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Reflections on the Past Report on the Present Envision the Future

Reflections on the Past Report on the Present Envision the Future. NAHMMA's 2005 Conference September 21, 2005 Tacoma, Washington Steven G. Gilbert, PhD, DABT www.asmalldoseof.org LINK. 95% Recyclable Cars. NYT Sept 19, 2005. Outline - Theme. Theme Knowledge and Experience

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Reflections on the Past Report on the Present Envision the Future

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  1. Reflections on the Past Report on the Present Envision the Future NAHMMA's 2005 Conference September 21, 2005 Tacoma, Washington Steven G. Gilbert, PhD, DABT www.asmalldoseof.org LINK

  2. 95% Recyclable Cars NYT Sept 19, 2005

  3. Outline - Theme • Theme • Knowledge and Experience • Prevention before treatment • Reflections On The Past • Knowledge / Individual Sensitivity • Report On The Present • Envision The Future • Ethics & Precautionary Principle

  4. Future = Children

  5. Environmental & Human Health “Conditions that ensure that all living things have the best opportunity to reach and maintain their full genetic potential.” S. Gilbert (1999)

  6. So Many Chemicals so Little Data 2863 above 1 Million pounds 12 or 0.4% good data 21.4% some data 78.2% no data www.preventingharm.org

  7. The Consequences • Nearly 12 million children (17%) under age 18 in the US suffer from one or more developmental disabilities • Learning disabilities – 5-10% of kids in public school • ADHD – 3-6% of all school kids, maybe higher

  8. Reflections On The Past What we know from knowledge and experience. How do we apply this knowledge?

  9. Socially responsible white guys?

  10. Knowledge to Policy • Thalidomide • Methylmercury • Lead • Ethanol (Alcohol)

  11. Thalidomide • Introduced in 1956 as sedative (sleeping pill) and to reduce nausea and vomiting during pregnancy • Withdrawn in 1961 • Discovered to be a human teratogen causing absence of limbs or limb malformations in newborns • 5000 to 7000 infants effected • Resulted in new drug testing rules – expanded FDA role

  12. Fetal Effects of MeHg

  13. The Mercury Cycle

  14. State / National Efforts Complex State Guidelines “Limit the amount of canned tuna you eat, based on your bodyweight. …” National Effort Cap/Trade for coal fired utilities http://www.doh.wa.gov/fish/FishAdvMercury.htm

  15. Lead In Homes

  16. Lead Industry Advertisements History of Lead Industry Advertisements (LINK) http://www.cincinnatichildrens.org/research/project/enviro/hazard/lead/lead-advertising/default.htm http://www.cincinnatichildrens.org/research/project/enviro/hazard/lead/lead-advertising/default.htm

  17. Agency Blood Lead Levels

  18. FAS Child

  19. FAS & FAE Most common preventable cause of adverse CNS development Fetal Alcohol Syndrome (FAS) 4,000-12,000 infants per year in US Fetal Alcohol Effect (FAE) 7,000-36,000 infants per year in US 1 to 3 infants per 1,000 world wide??

  20. Policy Approaches • 1981 - U.S. Surgeon General first advised that women should not drink alcoholic beverages during pregnancy. • 1988 - U.S. requires warning labels on all alcoholic beverages sold in the United States. • 1990 - U.S. Dietary Guidelines state that women who are pregnant or planning to become pregnant should not drink alcohol. • 1998 - 19 states require the posting of alcohol health warning signs where alcoholic beverages are sold

  21. Report On The Present What are the current and near term issues? Prevention

  22. Purpose of PBDEs PolyBrominated Diphenyl Ether • Fire kills more than 3,000/year • Injures more than 20,000 • $11 billion in damage • Flame retardants • Used in many consumer products

  23. Structure of PBDEs O Bry Brx PolyBrominated Diphenyl Ether X & Y are number of Bromine atoms Common Penta, Octa, and Deca

  24. PBDEs in House Dust (ppb) From EWG - Toxic Fire Retardants Contaminate American Homes - http://www.ewg.org/reports/inthedust/summary.php

  25. PBDEs in Breast Milk (ppb) From EWG - Toxic Fire Retardants in Breast Milk from American Mothers - http://www.ewg.org/reports/mothersmilk/es.php

  26. Pharmaceutical Waste Issues Pharmaceuticals and Personal Care Products (PPCPs) Issue: Contamination of water and land fills Source: Medical facilities (hospitals, senior care facilities), homes Actions: take back?, hazardous waste? X

  27. PPCPs – Managing the Issue

  28. Product Stewardship Issue: Contamination of water and land fills Source: industry, consumers, almost everything Actions: manufacturing, take back?, hazardous waste? X

  29. Product Stewardship Carpet Batteries Electronics Packaging Vehicles Mercury/Lead Other Products

  30. Schools Chemistry Labs Hazardous Materials Accidents - Natural Disasters (earth quakes, flooding) Minimize Chemical Use http://www.epa.gov/epaoswer/osw/conserve/clusters/schools/index.htm

