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Making the Link: Protecting Health from Environmental Exposures

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... precautionary local, state, national and international policy ... health care system in Norton Sound to properly diagnose and treat health effects ... – PowerPoint PPT presentation

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Title: Making the Link: Protecting Health from Environmental Exposures


1
Making the LinkProtecting Health from
Environmental Exposures
  • Vi Waghiyi Sarah Petras
  • vi_at_akaction.net sarah_at_akaction.org
  • info_at_akaction.net
  • www.akaction.org
  • (907) 222-7714 phone
  • (907) 222-7715 fax

2
Environmental Health and Justice in Alaska
  • Our mission
  • To assure justice by advocating for environmental
    and community health. We believe everyone has a
    right to clean air, clean water and toxic-free
    food.
  • Core Values
  • Community right-to-know
  • Environmental justice
  • Precautionary principle
  • Elimination of the production and release of
    toxics
  • Rights and sovereignty of Indigenous peoples
  • Culture of caring and wellness

3
Addressing Environmental Health Issues in Alaska
  • Respond to community calls for assistance
  • Conduct community-based participatory research
    (CBPR)
  • Ensure community right-to-know
  • Advocate for health and justice through prompting
    of protective, precautionary local, state,
    national and international policy changes
  • Field and community health investigations
  • GIS computer mapping

4
Toxic Waste Sites in Alaska
5
Contaminants in the North
  • The north has become a hemispheric sink for
    pesticides and other industrial chemicals
  • Northern food webs favor the deposition and
    retention of persistent, bioaccumulative toxics
  • Contaminants in the north threaten the health of
    peoples that rely on traditional diets of fish
    and marine mammals
  • Global warming enhances the mobilization and
    transport of contaminants from local and distant
    sources

6
The North is a Hemispheric Sink
7
Formerly Used Defense Sites
Elder Annie Alowa from Savoonga, Alaska, pictured
at Formerly Used Defense Site on St. Lawrence
Island
8
Where is St. Lawrence Island?
Located in the Pacific Ocean, between Russia and
the U.S.
9
Disease PatternsObserved on St. Lawrence Island
  • Cancers
  • Thyroid disease
  • Diabetes
  • Heart disease
  • Low birth weight babies, premature births, still
    births, miscarriages
  • Other reproductive health problems

10
PCBs in Blood Serum of St. Lawrence Island People
  • Levels of PCBs in the blood of St. Lawrence
    Island Yupik people 6-9 times higher than average
    in lower-48 populations
  • Evidence of PCBs accumulating in the Arctic via
    global transport
  • Military contamination also a significant source
  • Published in the International Journal of
    Circumpolar Health (Carpenter et al., 2005)

Average for populations in the lower-48
11
Formerly Used Defense Sites in Norton Sound,
Alaska
12
Specific Aimsfor Environmental Health and
Justice for Norton Sound, Alaska Project
  • Identify sources of contaminants, including those
    from military and long-range, atmospheric sources
  • Describe past and current health problems
  • Increase the capacity of the health care system
    in Norton Sound to properly diagnose and treat
    health effects linked with environmental
    contaminants
  • Work toward responsible cleanup of contaminated
    sites and prevent new sources of contaminants 
  • Assist Norton Sound communities in securing
    training and tools needed to establish
    independent programs operated by the villages to
    monitor contaminants

13
Environmental Health and Justice Project for
Norton Sound, Alaska
  • Project partners
  • 15 Villages in Norton Sound Region
  • State University of New York
  • Alaska Community Action on Toxics
  • Norton Sound Health Corporation
  • Other researchers at Clarkson
  • University, St. Lawrence
  • University, Environment
  • Canada, Health Canada,
  • University of Alaska,
  • National Marine Fisheries
  • Service, and University of
  • California

14
(above) Morgan Apatiki, Community Health
Researcher from Gambell, AK, collecting food
samples for our Traditional Food Study(upper
right) Student testing water quality in Nome, AK
during 2008 Field Institute (right) Field
sampling in Elim, AK, 2007
Environmental Health Programs
  • Training for community health and field
    researchers
  • Field Institute
  • Quarterly seminars for Village Health Aides
    other health care professionals
  • Environmental Health Care Toolkit
  • Alaska Collaborative on Health and the
    Environment

