Chemicals and Our Health 2012

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Chemicals and Our Health:
Why Recent
Science is a
Call to Action
THE HEALTH REPORT 2
Acknowledgments
1his report is the result of a col
laborative effort of the 5afer Chemicals,
Healthy Families coalition, a campaign
dedicated to protecting American
families from toxic chemicals. 1he
report incorporates a significant body
of peerreviewed science on chemicals
and health. ln addition, this report builds
upon a previous report titled Thc HcoIth
Losc jor Rcjorming thc Toxic Substonccs
LontroI Act published in Z9.
For more information on our campaign
please visit our website at www.soj-
crchcmicoIs.org.
Our sincere thanks to the
following contributors and
reviewers:
Richard Clapp, D5c, MPH, Professor
Emeritus Boston University 5chool of
Public Health
Lindsay Dahl, 5afer Chemicals, Healthy
Families
Rachel Gibson, JD, MPP, Health Care
Without Harm
Liz Hitchcock, 5afer Chemicals, Healthy
Families
5arah Janssen, MD, PhD, MPH, Natural
Resources Defense Council
1ed 5chettler, MD, MPH, 5cience and
Environmental Health Network
Maureen 5wanson, MPA, Learning Dis
abilities Association of America
Leonardo 1rasande, MD, MPP, Pediatrics,
Environmental Medicine and Health
Policy, New York University
1racey Woodruff, PhD, MPH, Program on
Reproductive Health and Environment,
University of California, 5an Francisco
Rachel Miller, MD, Pulmonary, Allergy
and Critical Care Medicine, Columbia
University
Contents
Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Learning and Developmental Disabilities . . . . . . . . . . . 9
Alzheimers and Parkinsons Diseases . . . . . . . . . . . . . 12
Reproductive Health . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Reducing Our Health Care Costs . . . . . . . . . . . . . . . . . 20
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Endnotes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
July 2012
SAFER CHEMICALS HEALTHY FAMILIES 3
A
greement is growing across
the political spectrum
and among scientists, health
professionals, and concerned
parents that federal law does not
adequately protect Americans from
toxic chemicals. 1he primary law
responsible for ensuring chemicals
are safe-the 1oxic 5ubstances
Control Act |15CA-was passed
in 19/ and has never been
updated. 1he law is so weak that
the U.5. Environmental Protection
Agency |EPA has only been able
to require testing on less than two
percent of the more than B,
chemicals that have been on the
market at some point since 15CA
was adopted.
1
Much has changed since 15CA be
came law decades ago. 5cientists
have developed a more refined
understanding of how some chemi
cals can cause and contribute to
serious illness, including cancer,
reproductive and developmental
disorders, neurologic diseases, and
asthma.
By reforming 15CA, we can reduce
our exposure to toxic chemicals,
improve our nations health, and
lower the cost of health care. 1his
report documents some of the
scientific findings and economic
analysis in support of meaningful
15CA reform.
Chronic disease: many
trends are on the rise
More than 3 years of environmen
tal health studies have led to a
growing consensus that chemicals
are playing a role in the incidence
and prevalence of many diseases
and disorders in the United 5tates,
including:
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which have increased by more
than Z% since 19/5.
Z
4+"'30)-',-"+, the incidence
of which went up by 4%
between 19/3 and 199B.
3

While breast cancer rates have
declined in recent years in
postmenopausal white women,
rates of breast cancer in pre
menopausal white women and
postmenopausal black women
remain unchanged.
4,5
A womans
lifetime risk of breast cancer is
now one in eight, up from one
in ten in 19/3.
5301%', which approximately

doubled in prevalence between
19B and 1995 and has contin
ued to rise. ln Z9, nearly 1 in
1Z Americans had asthma.
/,B
6&77&-#208)&,)-/,-"&9&,:)',.)
%'&,0'&,&,:)');+":,',-8
affected 4% more women
in ZZ than in 19BZ. From
19BZ to 1995, the incidence
of reported difficulty almost
doubled in younger women,
ages 1B-Z5.
9,1
<1")*&+01)."7"-0)+"3#20&,:)&,)
#,."3-",.".)0"30&-2"3 |cryp
torchidism increased sharply
between 19/ and 1993, with
uncertain trends since then.
11
!"'+,&,:)',.)."9"2/;%",0'2)
.&3'*&2&0&"3, including autism
and attention deficit hyperactiv
ity disorder, affect nearly one in
six U.5. children, as of ZB.
1Z

