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Reflections on the Past

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S. Gilbert (1999) Environmental & Human Health. A Small Dose ... Garrett Hardin - The Tragedy of the Commons ... Steven G. Gilbert. Neurotoxicology, 26/4 pp ... – PowerPoint PPT presentation

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Title: Reflections on the Past


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  • Withdrawn in 1961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/defau
lt.htm
http//www.cincinnatichildrens.org/research/projec
t/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
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/inthed
ust/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_Com
    prehensive_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 Commissions 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

51
Questions or Comments?
Download Presentation from www.asmalldoseof.org
52
Authorship Information
This presentation is supplement to A Small
Dose of Toxicology
For Additional Information Contact Steven G.
Gilbert, PhD, DABT E-mail smdose_at_asmalldoseof.org
Web www.asmalldoseof.org
53
A Small Dose of Toxicology
See www.asmalldoseof.org -- smdose
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