Systemic Contamination

From the Foundation's 1994 Annual Report

Chemistry has transformed modern life, from the prosaic stuff of everyday living to the most advanced technologies: plastic bags protecting lunch, food additives that retard spoilage, fuels propelling cars and space shuttles, printed circuit boards and the solvents that clean them, pesticides and the surfactants that make their spreading more effective, virtually every tool of modern medicine. Life as we live it today in the United States would not be remotely like what we enjoy were it not for the chemical inventions of the last 100 years.

Around the world, some one hundred thousand synthetic chemicals are now on the market. Each year one thousand or more new substances are introduced. These advances do not come without risk, however, for the impacts of modern chemistry go far beyond the intended uses of its inventions. In fact, the products of modern chemistry touch the lives of every person on Earth, quite literally. No child is born chemical-free. No person living on earth today is without detectable contamination in his or her body -- no person in any region, no matter how remote.

We understand the benefits of this chemical revolution. Largely by default we accept its risks. Some of the most obvious risks have been regulated. Indeed, a large regulatory structure has been built to provide protection. But the sciences of epidemiology and toxicology are poorly equipped to keep apace of the proliferating pool of chemicals brought to market each year. They can't even cope with some that have been around for decades. This is true for several reasons, not the least of which is inadequate funding at every level.

More fundamentally, these sciences run headlong into three realities: too little is understood of the basic mechanisms that render people vulnerable to toxic contamination. Too often there are long latencies between exposure and impact, making links obscure. And in the real world, contaminants come in complex, varying mixtures, meaning that one-to-one cause-and-effect relationships are rarely obvious.

Those wishing to use the science for policy guidance run into another reality: the immense commerce in chemical products creates huge obstacles to all but the most compelling, inarguable instances of harm and abuse. Money talks. Any shadow of uncertainty usually suffices to prevent bold or even reasonable cautionary measures. Even cases where there is virtual unanimity among scientists and doctors about cause and effect meet entrenched opposition.

The result is inadequate protection and unwelcome surprises. When DDT first came on the market, it was hailed as a great boon to humankind. Its inventor, Paul Müller, received the Nobel Prize in 1948. Health specialists compared its acute toxicity to the generation of pesticides it was replacing and found it safe -- indeed, by the old standards, it was. Only decades later did science begin to appreciate that the old standards were irrelevant to the health impacts caused by DDT. By then, DDT had been spread throughout the planet. And new health science, emerging only now in the 1990s, suggests that the most insidious effects of DDT may have been undetected until now.

The Foundation supports work to eliminate the risks of systemic contamination in three principal areas: environmental threats to children's health, contamination of aquifers, and large-scale pollution in the former Soviet Union. These efforts are unified by a central truth: while sustainable deployment of the fruits of modern chemistry can contribute to economic prosperity, economic growth built upon unsustainable chemistry is a chimera.

Several large-scale trends in human health suggest that the risks of modern chemical life are under-appreciated. One involves ongoing increases in the incidence of several cancers, thought to be related to environmental exposures. While the mortality rates may be decreasing as treatment becomes more effective, the number of people suffering continues to rise. A second is the frequency of asthma, especially in children, which appears to be linked to air pollution.

The most dramatic trend leapt unexpectedly out of an historical analysis of decadal changes in human sperm count. In 1992 a group of Danish epidemiologists published results suggesting that from 1940 to 1990 there had been a 40% drop in sperm count. This was not the first study of its kind but it was the most comprehensive, for it pooled the findings from 61 separate studies from around the world. The study's conclusions met with immediate and significant skepticism. And as should happen in science, the publication of the work set off a flurry of new studies, each attempting to disprove the Danes' results. In fact, and to the consternation of some health experts, of the several studies with new data that have been published in response to the Danish paper, each has corroborated its results. The strongest study, done by a team of French scientists and published in the New England Journal of Medicine, concluded that sperm count in France had dropped by 50%.

The causes of this and other trends remain disputed. The most plausible interpretation currently under study is that toxic contamination in the womb alters the sexual development of the exposed fetus in such a way that, once the child reaches adulthood, his ability to produce healthy sperm is impaired. This effect, called "endocrine disruption" because it takes place when contaminants interfere with hormone (endocrine) messages, is a type of health impact that as little as five years ago was not even considered by regulatory authorities. Today it is just beginning to gain attention.

