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Slowly poisoned: health consequences of pollution and environmental toxins

Slowly poisoned: health consequences of pollution and environmental toxins. Martin Donohoe, MD, FACP Portland State University Campaign for Safe Foods, Oregon Physicians for Social Responsibility. Overview. Public health approach Air pollution Garbage Toxins Education/Corporate Influence

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Slowly poisoned: health consequences of pollution and environmental toxins

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  1. Slowly poisoned: health consequences of pollution and environmental toxins Martin Donohoe, MD, FACP Portland State University Campaign for Safe Foods, Oregon Physicians for Social Responsibility

  2. Overview • Public health approach • Air pollution • Garbage • Toxins • Education/Corporate Influence • Progress and Solutions

  3. Some Major Sources of Air Pollution • Industry - #1 • Agriculture • Automobiles • Indoor combustion of coal and biomass for cooking, heating and food preservation

  4. Air Pollution

  5. Air Pollution

  6. Air Pollution • Top ten most polluted cities in the world are in China and India • Most polluted areas in US: • LA, Houston, San Joaquin Valley in Central California, Pittsburgh

  7. Health Effects of Air Pollution • Causes approximately 60,000 - 75,000 premature deaths/yr. in U.S. (656,000 in China) • More than are killed by auto accidents • 1.8 million worldwide

  8. Health Effects of Air Pollution • Air pollution causes asthma and impairs lung development and function • Deaths from cardiopulmonary diseases correlate with air pollution levels in US cities • Both day to day and over time

  9. Health Effects of Air Pollution • Increased admissions for CHF, asthma, COPD, PVD, and cerebrovascular disease (stroke and TIA) • Increased lung cancer mortality • Decreased exercise tolerance, increased pulmonary symptoms

  10. Health Effects of Air Pollution • Increased risk of DVT • Impaired sperm production • Increase in SGA and LBW infants • Increased risk of appendicitis • ?Via link with inflammation? • Increased numbers of migraines

  11. Effects of Ozone Destruction • Ozone hole over Antarctic (2½X size of Europe) • Increased cataracts (UV damage) • Increased lifetime melanoma risk • 1/1500 - 1930 • 1/68 - today

  12. Automobiles

  13. Automobiles • Number of autos-US: 1 car/2 people-Mexico: 1/8-China: 1/100 (increasing; leaded gasoline) • Global auto population to double in 25-50 years

  14. Automobiles • Average miles traveled/car/year in U.S. • 1965 - 4,570 mi. • 2006 – 12,000 mi.

  15. Automobiles • 25 lbs. of CO2 produced for every gallon of gasoline manufactured, distributed, and then burned in a vehicle • U.S. energy costs exceed $500 billion/yr. (plus military costs to keep foreign oil flowing)

  16. Automobiles • Average fuel efficiency of U.S. autos stagnant • Ford Model T – 25 mpg (1908); Avg. Ford vehicle – 22.6 mpg (2003) • Standards improving, but lag behind European and Japanese requirements

  17. Automobiles • Relatively low oil prices, until recently • Growing market (until recently) for low-efficiency pickups, minivans, and SUVs • Multiple alternatives exist • Renewables under-funded

  18. Garbage • 98% of the country’s total refuse is industrial waste; 2% municipal waste • In one year, Americans generate 236 million tons of municipal garbage • 30% recycled • 164 million tons thrown away

  19. U.S. Garbage Composition • Paper and Paperboard - 39% • Yard Waste - 13% • Food Waste - 10% • Plastics - 10% • Metals - 8% • Glass - 6% • Wood - 5%

  20. U.S. Recycling Rates • Tires - 22% • Plastic containers - 36% • Glass containers - 28% • Yard waste - 41% • Paper and Paperboard - 42% • Aluminum packaging - 54% • Steel cans - 60% • Auto batteries - 93%

  21. Garbage • Landfills (2300 in US) • Incinerators • Garbage exports

  22. Toxins

  23. Annual World Production of Synthetic Organic Chemicals • 1930 - 1 million tons • 1950 - 7 million tons • 1970 - 63 million tons • 1990 - 500 million tons • 2000 - 1 billion tons

  24. Toxins • 6 trillion tons of over 85,000 chemicals produced annually • more than 90% have never been screened for toxicity • Chemical manufacturers are not required to prove safety • the legal burden is on the government to prove that a product is dangerous • Consumer Product Safety Commission has failed in its regulatory responsibilities

  25. Toxic Pollutants • 85,000 known or suspected hazardous waste sites in the U.S. • Plus up to 600,000 lightly contaminated former industrial sites (“brownfields”)

  26. Toxic Pollutants • 1 in 4 U.S. citizens lives within 4 mile of a Superfund site • Taxpayers paying increasing share of cleanup costs • 54% in 2003 • Vast majority presently • Overall funding decreasing