Between 199/ and ZB, the
prevalence of autism increased
nearly 3% nationally.
13
According to the U.5. Centers for
Disease Control and Prevention
|CDC, 133 million people in the
U.5.-almost half of all Americans-
are now living with these and other
chronic diseases, which account for
/% of deaths and /5% of U.5.
health care costs.
14
ln general, these and other com
mon diseases or disorders are the
result of many factors, but many
chemicals, by themselves or in
combination with other chemical
and nonchemical factors, can be
harmful to multiple systems in
the body, increasing the risk of
adverse health outcomes.
The health and economic
benets of reforming
chemical policy
Estimates of the proportion of the
disease burden that can be attrib
uted to chemicals vary. A recent
World Health Organization review
conservatively estimates that the
global disease burden related to
chemicals is more than B%.
15
Here
in the United 5tates, researchers
estimate that 5% of childhood
cancer and 3% of childhood
asthma are attributable to chemical
exposures.
1,1/

Whatever the actual contribution
of chemicals to the overall disease
burden or specific diseases, ef
fective chemical policy reform will
incorporate the last 3+ years of
science to reduce those exposures
that contribute to chronic disease
and provide incentives to move to
safer alternatives. Any decline in
the incidence of chronic diseases
also can be expected to lower
health care costs.
1he U.5. now spends over S/,
per person per year directly on
health care.
1B
1his sum does not
include the cost of additional
impacts, such as the costs of
educating children with learning
disabilities or emotional costs to
a family coping with a mothers
breast cancer diagnosis. Chemical
policy reform holds the promise of
reducing the economic, social, and
personal costs of chronic disease
by creating a healthier future for
all Americans.
Executive Summary
THE HEALTH REPORT 4
C
onsensus is growing among
scientists, health care provid
ers, health and environmental
advocates, consumer product
manufacturers, and even some in
the chemical industry, that when
it comes to protecting Americans
from toxic chemicals, current law
has not kept
up with the
times.
1he pri
mary chemical
safety law,
the 1oxic
5ubstances
Control Act of
19/ |15CA,
grandfa
thered in
all chemicals
that were in
existence prior
to 19/, not
requiring any
safety testing
in order
for them to
remain on
the market.
Because of
weaknesses in
the law, in the
thirtysix years
since 15CA
was en
acted, the U.5.
Environmental
Protection
Agency |EPA
has been able
to require
testing on less than two percent
of the more than B, chemicals
that have been on the market
at some point since 15CA was
adopted.
Much has changed since 19/:
chemical production volumes have
increased rapidly, chemicals have
become more pervasive in daily
life, and scientists have developed
a more thorough understanding
of how people are exposed to
chemicals and how exposures can
contribute to serious illness, includ
ing cancer, learning and devel
opmental disabilities, neurological
diseases, reproductive disorders,
and asthma.
Making the health
care case for reform
We know that many chronic
diseases are the result of multiple,
interacting risk factors. Exposures
to chemicals are among them-
along with inadequate nutrition,
lack of exercise, infection, challeng
ing social and economic condi
tions, age, tobacco use, and genes
that can increase susceptibility to
disease. 1he interplay of variables
begins before conception and
continues for an entire lifetime.
19