15
Community Health Implications of Norton Sound
Project
  • Independent research informs clean-up decisions
  • Promoting proper diagnoses and treatment of
    environmental health effects
  • Better oversight and holding military accountable
    for clean up
  • Influencing public health policy to prevent
    exposures from this and other formerly used
    defense sites and long-range transport

16
Reproductive Health and the Environment
  • exposure to low-level contaminants may be
    subtly undermining our ability to reproduce.
  • Environmental Health Perspectives, journal of
    the National Institute of Environmental Health
    Sciences 2006

17
Health of Arctic Children Threatened
Alaska Native infants have a much higher rate
of hospitalization for infection than any other
group of U.S. infants Prenatal exposure to
contaminants, which are known to affect the
developing immune system, could play a role, and
that possibility is now being examined. -Dr.
Jim Berner, pediatrician, Alaska Native Tribal
Health Consortium
18
Birth Defects in Alaska
  • Data from the Alaska Birth Defects Registry
    shows
  • Birth prevalence of major congenital anomalies in
    Alaska is twice as high as in the United States
    as a whole
  • Alaska Native infants have twice the risk of MCAs
    as white infants born in Alaska
  • Recommendations for women include
  • Avoid contact with known or suspected
    environmental teratogens

even independent of differences in cigarette
smoking, alcohol consumption and maternal
agewhich is a well-known risk factor for birth
defectsAlaska Natives still have an increased
risk ... that we don't really know how to
explain." Dr. Bradford Gessner, Maternal and
Child Health Epidemiology unit
19
Adverse Birth Outcomes Associated with Open
Dumpsites in Alaska
  • Mothers residing in villages with high hazard
    ranking were
  • 43 more likely to have a low birth weight baby
  • 45 more likely to give birth prematurely
  • More likely to have babies afflicted with
    intrauterine growth retardation
  • Gilbreath, S. and Philip Kass. 2006. American
    Journal of Epidemiology.

20
Chemicals Associated with Reproductive Health
Effects
  • Commonly-used pesticides
  • Polychlorinated biphenyls (PCBs)
  • Chemical additives (used in production of
    plastics, e.g., bisphenol A)
  • Perfluorinated compounds (used in production of
    stain-resistant, water-repellant, or non-stick
    surfaces)
  • Chemical additives to beauty and self-care
    products (e.g. phthalates)
  • Polybrominated diphenyl ethers (PBDEs) (used as
    flame retardants in household upholstery and
    electronics)

21
Health Concerns associated with Metals Mining
  • Blasting, crushing operations mobilize toxic air
    emissions
  • Leaching of heavy metals into streams and rivers
    can harm fish and drinking water sources
  • Cyanide used in leaching process is lethal at
    very small doses
  • Negative effects on quality of life, social,
    cultural and emotional impacts
  • Lone Tree and Marigold Mines in NVphoto by Peter
    Essick

22
Toxics Release InventoryMines are Among Largest
Industrial Polluters of Toxic Chemicals
  • Red Dog Mine 533,421,591 lbs of toxic chemicals
    released in 2007 with increasing trend
  • Largest polluter in the nation, 4 times that of
    any other facility in the U.S.

Red Dog Mine-Ikalukrok Creek Junction
23
Environmental Health Care Toolkit
  • Designed for Village Health Aides in Alaska for
    use in clinics
  • Purpose To promote proper diagnosis, treatment,
    and prevention of health problems linked to
    environmental contaminants in Alaska
  • A work in progress We welcome your feedback!