  27. Toxins • Body burden of industrial chemicals, pollutants and pesticides high • EWG study • Fetuses and children are most vulnerable to toxins • Normal birth sex ratio changing due to fewer male births • Cryptorchidism also increasing

  28. Pesticides • 2.2 billion lbs/yr pesticides • Including agricultural pesticides, wood preservatives, and disinfectants • 8.8 lbs/person/yr in US • EPA estimates U.S. farm workers suffer up to 300,000 pesticide-related acute illnesses and injuries per year

  29. Pesticides • NAS estimates that pesticides in food could cause up to 1 million cancers in the current generation of Americans • 1,000,000 people killed by pesticides over the last 6 years (WHO) • EPA currently allow pesticide testing in humans, despite strong opposition • 2008: USDA axes national survey charting pesticide use

  30. Floriculture • Most commercial flowers grown in sealed greenhouses in developing countries • Carry 50 times the amount of pesticides allowed on food • 1/5 of chemicals used banned in U.S. • Workers underpaid, 50-60% suffer from pesticide poisoning

  31. Pesticides

  32. Pesticides • $2.4 billion worth of insecticides and fungicides sold to American farmers each year • Pesticide runoff contributes to coastal dead zones • Baltic Sea, Mouth of Mississippi in Gulf of Mexico • Red tides • Pesticides inhibit nitrogen fixation, decrease crop yields

  33. Pesticides • Evidence suggests that pesticides promote pests (vs. natural pesticides) • 30% of medieval crop harvests were destroyed by pests vs. 35-42% of current crop harvests • Implies organic farming more cost-effective

  34. Pesticides and Other Toxins Linked to Neurological Disease • Parkinson’s Disease • Autism • Others • Also linked to diabetes, obesity (with prenatal exposure)

  35. Anthropological Study of Children Exposed to Pesticides Children from villages practicing organic agriculture Children from villages practicing non-organic agriculture

  36. Lead • 2 million US children with elevated levels • 120 million people with level > 10mcg/dL worldwide • Due to increased environmental exposure and, possibly, early umbilical cord clamping • #s affected dropping

  37. Lead • Affects brain development, associated with lower IQ • No safe level for neurological development • Levels between 4 and 10 significantly increase risk of cardio- and cerebrovascular disease • Elevated levels associated with crime and violent behavior

  38. Lead • Poor, African-Americans, Hispanics more commonly exposed • Developing world at risk

  39. Lead Poisoning: S/S, DX, and RX • S/S: AP, CP, arthralgias, myalgias, HA, anorexia, ↓libido, ↓memory, anemia, nephropathy, HTN, cataracts, CV dz, cancer, ↓sperm count, lead line on teeth, basophilic stipling • Dx: lead level, FEP (free erythrocyte protoporphyrin) • Rx: ↓exposure, CaEDTA, DMSA

  40. Toxic Pollutants – Economic Costs • Americans pay more than $55 billion annually for direct medical expenses plus special schooling and long-term care for pediatric diseases caused by lead • This excludes the greatest toxic pollutant - tobacco

  41. Mercury • Released into air by coal combustion, industrial processes, mining, and waste disposal • 4500 tons/yr • Travels throughout atmosphere and settles in oceans and waterways • Bacteria convert it to toxic methyl-mercury • Travels up food chain via fish

  42. Mercury • 16% of women of childbearing age exceed the EPA’s “safe” mercury level • Freshwater fish mercury levels too high for pregnant women to eat in 43 states • Mercury dental amalgams pose health risks to pregnant women, unborn babies, and children (FDA)

  43. Mercury: S/S, Dx, and Rx • S/S: neuropsychiatric symptoms, inflammation of gums with excessive salivation, rash, nephropathy • Linked to autism • Dx: mercury levels in air, blood, urine (>100 mcg/l in blood and/or urine = toxic) • Rx: chelation with BAL, penicillamine, DMPS, DMSA

  44. Arsenic • Contaminates groundwater in Bangladesh, also, India, China, Mexico, Argentina, Thailand, and parts of the U.S. • 13 million Americans have drinking water exceeding EPA’s “safe level” • Exposure also via seafood

  45. Health Consequences of Arsenic Exposure • Pigmentary skin changes • Diabetes • Increased risk of lung, bladder, and skin cancers • Lead, mercury, or arsenic found in 1/5 of both U.S.- and India-manufactured Ayurvedic medicines purchased via the internet

  46. Manganese • Welders exposed via fumes • Causes “manganism” (like Parkinson’s Disease) • Welding companies covered up link for decades (like lead paint, etc.)

  47. Cell phones • ?Link to parotid gland tumors? • ?Link to brain tumors? • Gliomas? • Acoustic neuromas? • Precautionary principle – hands-free headset • ?Other safety benefits?

  48. Toxic Pollutants • Dioxin - from manufacturing, medical incinerators, defoliants (“Agent Orange”)-Love Canal -cancers • Nitrates/nitrites, trichloroethylene, vinyl chloride, ozone • Diacetyl – popcorn lung

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