1he good news is that chemical
exposures are among the risk
factors that we can do something
about.
By reforming 15CA, we can reduce
exposure to toxic chemicals,
improve our nations health, and
lower health care costs.
1his report summarizes some of
the peerreviewed, scientific studies
showing that chemical exposures
contribute to the growing burden
of chronic disease in our country
and offers an analysis of the
economic benefits of reform.
5pecifically, we summarize the
growing scientific literature linking
chemical exposures to five cat
egories of chronic conditions that
impact the daily lives of millions of
Americans:
Certain types of cancer
Learning and developmental
disabilities
Alzheimers and Parkinsons
diseases
Reproductive health and fertility
problems, and
Asthma.
1his report also incorporates the
results of published studies that
estimate the proportion of our
disease burden that is attributable
to chemical exposures and the
potential health cost savings from
improved protection from toxic
chemicals.
Introduction
Many health professional organizations
from across the country are expressing
concern with the inadequate health
protections aorded by current law. The
American Medical Association,National
Medical Association, American Academy of
Pediatrics, American Nurses Association,and
American Public Health Association have
called on the U.S. Congress to fundamentally
restructure TSCA such that it better
protects public health and the environment.
C
ancer affects millions of
American families and adds
billions of dollars to our nations
annual health care bill.
According to the National Cancer
lnstitute, almost 45% of men and
3B% of women in the United
5tates will be diagnosed with
cancer at some point in their
lives.
Z,Z1
Cancer is the second
most common cause of death in
the U.5., exceeded only by heart
disease.
ZZ
Nearly 1 out of every
4 deaths in the United 5tates is
caused by cancer.
Z3

Over the past two decades, the
rates of some cancers have risen
significantly. 1hese include:
Z4
Kidney, liver, thyroid, esopha
geal, and testicular cancer, as
well as melanoma in men;
NonHodgkins lymphoma,
Hodgkins disease, melanoma,
and cancers of the thyroid,
liver, and kidney in women; and
Childhood cancers overall, espe
cially childhood leukemia and brain
cancer |see Figure 1.
ln Z1, the direct medical costs
of cancer were S1Z.B billion and
the overall costs were SZ3.B
billion.
Z
Medical costs for pediatric
cancers in ZB totaled an esti
mated S1.9 billion.
Z/
The link to chemical
exposure
Much of what we know about
chemicals and cancer comes from
experimental laboratory studies,
longterm follow up of workers
exposed to chemicals in their place
of employment, and epidemio
logic studies in communities where
residents are exposed to hazard
ous substances. Laboratory animal
studies are generally considered
relevant for predicting toxic effects
Cancer
THE HEALTH REPORT 6
of chemicals in people, with certain
exceptions.
1he U.5. Department of Health and
Human 5ervices relies on these
types of studies to develop and
periodically update its Report on
Carcinogens. 1he 1Zth edition of
the report lists over Z chemicals
as known human carcinogens,
such as formaldehyde, asbestos,
hexavalent chromium, and vinyl
chloride, or reasonably anticipated
to be human carcinogens, such as
trichloroethylene |1CE, methylene
chloride |dichloromethane, styrene,
and 1,4dioxane.
ZB
5ubsequent to
the publication of the 1Zth edi
tion, EPA officially concluded that
trichloroethylene |1CE is carci
nogenic in humans for all routes
of exposure, noting that there is
substantial potential for human
exposure as 1CE is widespread in
ambient air, indoor air, soil, and
groundwater.
Z9
1he classifications
of these and the other chemicals
listed in 1able 1 are largely based
on studies of similarly exposed and
diagnosed workers.
Despite being classified as known
or probable carcinogens, many
of these chemicals remain nearly
ubiquitous in the environment
where people are easily exposed.
For example, formaldehyde is a
common indoor air contaminant
because of its use in furniture,
cabinets, countertops, insulation,
wallpaper, paints, and paneling.
lt is present in a wide variety of
other consumer products, such as
antiseptics, medicines, cosmetics,
dishwashing liquids, fabrics and
fabric softeners, shoecare agents,
carpet cleaners, glues and adhe
sives, lacquers, paper, coatings,
and plastics.
3
ln a Z9 California
study, nearly all new singlefamily
Figure 1 - Cancer Incidence and Mortality for Children Under 20
Lonccr is thc sccond most common cousc oj dcoth jor Amcricons undcr thc ogc oj 20.
Thc incidcncc oj chiIdhood conccr incrcoscd morc thon 20% bctwccn 1975 ond 1990. Sincc
1990, thc incidcncc hos rcmoincd roughIy ot this cIcvotcd rotc. MortoIity dccIincd subston-
tioIIy during this pcriod, duc IorgcIy to improvcmcnts in trcotmcnt.
25
=>?@ABC U.5. EPA. Americas Children and the Environment. www.cpo.gov,cnvirohcoIth,chiIdrcn
65<5C)National Cancer lnstitute, 5urveillance, Epidemiology and End Results Program
homes had indoor formaldehyde
concentrations that exceeded
guidelines for cancer and chronic
lung irritation.
31
1richloroethylene is present in
some paint removers, adhesives,
rug cleaners, metal cleaners, pep
per sprays, and spot removers.
3Z

