I Wish I Were Far From the Madding Crowd

July 9, 2010

Anticipating health effects from the BP oil spill

Assessing the Human Health Effects of the Gulf of Mexico Oil Spill: An Institute of Medicine Workshop

The National Academies’ Institute of Medicine held a workshop to examine a broad range of health issues resulting from the Gulf oil spill.

Home Activity page at http://www.iom.edu/Activities/PublicHealth/OilSpillHealth.aspx.

The workshop, “Assessing the Human Health Effects of the Gulf of Mexico Oil Spill,” was held June 22 and 23 in New Orleans. During the first day’s sessions, speakers and panelists discussed the potential adverse health effects for humans stemming from the oil spill for various populations. The second day’s sessions explored current monitoring activities, the types of research methods and data sources currently available, and questions to consider when developing short- and long-term surveillance and monitoring systems.

Presentations covered the groups at risk of exposure and possible acute, chronic, and delayed health effects.

Official U.S. Government Web Site on the Spill Response

http://www.restorethegulf.gov/

This site is apparently replacing the Deepwater Horizon website.  It contains news and links to resources from many Federal agencies.  For example, the Small Business Administration has a Disaster Assistance site for providing loans to affected small businesses.

Today’s news (from the old website) includes news that the National Institutes of Health (NIH) will devote $10 million to research the potential human health effects of the oil spill. The NIH National Institute of Environmental Health Sciences (NIEHS) will recruit clean-up workers and Gulf residents to collect biological samples, health histories, and information about the clean-up work they performed and the nature of their oil exposure.

White House site: http://www.whitehouse.gov/deepwater-bp-oil-spill

The White House blog provides a timeline of the government’s response to the spill at http://www.whitehouse.gov/blog/issues/Deepwater-BP-Oil-Spill.

EPA testing of dispersant toxicity

On June 30 EPA posted information about the first round of toxicity testing at http://www.epa.gov/bpspill/dispersants-testing.html.  The testing was done using eight dispersants.  EPA also plans to test the toxicity of the dispersants mixed with crude oil.

Links to worker health and safety resources from OSHA and the CDC can be found on the EPA site.

Maps and data

The latest information about the oil spill’s trajectory, the position of NOAA’s research ships, spilled oil’s coastal location and the areas closed to shipping can be found at geoplatform.gov/gulfresponse/.

To access the data materials generated for and by the Deepwater Response Incident, you can go to data.gov/restorethegulf/.

Oil containment effort

McClatchy is reporting that the effort is facing two key moments, connecting a third ship to the oil containment system and replacement of the “top hat” – http://news.yahoo.com/s/mcclatchy/20100707/sc_mcclatchy/3559853

Oil drilling moratorium

Obama loses moratorium bid on offshore oil drilling

Court refuses stay in deepwater drilling case
Court rejects bid to restore drilling moratorium

Apparently the courts don’t believe that there’s justification for a moratorium.  This despite the fact that an Associated Press investigation found that federal regulators do not typically inspect plugging of these offshore wells or monitor for leaks afterward.  (See “Enviro groups stunned that govt ignoring 27K wells”)

Of 50,000 wells drilled over the past six decades in the Gulf, 23,500 have been permanently abandoned. Another 3,500 are classified by federal regulators as “temporarily abandoned,” but some have been left that way since the 1950s, without the full safeguards of permanent abandonment.

Abandoned offshore oil wells

The story reports that the Government Accountability Office (GAO) warned in 1994 that leaks from abandoned offshore wells could cause “an environmental disaster.”  GAO recommended that the Minerals Management Service (MMS) set up an inspection system.  (Which MMS didn’t do. ) Although MMS did commission a 2001 study on such wells.  According to that study MMS officials were

“concerned that some abandoned oil wells in the Gulf may be leaking crude oil.” But nothing came of that warning.

The GAO report is “Offshore Oil and Gas Resources: Interior Can Improve Its Management of Lease Abandonment.”

