dL ((DHHS & CDC, 2011; Lanphear et al., 2005; Chiodo et al., 2007; Jusko et al., 2008; Jedrychowski et al., 2009). The problem with our society is that we are much more likely to tolerate damaging levels of lead in children who are brown, black, or economically deprived.
Opportunities and Barriers
As if we needed further reminder this week that Black Lives Matter. We need to confront the systematic racism that has made Flint possible. Racism has been institutionalized into all our major organizations and professions, and Public Health is no exception. That is the barrier. Changing a culture is not easy. But the opportunities are vast. The cost of IQ points lost to lead alone amount to $192-270 billion per birth cohort, not counting the personal cost of a lower IQ. The return on investment is such that for every dollar spent on lead abatement, $17-221 would be recompensed (Gould, 2009). I have been pleased to see that Health Disparities have been explicitly addressed in Benedictine’s MPH program; whether that is a result of our Benedictine values or national mandates, the change is to be lauded – at least as a start. Changing culture is not easy, but I do believe that education can be part of that. Recognizing and understanding injustice is the first step in working against it, and I hope that in the future we will all be part of remedying this grave injustice.
Bennett, D., Bellinger, D.C., Birnbaum, L.S., Bradman, A., Chen, A., Cory-Slechta, D.A…., Witherspoon, N.O. (2016). Project TENDR: Targeting environmental neuro-developmental risks. The TENDR consensus statement. Environ Health Perspect 124:A118–A122; http://dx.doi.org/10.1289/EHP358.
Chiodo, L.M., Covington, C., & Sokol, R.J. (2007). Blood lead levels and specific attention effects in young children. Neurotoxicology and Teratology 29 (5): 538-46.
CityData. (2016). Near West Side Chicago. Retrieved from http://www.city-data.com/neighborhood/Near-West-Side-Chicago-IL.html
County Health Rankings & Roadmaps. (2016). County health rankings & roadmaps. Robert Wood Johnson Foundation. Retrieved from http://www.countyhealthrankings.org/our-approach
Department of Health and Human Services (DHHS) & Centers for Disease Control and Prevention (CDC). (2011). Advisory committee on childhood lead poisoning prevention. Atlanta, Georgia. Retrieved from http://www.cdc.gov/nceh/lead/acclpp/meetings/minutes/acclpp_minutes_final2.pdf
Environmental Protection Agency (EPA). (2016). Children’s environmental health facts. Retrieved from https://www.epa.gov/children/childrens-environmental-health-facts
Gould, E. (2009). Childhood lead poisoning: Conservative estimates of the social and economic benefits of lead hazard control. Environmental Health Perspectives 117(7):1162-1167.
Healthy People 2020. (2016). Healthy People 2020: Environmental Health. U.S. Department of Health and Human Services. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/environmental-health/objectives
Jedrychowski W., Perera, F.P., & Jankowski, J. (2009). Very low prenatal exposure to lead and mental development of children in infancy and early childhood. Neuroepidemiology 32 (4): 270-78.
Jones, R.L., Homa, D.M., Meyer, P.A., Brody, J.F., Caldwell, K.L., Pirkle, J.L., & Brown, M.J. (2009). Trends in blood lead levels and blood lead testing among U.S. children aged 1 to 5 years, 1988-2004. Pediatrics 123 (3): e376-e385.
Jusko, T.A., Henderson, C. R., Lanphear, B.P., Cory-Slechta, D.A., Parsons, P.J., & Canfield, R.L. (2008). Blood lead concentrations < 10 µg/dL and child intelligence at 6 years of age. Environmental Health Perspectives 116 (2): 243-8.
Kolowich, S. (2016). The water next time: Professor who helped expose crisis in Flint says public science is broken. The Chronicle of Higher Education, February 2. Retrieved from http://chronicle.com/article/The-Water-Next-Time-Professor/235136
Lanphear, B.P., Hornung, R., Khoury, J., Yoton, K., Baghurst, P., Bellinger, D.C., … Roberts, R. (2005). Low-level environmental lead exposure and children’s intellectual function: An international pooled analysis. Environmental Health Perspectives 113 (7): 894-9.
Oyana, T.J., Margai, F.M. (2010). Spatial patterns and health disparities in pediatric lead exposure in Chicago: Characteristics and profiles of high-risk neighborhoods. Prof. Geogr; 62:46–65. doi: 10.1080/00330120903375894.
World Health Organization (WHO). (2014). 7 million premature deaths annually linked to air pollution. World Health Organization. Retrieved from http://www.who.int/mediacentre/news/releases/2014/air-pollution/en/
You, too, can have a beautiful organic lawn with handy tips from Midwest Grows Green:
#TakeAction in your own lawn
Build a lawn ready to last the summer with tips from our Natural Lawn Calendar:
- Fertilize the 1st-15th of the month
- Look for signs of weed, disease, or pest problems – address underlying soil or turf health issues
Visit MPAC resources for more natural lawn tips.
#TakeAction in your community
In a unanimous vote this June, the Municipal Water Reclamation District (MWRD) of Greater Chicago passed a policy to reduce its herbicide use by 92 percent. MWRD Commissioner Frank Avila consulted with MPAC and MGG to eliminate synthetic herbicide use in turf landscapes, shrub beds, and paved areas. Read more about the collaboration here.
100 pledges…one hundred engaged natural lawn care activists now back your commitment to this MGG effort! Your overwhelming support these first three months helped us make headway to achieving 10 pesticide free parks by the end of 2016. For that we thank you and look forward to your continued support in recruiting 200 pledges!
Read more about caring for your lawn organically at http://midwestpesticideaction.org/