1CE has been detected in ambient
air, surface water, and groundwater
and is one of the most common
contaminants found at toxic waste
sites.
33
According to the Agency
for 1oxic 5ubstances and Disease
Registry |A15DR, between 9%
and 34% of drinking water supply
sources tested in the U.5. contain
some 1CE.
34
Early exposure, cancer
later in life
Recent research shows that early
life exposures can increase the
risk of cancer many decades later.
Laboratory animal studies, for
example, show that early exposures
increase the susceptibility of the
breast and prostate gland to can
cer in adulthood.
35,3
ln humans, in
utcro exposure to diethylstilbestrol,
a synthetic estrogen, increased
the risk of reproductive tract and
breast cancer in women decades
after birth.
3/

A Z/ report documented a
strong association between higher
earlylife
exposure to
a pesticide
called
dichlorodiphe
nyltrichlo
roethane
|DD1
and later
development
of breast
cancer.
3B

While previous
studies that
had looked
at the relationship between breast
cancer and the levels of DD1
in women at the time of breast
cancer diagnosis did not find a
strong connection,
39
the more
recent study used stored blood
samples to determine the DD1
levels the women were exposed to
when they were younger. Women
who were exposed to higher levels
of DD1 before age 14 had a
markedly increased risk of breast
cancer later in life, compared to
women whose DD1 levels were
lower. But higher exposures after
the age of 14 were not associated
with an increased risk. 1hese and
many other studies demonstrate
that exposures to hazardous
chemicals during vulnerable periods
of development can have profound
effects that may not manifest until
later in life.
4,41
Breast cancer is a
leading cause of
death in women.
4Z

Breast cancer
rates in the U.5.
increased by more
than 4% between
19/3 and 199B.
43

1oday, a womans
lifetime risk of
breast cancer is
one in eight, up
from 1 in 1 in
19/3.
44
1he study
of DD1 exposure
in young women, described above,
has been modeled in laboratory
animals, where early life exposures
to low doses of chemicals have
been shown to increase the risk
for breast cancer by affecting
mammary development and lifetime
susceptibility to cancer. For exam
ple, in laboratory animals, bisphe
nol A, dioxin, and perfluorooctanoic
acid |PFOA have been shown
to alter gene expression and,or
modify mammary gland develop
ment, increasing the later risk of
cancer.
45,4,4/