RCED-94-82, May 11, 1994
Summary (HTML)   Full Report (PDF, 50 pages)     Recommendations (HTML)

From the summary at http://gao.gov/products/RCED-94-82

Among GAO’s findings:

  • MMS does not have an inspection strategy targeting its limited resources to ensure that wells are properly plugged and lease sites cleared
  • in March 1993, the active OCS leases in the Gulf of Mexico had estimated lease abandonment costs of about $4.4 billion, but were covered by bonds that totalled only $68 million

GAO’s recommendation (below) was closed, but not implemented.

Recommendation: In order to better protect the environment from the effects of OCS oil and gas lease abandonment and the federal government from incurring the costs of such abandonment, the Secretary of the Interior should direct the Director, MMS, to require MMS to develop an inspection strategy for targeting its limited resources to ensure the proper plugging and abandonment of OCS wells and the clearance of lease sites.

Comments: After reviewing the results of the March 1996 study of techniques for removing offshore structures, MMS has decided that its inspection program is adequate. MMS does not intend to develop a different inspection strategy.

So not only is it an environmental disaster waiting to happen, MMS wasn’t even getting money from the oil companies that it was supposed to.

I’ve posted a list of other GAO reports on oil and gas management at https://amidthemaddingcrowd.wordpress.com/gao-reports-on-oil-and-gas-management/.

March 28, 2010

Risk factors for breast cancer – Missing one of the major ones?

Up to a third of breast cancers could be avoided (Yahoo! News)

http://news.yahoo.com/s/ap/20100325/ap_on_he_me/eu_med_avoiding_breast_cancer

European breast cancer conference in Barcelona. Carlo La Vecchia cited figures from the International Agency for Research on Cancer (website).  I couldn’t find the precise source for the figures, but perhaps they came from “Estimates of cancer incidence and mortality in Europe in 2008” (abstract only).

Conference website – http://www.ecco-org.eu/Conferences-and-Events/EBCC-7/page.aspx/840

Abstracts – http://www.ecco-org.eu/Conferences-and-Events/EBCC-7/Abstracts-online/page.aspx/2177

Or go directly to http://ex2.excerptamedica.com/ciw-10ebcc/

Type in “cancer” in the search field.  You should get 655 abstracts.

The focus of the conference was clearly on diagnosis and treatment with little to no discussion of environmental factors.  Certainly screening, diagnosis, and treatment are critical, but shouldn’t we try to prevent as much as we can?

More from the Yahoo story

Dr. Michelle Holmes of Harvard University, who has studied cancer and lifestyle factors, said people might wrongly think their chances of getting cancer depend more on their genes than their lifestyle.

“The genes have been there for thousands of years, but if cancer rates are changing in a lifetime, that doesn’t have much to do with genes,” she told The Associated Press in a phone interview from Cambridge, Mass.

Could perhaps increasing exposure to substances in the environment change rates in a lifetime?  That doesn’t have much to do with genes either.  Though if you’re being exposed to chemicals that interfered with how your genes were turned on and off before you were born, or are interfering with that now, perhaps it does.

Breast cancer is the most common cancer in women. In Europe, there were about 421,000 new cases and nearly 90,000 deaths in 2008, the latest available figures. The United States last year saw more than 190,000 new cases and 40,000 deaths.

Tara Beaumont, a clinical nurse specialist at Breast Cancer Care, a British charity, noted that three of the major risk factors for breast cancer — gender, age and family history — are clearly beyond anyone’s control.

What about environmental exposure to chemicals?

IARC, on its World Cancer Day page, notes that it has an active program in the identification of carcinogenic risks. The IARC Monographs identify environmental factors—including chemicals, complex mixtures, occupational exposures, physical and biological agents, and lifestyle factors—that can increase the risk of human cancer.

In other words, there are several other environmental factors besides lifestyle that have been identified.  See the articles below for examples of how environmental factors could be contributing to breast cancer.

While the advice to eat less and exercise more is good (in fact, given that no one really has much direct control over environmental exposures that advice is probably even more important), I find it disturbing that the major risk factors cited in news stories seem to be reduced to diet, lifestyle, gender, age, and family history (that is, genetics), leaving environment out of the picture.

