Cancer mortality is going down but cancer incidence keeps going up
Young women may be losing their health and their right to choose to become mothers Shaping Our Legacy: Reproductive Health and the Environment. A report on the Summit on Environmental Challenges to Reproductive Health and Fertility, January 28–30, 2007. www.prhe.ucsf.edu/prhe/pubs/shapingourlegacy.pdfwww.prhe.ucsf.edu/prhe/pubs/shapingourlegacy.pdf and Hormone Disruptors and Womens Health, Reasons for Concern at www.healthandenvironment.orgwww.healthandenvironment.org 30% more babies are being born premature 25 to 50% of women have fibroids 10 to 15% suffer from endometriosis Girls are developing breasts and starting their periods earlier Breast cancer went up 40% between 1973 and 1998
Young men may grow up to be half the man their fathers were Sperm counts down 50% over 50 years Compared with 30 years ago 46% more men get testicular cancer 76% more men get prostate cancer Shaping Our Legacy: Reproductive Health and the Environment. A report on the Summit on Environmental Challenges to Reproductive Health and Fertility, January 28–30, 2007. www.prhe.ucsf.edu/prhe/pubs/shapingourlegacy.pdf www.prhe.ucsf.edu/prhe/pubs/shapingourlegacy.pdf
CDC reports 6.1 million U.S. couples with infertility problems in 1995 7.3 million couples with infertility in 2002 Largest reported increase in women under 25 Barrett, Julia R., Fertile Grounds for Inquiry, EHP, November 2006 and Shaping Our Legacy Are we losing the right to reproduce?
The Disease Burden is worse for Blacks, Latinos and Native Americans Death from cardiovascular disease is 29% higher for African American adults and 40% higher from stroke. African American women are twice as likely to die from cervical cancer than white women. American Indians, Alaska natives, African Americans and Hispanics are at least twice as likely to have diabetes than whites.
Why do we think the problem has anything to do with chemicals?
Human Tragedies: Minamata, Japan Chemical Plant Dumps Mercury into Bay
Human Tragedies: DBCP Harmful to workers who made it and the workers who used it
Human Tragedies:Thalidomide http://www.jamd.com/search?assettype=g&assetid=3159439&text=Sherri+Finkbine
Human Tragedies: Diethylstilbestrol (DES) Exposure to DES in the womb = Deformed uterus = Impaired fertility Increased risk of miscarriage Premature labor & birth Fibroids Cancer of the Vagina and Cervix Third Generation Effects
Animal Studies Predict Human Harm Vandenberg, LN, MV Maffini, PR Wadia, C Sonnenschein, BS Rubin and AM Soto. 2007. Exposure to environmentally relevant doses of the xenoestrogen bisphenol-A alters development of the fetal mouse mammary gland. Endocrinology 148(1):116-27.
www.cdc.gov/exposurereport/ Bisphenol A in 92.6% of 2,517 NHANES participants 6 years old and older in 2003-2004
Phthalates Since 2003, in cells: Human breast cancer cells stimulated Counteract tamoxifen In lab animals: Decreased testosterone Change in mammary glands Additive harm In humans: Sperm damage More allergic symptoms In amniotic fluid Correlation with anogenital distance and mothers reported use of baby products Lower levels of thyroid hormone
Why has it taken us so long to figure this out?
Linear dose response curves dont capture the chemical problem Outdated frameworks miss low dose effects, mixtures, synergies, timing, sensitivities and other differences between people and long delays between Exposures and visible effects, including Multigenerational effects
Hormones: Tiny doses control communication and coordination of body tissues 300 ppt in a 143 lb. woman is equivalent to.000000000002 of one plain M &M
In a factory Atrazine Bisphenol A DDT DES Dioxins PBB PCB Phthalates Two Ways to Make Hormones In a human body Estrogens Testosterone Adrenaline Insulin Thyroid Progesterone LH FSH
Hormone disruptors send the wrong message at the wrong time to the wrong place
Mixtures and synergies destroy resiliency and create disease Adapted from T. Schettlers modification of Hubbs-Tait et al. Psychological science in the public interest Genes Access to Health Care Social Support Nutrition Radiation Gene Expression Poverty Stress Racism Toxic Chemicals Infections
Women exposed to relatively high levels of DDT prior to mid- adolescence are 5 times more likely to develop breast cancer Cohn, BA, MS Wolff, PM Cirillo and RI Sholtz. 2007. DDT and breast cancer in young women: New data on the significance of age at exposure. Environmental Health Perspectives doi:10.1289/ehp.10260 Long Delays
Manufactured doubt and fear prevent new science from becoming new policy
Lessen stressors to create resiliency and decrease disease Adapted from T. Schettlers modification of Hubbs-Tait et al. Psychological science in the public interest Genes Access to Health Care Social Support Nutrition Radiation Gene Expression Poverty Stress Racism Toxic Chemicals Infections
Lower exposures we can lower Insert slide Executive Summary, CDC's Third National Report on Human Exposure to Environmental Chemicals, 2005
Change The Framework from Linear Dose Response Curves to a Recognition That Chemicals Work Like Pharmaceuticals Chemical Facts Mixtures and synergies Sensitive populations Timing
TSCA: US chemical regulation: Reward ignorance and punish innovation 81,000 chemicals registered in US in 2003 99% of chemicals by volume grandfathered in without evidence of safety when TSCA become law in 1976 Definitions of unreasonable risk and least onerous control are unworkable Under TSCA, restrictions on 5 chemicals are in place, we dont know the health effects of more than 85% of these chemicals Denison, R.A., Not That Innocent and Tickner, J.A., Introduction to TSCA
How the FDA got the power to require proof of safety before a drug was marketed www.fda.gov/cder/about/history/www.fda.gov/cder/about/history/ and Pomper, G.M., Ordinary Heroes and American Democracy
It seems so simple If you cant show that its safe then you cant sell it www.womenshealthandenvironment.org www.womenshealthandenvironment.org A closing haiku