  31. Dental and Medical H2E – Hospitals for Healthy Environment A joint project of the American Hospital Association, the EPA, Health Care Without Harm, and the American Nurses Association. Product use – Waste Purchasing - Prevention Example – Mercury, phthalate DEHP http://www.h2e-online.org/

  32. Ultimate Mixtures Study New Orleans Hurricane Katrina “…. the worst environmental calamity in U.S. history, with oil spills rivaling the Exxon Valdez, hundreds of toxic sites still uncontrolled, and waterborne poisons soaking 160,000 homes.” Super fund sites, rail cars, Industry, homes

  33. Envision The Future How do we get there from here? Ethics and the Precautionary Principle.

  34. The First Bioethicist Aldo Leopold "A thing is right when it tends to preserve the integrity, stability, and beauty of the biotic community. It is wrong when it tends otherwise." - Aldo Leopold, 1949, A Sand County Almanac ---------- 1887 - 1948 ----------

  35. Limits on Freedom “An ethic, ecologically, is a limitation on freedom of action in the struggle for existence” Aldo Leopold

  36. “The Commons” The Tragedy of the Commons By Garrett Hardin, Science, 1968

  37. Technical Solutions “It is our considered professional judgment that this dilemma has no technical solution.” The Tragedy of the Commons By Garrett Hardin, Science, 1968

  38. Problems – Solutions? • Lead and kids • Fetal alcohol syndrome • Ocean Fisheries • House hold waste • Purchasing • Persistent chemicals • The Commons

  39. Precautionary Principle “When an activity raises threats of harm to human health or the environment, precautionary measures should be take even if some cause and effect relationships are not fully established scientifically.” Wingspread Conference, 1998.

  40. Safety & Efficacy vs Harm • FDA regulations of Drugs (1938) • FDA regulations of Dietary Supplements (Dietary Supplement Health and Education Act of 1994 (DSHEA)) • FDA Concludes Ephedra presents an unreasonable risk of illness or injury (Dec, 2003)

  41. Central components • Taking preventive action in the face of uncertainty • Shifting the burden of proof/responsibility to the proponents of an activity • Exploring a wide range of alternatives to possibly harmful actions • Increasing public participation in decision making • Wingspread Conference, 1998.

  42. Seattle Initiative • City Comprehensive Plans • Every citizen of Seattle has an equal right to a healthy and safe environment. • Seattle sees the Precautionary Principle approach as its policy framework to develop laws for a healthier and more just Seattle. • Inclusion of PP in Comp Plan Environment Element • (http://www.seattle.gov/dpd/Planning/Seattle's_Comprehensive_Plan/DPD_001178.asp) • Also see www.asmalldoseof.org

  43. States in the US • California • San Francisco Precautionary Purchasing Ordinance - June 2005 • Resolution of the Marin county board of supervisors • “A resolution to continue to incorporate the precautionary principle in county operations.” Oct 2004 • Oregon • Multnomah County, OR Resolution - September 2004 • New York State Legislation - April 2005 • Bill A07256 “To protect public health and the environment by establishing a precautionary policy for state and local governments in New York State.” • Bill A07257 “To establish a preference for the purchase of commodities, services, and technologies by the State of New York that minimize potential adverse impacts on public health and the environment.”

  44. US Government Effort Kids-Safe Chemicals Act of 2005 U.S. Senators Frank Lautenberg • Update the Toxic Substances Control Act • Toxic chemicals must be tested • Focus on Prevention

  45. REACH-European Union • REACH -- Registration, Evaluation and Authorization of Chemicals • The two most important aims are to improve protection of human health and the environment from the hazards of chemicals and enhance the competitiveness of the EU chemicals industry. • The Commission’s White Paper on the Strategy for a future Chemicals Policy was adopted on 13 February 2001. • A Precautionary approach

  46. REACH • REACH -- Registration, Evaluation and Authorization of Chemicals • Initially regulate High Production Volume (HPV) chemicals - produced or imported above 1,000 metric tons. • Total world wide production of chemicals 400 million metric tons per year or $1.6 Trillion • To be introduced into European Parliament late this year.

  47. EPA-EHPA Rename EPA to EHPA Environment and Health Promotion Agency

  48. Socially Responsible

  49. NW Public Health Public Health and the Precautionary Principle By Steven G. Gilbert See: http://healthlinks.washington.edu/nwcphp/nph/ nwph

  50. Additional Information • The Science and Environmental Health Network (SEHN) (www.sehn.org) • Late lessons from early warnings: the precautionary principle 1896-2000 – European Environment Agency (free) • Garrett Hardin - The Tragedy of the Commons (Science, 1968) • Ethical, legal, and social issues: our children's future. Steven G. Gilbert. Neurotoxicology, 26/4 pp 521-530, 2005. • Public Health and the Precautionary Principle. Steven G. Gilbert. NW Public Health, Spring 2005. http://healthlinks.washington.edu/nwcphp/nph/ • www.asmalldoseof.org

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