Why is that?  Because it’s easier to blame cancer victims than to confront companies and industries that sell us products that release substances that can mess with our health and who continue to release carcinogens and endocrine disruptors into our air and water?  (I’ll refer you again to the TEDX site, “Prenatal Origins of Cancer” for more information on that.)

Another perspective

In a post “do patients need doctor navigators to use the internet?”, David Collins discusses a March 25 New England Journal of Medicine opinion piece titled “Untangling the Web — Patients, Doctors, and the Internet” in which the authors “expressed a lot of concerns about how the internet is putting patients in touch with a lot of questionable information about disease” and about how they thought that changes the doctor-patient relationship in an adverse way.  (While they do raise some good points about the quality of some of the information on the Internet, I tend to agree with Collins.)

The reason I’m citing that here is the following statement from his post:

When I joined cancer public health in the ’70s the medical community almost universally rejected the idea that food and nutrition had anything to do with the prevention of cancer. People who talked about a relation between nutrition and cancer were sneered at and called the “fruits and nuts” crowd. Thirty-five years later as I approached retirement I had to chuckle inwardly many times about the current enthusiasm for the view that diet and nutrition are key to the prevention of much cancer. These days ya gotta eat your greens and grains!

So even the experts can change their minds….

Finally, it seems that environmental factors only really get attention when there are clusters of rare cancers.

Democratic Senators Eye New EPA Role Investigating Local Cancer Clusters

Environmental Policy Alert – March 24, 2010

From InsideEPA.com’s Environmental NewsStand (pay-per-view news)

Note: The site has a one-time offer of three free articles or documents by creating a new account today.

Senate environment committee Chairwoman Barbara Boxer (D-CA) and Sen. Bill Nelson (D-FL) are working on legislation that would give EPA and the Department of Health & Human Services (HHS) a major new role helping local health agencies investigate and address cancer clusters and communicate risks to local residents.

Press release from Sen. Bill Nelson on legislation

Nelson plans to preview testimony he’s been invited to give at next Wednesday’s hearing (my blog post on the March 17 hearing), which aims to find ways to strengthen the federal government’s hand in investigating cancer clusters, like the Acreage.

Recent Acreage blog post on Nelson’s efforts

Right now the federal Environmental Protection Agency ( EPA ) and Department of Health and Human Services ( HHS ) usually don’t get involved absent a request from a state.
“This effort is aimed at finding ways to bring in more federal resources more rapidly to help protect people, especially little children,” said Nelson, who’s also expected on Friday to announce he’s partnering with U.S. Sen. Barbara Boxer on new legislation to do the same.
Sen. Nelson’s testimony at Senate committee hearing on EPA and children’s environmental health

March 17, 2010

EPA and Children’s Environmental Health

Lax regulations on toxics put kids at risk, experts testify

(from CNN’s “Paging Dr. Gupta” blog)

The above post concerns a hearing held to hear about a report from the Government Accountability Office (GAO) on EPA’s progress in protecting children from environmental threats.  It discusses the challenges EPA faces in protecting children’s health.  (To be fair, many people acknowledge that shortcomings in the Toxic Substances Control Act, or TSCA, are responsible for EPA’s being unable to protect children and others from environmental pollutants.)

I’m not usually one to plug particular networks, but I thought the following mentioned in the Dr. Gupta blog might be of interest.

CNN editor’s note: Dr. Sanjay Gupta looks at the environment and health in an upcoming hourlong investigation, Toxic Towns USA, airing April 24 at 8 p.m. ET

Documents from the hearing

Children are exposed to many sources of potentially-harmful environmental pollutants

from the GAO Report Highlights

Selected report contents:

  • Background
  • EPA Has Not Focused Attention on Children’s Health in Agencywide Priorities, Strategies, and Rulemakings

Includes a figure showing the steps where children are considered in the EPA rulemaking progress.  The report does note that some offices within EPA more consistently incorporate considerations for children’s health in their work than others, but notes that at least one other federal agency does not even seem to do that.

