Monday, April 21, 2014
By SYDNEY R. SEWALL
AUGUSTA — Pediatricians are interested in preventing illness and disabilities, and one expanding area of my concern is environmental health.
ABOUT THE AUTHOR
Sydney R. Sewall, M.D., M.P.H., is an Augusta pediatrician who serves on the boards of the Maine Chapter of the American Academy of Pediatrics in Auburn, and the Environmental Health Strategy Center in Portland and Bangor.
Whether a child fulfills his or her full potential is the result of some combination of parenting, nutrition, educational experiences, health practices and a bit of luck interacting with genetics and environmental exposures.
These two biologic factors are intertwined -- some toxins alter how a developing child's genes actually get expressed, while others interfere with ongoing cellular function in the nervous system or other organs.
Unfortunately, parents have very little control over toxic exposures and mistakenly assume that government protections are in place. That's the case only to a limited degree.
Many Mainers became familiar with government's role in managing our exposure to toxins by following the debate in the Legislature this year over the Kid-Safe Product Act.
Government involvement is not new. In fact, the federal government passed a bill called the Toxic Substances Control Act in 1976.
The reason Maine had to take action locally, however, is that the Toxic Substances Control Act fails to provide us with meaningful protection from the effects of harmful chemicals -- in particular, it doesn't recognize the extra vulnerability of children to these effects.
I am pleased that my professional organization, The American Academy of Pediatrics, published a policy statement this month pushing for an overhaul of our national chemical management policy to reflect our expanding understanding of developmental toxicology.
Society depends on chemistry to function, and the amount and variety of "stuff" out there is staggering: 80,000 separate chemicals, including 3,000 that are "high volume," meaning the United States uses more than a million pounds per year.
Biomonitoring studies show that we all are exposed to multiple substances through the foods we eat and the air we breathe -- even though the substances were never intended for human consumption. There is no way to completely avoid exposure.
Children are uniquely vulnerable for a variety of reasons. Relative to their body weight, they eat, drink and breathe more than adults, so consume more contaminants. They also spend more time sitting or crawling on the ground where some toxins are found.
If exposures occur during critical windows of development, irreversible damage may occur in some organ systems. It looks as though brain and endocrine function are the most susceptible.
The failures of the Toxic Substances Control Act are not related to its intent, but to the details of how it operates. Its purpose was to protect public health without creating unnecessary economic barriers to technologic innovation.
The law itself, however, creates huge legal obstacles to regulation: in 35 years, only five chemicals or chemical classes have been limited by the Toxic Substances Control Act. In addition, all substances in use before 1976 were grandfathered, making it almost impossible for the Environmental Protection Agency to control their use even if evidence subsequently emerged of harmful effects.
Asbestos controls, for example, required a separate act of Congress. Manufacturers are not required to do safety testing before marketing new chemicals, and any test data available to the EPA can be hidden from the public as "confidential business information."
The American Academy of Pediatrics is one of a number of organizations that endorse the need for a revision of the Toxic Substances Control Act. Other groups include the American Medical Association, the American Public Health Association, the American Nurses Association, Physicians for Social Responsibility -- the list goes on.
A bill recently introduced by Sen. Frank Lautenberg, D-N.J., the Safe Chemicals Act of 2011, would improve protections for family members big and small. It would require the EPA to identify and restrict use of the "worst of the worst" chemicals while requiring basic health and safety information for all chemicals on the market.
The bill would also upgrade the scientific methods for testing and evaluating chemicals and generally provide the EPA with the tools and resources it needs to address chemicals that threaten our health.
We need not give up on the idea of "better living through chemistry" -- we just need to modernize its application.
In its 35 years of operation, the Toxic Substances Control Act has failed to live up to public expectations to protect us. I urge Maine Sens. Olympia Snowe and Susan Collins to co-sponsor the Safe Chemicals Act of 2011 to help prevent harm to kids from everyday chemical exposures.
– Special to the Press Herald