Needed: A warning system for environmental health risks

Health Progress, Sep/Oct 1999 by Place, Michael D

While serving in the Archdiocese of Chicago, I became aware of air and water pollution and its unfortunate effect on people's health. Like most Americans, however, I assumed that the Environmental Protection Agency (EPA) had brought industrial emissions under control and that things were steadily improving. I did not comprehend the problem's depth and complexity.

So I was taken aback when, last year, I went to the Bronx to visit the Dominican Sisters Family Health Service and Sr. Virginia Hanrahan, OP, the organization's president and chief executive officer, told me about the high rate of asthma and other pulmonary problems among the area's children. Why is the rate so high? I asked Sr. Virginia. "The environment," she replied.

That visit began to change my perspective on environmental health issues. I have since learned that, in recent years, scientists have noted a dramatically increased incidence of certain serious illnesses that tend to target children. Among these illnesses are:

Asthma. Death as the result of asthma in children and young people jumped 115 percent between 1980 and 1993. The disease is today the leading cause of hospitalization for young children.

Cancer. Every year, 8,000 children under 15 are diagnosed as having cancer. Between 1973 and 1996 there was, among kids, a 23 percent increase in acute lymphoblastic leukemia and a 32 percent increase in brain cancer. Birth defects. Infant deaths caused by birth defects rose from 7 percent in 1919 to 20.5 percent in 1986. Birth defects are today the leading cause of infant mortality.

Scientists have come to believe that environmental factors are involved in each of these often fatal illnesses. Take asthma, for example. Although medical experts do not yet know precisely what causes the disease, they are certain that exposure to air pollutants such as sulfur dioxide, nitrogen dioxide, particulate matter, and many indoor toxins makes it worse for its sufferers.

The same is true for birth defects, cancer, and other illnesses that seem to strike especially hard at kids. In each of them, the evidence indicates a strong connection to environmental hazards.

NO NATIONAL WARNING SYSTEM

Unfortunately, however, the United States has no national system for monitoring public health problems linked to environmental toxins. Although federal agencies track many infectious diseases, they do not track the effect of environmental hazards on public health.

This is ironic, if you stop to think about it. Thirty years ago, America's environment was in terrible shape-remember, for example, the time Cleveland's polluted Cuyahoga River actually caught fire? Yet most states and big cities still had public health departments that did a good job of warning people about threatening illnesses, such as tuberculosis. Then in 1970 the EPA was born. The EPA has worked wonders in cleaning up our nation's water and air. But, since its founding, most state and local governments have drastically cut the budgets of their public health departments.

The result has been that state and local health departments now lack the resources to guard the public from environmental health dangers. Meanwhile, EPA funding has grown. But public health is not the EPA's main focus. (Among its 18,000 employees, the agency has only three medical doctors.) For example, the EPA successfully forced most industries to install equipment to screen large-particle pollutants from the smoke their factories belch into the air. Unfortunately, small industrial particles are more likely to exacerbate lung disease, and it was only a few years ago that the EPA began to regulate them.

No wonder, then, that the incidence of respiratory disease in the United States has in recent decades jumped significantly.

THE BENEFITS OF A WARNING SYSTEM

We know from experience that a national warning system will work. Not too long ago, lead was routinely added to gasoline because it helped keep automobile engines from "knocking." Then scientists discovered that lead was a toxin associated with a number of illnesses, including high blood pressure, anemia, mental retardation, and behavior disorders. Particularly alarming was the fact that lead seemed to cause neurological damage in young children.

As a result, the EPA in 1973 ordered petroleum companies to begin a gradual phasing out of lead from their products. However, opponents soon asked Congress to reverse the EPA's decision. They argued that the costs of the phaseout would be prohibitive and that the benefits from it would be small. It looked for a while as if Congress might agree with the opponents and halt the phaseout.

As it happened, though, the fed- eral Centers for Disease Control and Prevention (CDC), Atlanta, had for some time been studying lead levels in human bloodstreams. By comparing blood samples taken both before and after the EPA began its lead phaseout, the CDC showed there had been a dramatic decrease of lead in Americans' blood levels. This evidence persuaded Congress that the EPA's decision had been the right one. The phaseout continued until New Year's Day 1996, when leaded gasoline was banned in the United States altogether.