The Foundation has developed a special interest in pollution threats to children's health because of children's unique vulnerabilities and because, without exaggeration, they are the future. Eliminating exposures now not only avoids current suffering but also helps prevent future disabilities. The consequences for public health and for the economics of health care can be substantial.

The special vulnerabilities to contamination of children and the unborn arise from several causes. Part derives from sensitivity; the developing fetus is naturally primed to receive and respond to normal chemical signals at very low concentrations. By generating these chemical messages, genes function as the blueprint for what we become.

Part of this heightened vulnerability has to do with timing. The developing fetus and infant is still forming. Much of its development is directed by chemical signals that come from the mother -- in the uterus or via mother's milk. The timing and sequence of signals is crucial.

Children's vulnerabilities are compounded by their behaviors. Any parent will affirm that too many articles of common experience wind up in baby's mouth, that kids play in water, that they roll on the ground and in the grass. These natural behaviors all increase the chances of exposure if contaminants are present. Because children are still growing, they also consume more per unit of their body weight than do adults; this also increases their exposures.

Emerging science now demonstrates that some natural developmental signals are vulnerable to message disruption by synthetic and other toxic compounds, and that impacts can be manifest at exposures far lower than what is required to cause illness in an adult. Some contaminants masquerade as normal signals, arriving at the wrong time or changing the apparent concentration. Others block normal signals, preventing the onset of crucial steps.

These heightened vulnerabilities for children are especially unfortunate because many of the health regulations for protection from chemical contamination have been set using standards for healthy adults. And because the fetus or infant is still developing, receiving the wrong signal at a vulnerable moment in development (for example, when crucial neural connections are being formed in the brain) can be like starting down the wrong road, for life. Studies now emerging suggest that such impacts can diminish reproductive abilities, alter behavior, interfere with learning, and impair the immune system.

The Foundation's support for work on pollution threats to children's health emphasizes three areas. One is advancing the understanding of endocrine disruption: where is the science; what are the exposures and incumbent risks; what policy steps should be taken now; where should current and future research focus; how can public and policy-maker understanding be enhanced? The Foundation's funding in this area pays special attention to pesticides, some of which are known endocrine disrupters, because of their ubiquitous use in the food industry, their widespread application in lawns, and their common deployment in schools, all likely to create exposure for children. And while the immediate focus is on children, the unfortunate reality is that endocrine disruption effects are manifest throughout life.

A second target area is childhood lead poisoning. Nearly two million children in the United States under age six now have lead poisoning at levels that, according to the U.S. Center for Disease Control, can induce reading and learning disabilities, lower IQ, impair growth, reduce attention span, and cause hyperactivity and other behavioral problems. The evidence against lead is conclusively damning. As it has strengthened, the U.S. Center for Disease Control has progressively lowered its "level of concern" for lead in the blood of children from 40 micrograms per deciliter of blood in 1971 to only 10 micrograms in 1991. Recent analyses suggest that the net societal benefit of reducing the average blood lead concentration by only 1 microgram per deciliter would exceed $17 billion annually.

While treatment can help afflicted children, current treatments cannot reverse neurological damage. The only real cure is primary prevention, controlling sources of exposure before poisoning occurs. Lead exposure prevention programs have been tremendously successful at reducing population average exposures over the last 20 years; removal of leaded gasoline from the market proved immensely beneficial. Still, some 1.8 million preschoolers continue with blood-lead levels above the threshold for concern.

The lead problem is now well-understood. The main obstacles to its solution are political resolve and funding, especially for children at risk in economically-distressed housing. Pilot work by the Department of Housing and Urban Development suggests that abating severe lead hazards will cost more than $7,000 per unit, far more than the annual cash flow generated through rentals. Cheap abatement substitutes will not work. Some two million families with young children now reside in homes with priority lead hazards. While federal support for lead abatement has been galvanized by enactment, in 1992, of the Residential Lead-Based Hazard Reduction Act, federal funding for lead abatement in the most responsive of times has not exceeded $150 million per year. At this rate, priority hazards will not be removed until the latter half of the next century.

The Foundation has also begun funding a third environmental issue related to children's health, the rising frequency of childhood asthma. While the causes of this trend are still under study, medical experts identify air pollution, especially the nitrous oxides, ozone and particulates produced so abundantly by automobiles, buses and trucks in urban areas, as likely contributors to the disease.

In conjunction with this initiative, the Foundation has made a series of grants to support policies encouraging development and commercialization of zero-emission vehicles, whose deployment will lead to dramatic decreases in air pollution.
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