With about 1,000 pounds of dental equipment, a
Dental Health Aide Therapist awaits a ride after
traveling to Point Hope, AK by airplane.
24
Collaborative Effort
  • Village Health Aides provide village-specific
    information on prevalent exposures and diseases
    to cover in toolkit materials
  • EHC Toolkit Advisory Group (comprised of
    Community Health Aides, local physicians, and
    community field researchers) contributes to and
    reviews all toolkit materials
  • Annual Community Health Aide Program (CHAP) Forum
  • Annual Alaska TribalConference on Environmental
    Management (ATCEM)

25
Toolkit Contents
  • Foreword
  • Introduction
  • Environmental Health History and Assessment
  • Resources for More Information
  • Environmental Health Care Fact Sheets
  • Household Toxics
  • Hazardous Waste
  • Reference Cards on prevention of exposure for
    patients
  • Map of Villages and Federal Defense Facilities
  • Protecting Our Health in Alaska a poster for
    clinics and homes

26
Environmental Health History Assessment Form
  • Symptoms of environmental exposures can be
    misdiagnosed as common symptoms of other diseases
  • Exposures can occur in the home, at work, from
    food and water, from hobbies, and from outdoor
    activities
  • Taking an environmental health history is
    important in determining if patients had an
    environmental exposure and making a correct
    diagnosis

27
Environmental Health Care Fact Sheets
  • Fact sheets contain information about
  • what the contaminant is
  • how exposure occurs
  • symptoms of exposure
  • what to do for patients showing exposure symptoms
  • how to prevent or reduce exposure
  • Toolkit will 25-30 contain fact sheets on
    chemicals of concern in the Norton Sound region,
    including chemicals associated with household
    toxics, hazardous waste, mining, and FUDS

28
Reference Cards
  • Tips on how to prevent or reduce exposure
  • Handouts for patients
  • Example
  • REDUCING YOUR EXPOSURE
  • You can minimize your exposure to bisphenol-A in
    the following ways
  • Use glass, stainless steel, or polyethylene
    bottles (PETE, PET, or 1 HDPE or 2 LDPE or
    4) instead of polycarbonate (PC or 7) bottles.
  • Avoid heating foods in polycarbonate containers,
    as bisphenol-A tends to leach faster with higher
    temperatures. Use glass or ceramic containers
    instead.
  • Cut back on consumption of canned foods to
    reduce exposure to bisphenol-A contamination from
    the interior coating of the container. Also,
    avoid canned foods with higher fat content, which
    may have higher levels of bisphenol-A.
  • Before getting dental sealants, check with your
    dentist about the ingredients in the products
    they use, as some formulations may leach
    bisphenol-A.

29
Poster
  • Provides information on potential exposures
  • Tips on how to reduce exposures
  • Designed for clinics, waiting rooms, community
    buildings, and homes
  • Now available!

30
Maps
  • Contains the Map of Villages and Federal Defense
    Facilities in the Norton Sound Region
  • Other statewide and regional maps of toxic waste
    in Alaska are available on ACAT
  • website www.akaction.org/Mapping.htm

31
Resources Listings
  • Non-governmental organizations (NGOs)
  • Government agencies
  • Publications and other materials (books,
    websites, online databases, etc.)
  • Scientific journal articles and ACAT Health
    Bulletins
  • For Example
  • Alaska Community Action on Toxics (ACAT)
    www.akaction.org
  • Collaborative on Health the Environment (CHE)
    www.healthandenvironment.org
  • Access the CHE Toxicant and Disease Database
    database.healthandenvironment.org
  • Agency for Toxic Substances and Disease Registry
    (ATSDR) www.atsdr.cdc.gov
  • Pediatric Environmental Health
  • Editor Ruth A. Etzel, MD and Associate Editor
    Sophie J. Balk, MD
  • Skin Deep Cosmetics Safety Database
    www.cosmeticsdatabase.com
  • For more information, see full resources listings
    in toolkit

32
Additional Resources
  • Journal Articles
  • Polychlorinated Biphenyls in Serum of the
    Siberian Yupik People from St. Lawrence Island,
    Alaska (Journal of Circumpolar Health)
  • Adverse Birth Outcomes Associated with Open
    Dumpsites in Alaska Native Villages (American
    Journal of Epidemiology)
  • Health the Environment Bulletins
  • Body of Evidence Reproductive Health and the
    Environment
  • Diabetes The Role of Persistent Toxic Chemicals
    in this Complex Disease

33
Any Questions?
Thank you!
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