  • In Recent Years, EPA Has Not Fully Utilized Its Office of Children’s Health and Other Child-Focused Resources
  • Opportunities Exist for EPA to Lead and Coordinate National Efforts to Protect Children from Environmental Threats
  • Recommendations for Executive Action
  • Matter for Congressional Consideration
  • Appendix II
    EPA Policy on Evaluating Health Risks to Children
  • Appendix III
    Executive Order 13045 and Amendments
  • Appendix IV
    EPA Regulations Subject to Executive Order 13045

From GAO’s summary: “In 1997, Executive Order 13045 (from the EPA website) mandated that agencies place a high priority on children’s risks and required that policies, programs, activities, and standards address those risks. In response, the Environmental Protection Agency (EPA) created the Office of Children’s Health Protection and convened the Children’s Health Protection Advisory Committee….

“…While EPA leadership is key to national efforts to protect children from environmental threats, EPA’s efforts have been hampered by the expiration in 2005 of certain provisions in the executive order. For example, the Task Force on Children’s Environmental Health provided EPA with a forum for interagency leadership on important federal efforts, such as the National Children’s Study.”

GAO recommended that Congress consider the following:

Because EPA alone cannot address the complexities of the nation’s challenges in addressing environmental health risks for children, Congress may wish to consider re-establishing a government-wide task force on children’s environmental health risks, similar to the one previously established by Executive Order 13045….

Full Committee Hearing entitled, “Hearing on the Government Accountability Office’s Investigation of EPA’s Efforts to Protect Children’s Health”

The hearing mentioned in CNN’s blog – Held by the Senate Committee on Environment and Public Works, Wednesday, March 17, 2010, 10:30 AM EDT

[Webcast]

From the Committee’s Hearing page:

Chairman Barbara Boxer will convene the Full Committee for a hearing on the Government Accountability Office’s (GAO) investigation of the Environmental Protection Agency’s (EPA) children’s health program. The committee will also examine what can be done to strengthen protections for children.

Senator Bill Nelson (D-FL) is also expected to give testimony on the federal government’s role in investigating children’s health issues and how that can be improved.

GAO documents

Environmental Health: High-level Strategy and Leadership Needed to Continue Progress toward Protecting Children from Environmental Threats
GAO-10-205,  January 28, 2010
Summary (HTML)   Highlights Page (PDF)   Full Report (PDF, 83 pages)

Environmental Health: Opportunities for Greater Focus, Direction, and Top-Level Commitment to Children’s Health at EPA

GAO-10-545T,  March 17, 2010
Summary (HTML)   Full Report (PDF, 12 pages)

EPA’s response

Peter Grevatt, the director of EPA’s Office of Children’s Health Protection, stated in his written testimony:

EPA agrees that the GAO report reflects well the early history and progress of the Agency’s children’s health protection efforts. The report accurately portrays the Agency’s challenges in addressing children’s  environmental health, and sets forth sound recommendations on steps that could be taken to better incorporate protection of children’s health as an integral part of EPA’s everyday business.

Grevatt also noted that EPA Administrator Lisa Jackson had designated the protection of children’s health as one of her top priorities.  He then described how EPA would implement its strategy to protect children’s health.

EPA’s strategy on children’s health (starts on p.4 of the testimony—specific components are listed under each item in the testimony)

  1. EPA will use the best science to ensure that regulations provide for protection of children’s environmental health by actively addressing the potential for unique childhood vulnerability and exposure. Our goal is to reduce negative environmental health impacts on children through rulemaking, policy, enforcement and research that focus on prenatal and childhood vulnerabilities.
  2. Protecting children through safe chemicals management.
  3. Coordinate national and international community based programs to eliminate threats to children’s health while measuring and communicating our progress.

Children’s health protection at EPA

Office of Children’s Health Protection website

Basic information about the Office of Children’s Health Protection

America’s Children and the Environment

(more…)

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