Environmental Toxicology and Public Health

Environmental Toxicology & Public Health Overview Over 80,000 chemicals are registered under TSCA (Toxics Control Substance Act), few have undergone mandatory testing before entering the market, and this lack of effective oversight contributes to the problem that many products, ranging from diapers to strawberries, carry chemicals with unknown side effects. The resulting abundance of unregulated substances poses escalated risk to human health, due to persistent exposure. In parallel with the rising threats to human health is the concern that clinicians are not adequately prepared to accurately identify or proficiently treat diseases stemming from environmental influences such as pesticides and flame retardants. To evaluate this concern, a questionnaire was drafted, aimed to broadly assess the knowledge of medical providers regarding possible environmental causes of human health conditions. Methodology ● Conducted research on existing studies on environmental toxicants concerning public health ● This led to the formulation of our chief focus: Are medical practitioners knowledgeable about the effects toxicants have on public health? ● Drafted a preliminary questionnaire and invited prominent healthcare professionals to comment and provide feedback Prominent Feedback ● ● ● ● ● ● Linda Birnbaum, PhD, DABT, A.T.S (Director, National Institute of Environment Health Sciences; Director, National Toxicology Program) Jeanne Conry, MD, PhD (Past President, American College of Obstetricians and Gynecologists; Assistant Physician and Chief, The Permanente Medical Group) Ted Schettler, MD, MPH (Science Director, Science and Environmental Health Network) Mark Miller, MD, MPH (Director, University of California San Francisco Pediatric Environmental Health Specialty Unit) Bruce Lanphear, MD, MPH (Clinician Scientist, Child & Family Research Institute; Investigator, BC Children’s Hospital; Professor of Health Sciences, Simon Fraser University) Russ Hauser, MD, ScD, MPH (Frederick Lee Hisaw Professor of Reproductive Physiology; Professor of Environmental and Occupational Epidemiology, Harvard T.H Chan School of Public Health; Professor of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School) Key Considerations ● ● ● ● ● ● Identify audience- directed for all healthcare professionals, occupational or daily occurrences Shorten length and favor simple answer structures Understand that most healthcare professionals are not adequately taught- how does this conclusion benefit me Symptoms suggest poisoning- raise issue of environmental monitoring and history forms to encourage preventative measures Environmental History forms generate a lot of information that doctors may not know how to interpret Need higher quality research and better education Toxicant Case Studies A deeper look at commonplace chemicals ● Organophosphates: A class of pesticides which act through phosphorylation of the acetylcholinesterase enzyme at nerve endings ○ ○ Exposure: Food contamination, during application- inhalation and dermal Symptoms: Fatigue, headaches, nausea, depression, miosis, muscle twitching ● Heavy Metals (e.g. Cadmium, Mercury, & Lead): Metallic chemical elements with interrupt the absorption, metabolism, and utilization of essential minerals ○ ○ ● Exposure: Cigarette smoke, electronics, coating pigments, water/food contamination, soil, ammunition, volcano eruptions Symptoms: Bone defects, fatigue, anxiety, nervous system disorders, chronic pain, impaired motor skills BPA (Bisphenol A): An industrial chemical used in the manufacturing of resins and plastics ○ ○ Exposure: Dental sealants, metal products, polycarbonate plastics Symptoms: Vitamin D deficiency, weight gain, reproductive dysfunction A Wider Scope This type of inhibiting regulation is not common in other developed or OECD (Organisation for Economic Co- Operation and Development) countries. In fact, largely due to its inaction concerning toxicants, the United States in 2010 rose 20 places and was ranked number 61 on the Environmental Performance Index (EPI). In 2016 the TSCA was amended for the first time in over forty years by the Lautenberg Chemical Safety for the 21st Century Act which set parameters for better monitoring hazardous chemicals currently in the markets and later emerging. ● ● Review a minimum of twenty chemicals within the time frame of a seven-year period. State compliance A Wider Scope Leading the index was Iceland, Switzerland, Costa Rica and Sweden, three of which regulate under REACH, Europe’s chemical regulation, as well as additional directives and legislation, ie.: ● ● ● CLP: Classification Labelling & Packaginga statute dictating that substances must properly advertise associated risks and hazards to consumers and workers Biocidal Products Regulation Plant Protection Products Regulation The graph to the right displays the malignant neoplasm (cancer) incidence rate in four countries, Iceland, Switzerland, Sweden, and the U.S.A.