A Z/ literature review identified
Z1 chemicals associated with in
creases in mammary gland tumors
in at least one wellconducted
animal study.
4B
Of these, /3 have
been present in consumer products
or as contaminants of food, 35
are air pollutants, Z9 are produced
Table 1: Commonly Found Chemicals Known or Reasonably Anticipated to Be Human
Carcinogens
53
Arsenic Chromium |hexavalent Nickel
Asbestos Coal 1ars 5ilica
Benzene 1,4dioxane 5tyrene
Benzidine Ethylene oxide 5ulfuric Acid
Butadiene Formaldehyde 1oluene Diisocyanate
Cadmium Lead 1richlorethylene |1CE
Carbon 1etrachloride Methylene Chloride vinyl Chloride
These and many other
studies demonstrate
that exposures to
hazardous chemicals
during vulnerable periods
of development can have
profound eects that
may not manifest until
later in life.
THE HEALTH REPORT 8
at more than 1 million pounds per
year in the United 5tates, and Z5
have involved occupational expo
sures to more than 5 women.
Yet, despite the near certainty
of widespread human exposure
to many of these chemicals, the
findings have triggered virtually no
regulatory or other policy response.
Presidents Cancer
Panel calls for increased
regulation of chemicals
ln its ZBZ9 Annual Report,
the Presidents Cancer Panel-ap
pointed by President George W.
Bush-summarized its investigation
on evidence linking chemicals
to various kinds of cancer, and
concluded that, despite remaining
uncertainties, we know enough to
act. According to the Panel, the
true burden of environmentally
induced cancer is grossly underes
timated.
49
5ingling out 15CA as an egregious
example of ineffective regulation of
environmental contaminants, the
Panel called on President Obama
to use the power of his office to
remove the carcinogens and other
toxins from our food, water,
and air that needlessly increase
health care costs, cripple
our Nations productivity, and
devastate American lives.
5
The asbestos example
Effective 15CA reform will
give EPA the power to restrict
cancercausing chemicals like
asbestos, a material that has
been banned in 55 other coun
tries.
51
ln 19B9, EPA banned
asbestos in almost all products,
but a federal appellate court
overturned the ban on the
grounds that the agency failed
to meet its burden of proving
that asbestos presented an
unreasonable risk. 1he chilling
effect of this court decision is
clear: EPA hasnt tried to use
15CA to ban or restrict the
production or use of a chemical
since.
5Z

1o protect public health, EPA
needs the proper authority to re
strict human carcinogens to which
people are exposed. 15CA should
require EPA to assess chemicals
and hold chemical manufacturers
responsible for demonstrating the
safety of their products.
T
he number of American children
with learning and developmental
disabilities has been climbing over
the past decade, reaching nearly
one in six by ZB.
54
1he increasing
prevalence of autism and attention
deficit hyperactivity disorder accounts
for most of this change.
55
1he National
Academy of 5ciences estimates that
combinations of environmental factors,
including exposure to toxic chemicals,
along with genetic susceptibility, cause
or contribute to at least Z5% of
learning and developmental disabilities
in American children.
5
lntellectual disability |formerly referred
to as mental retardation affects Z%,
or approximately 1.4 million, children
in the United 5tates.
5/
As of Z9,
9% of children-roughly 5 million
kids-were diagnosed with attention
deficit hyperactivity disorder |ADHD.
5B,59

According to the U.5. Centers for
Disease Control and Prevention |CDC,
an estimated 1 in BB children in
the United 5tates have an autism
spectrum disorder.
Between 199/ and

ZB, the prevalence of autism in
creased nearly 3% nationally.
1
ln a
seminal study of Californias dramatic
rise in autism rates, researchers found
that about 3% of the rise could not
be explained by changes in the age
of diagnosis or the inclusion of milder
cases.
Z
1hese conditions impose tremendous
psychological and economic costs on
the affected children, their families,
and communities. On average, it costs
twice as much to educate a child
who has a learning or developmental
disability as to educate a child who
does not.
3
According to the CDC,
individuals with an autism spectrum
disorder have average medical expen
ditures that exceed those without the
disorder by S4,11-S,Z per year.
4

A Z study reported that the eco
nomic costs associated with autism in
the U.5. are approximately S35 billion
dollars per year.
5
Learning and Developmental Disabilities
Ten chemicals suspected of causing
developmental neurotoxicity
ln spring Z1Z, scientists from the National lnstitute of Environ
mental Health 5ciences and the Mount 5inai 5chool of Medicine
listed 1 chemicals and mixtures widely distributed in the
environment that are already suspected of causing developmen
tal neurotoxicity. 1hese are:
1. Lcod. a heavy metal banned from gasoline in the 19/s,
found in old paint, lead pipes and sinkers, toys, jewelry,
and other items made of vinyl plastic.
Z. McthyImcrcury. released into the air from coalburning
power plants; also found in some medical equipment,
switches, personal care products, and fluorescent bulbs.
3. PoIychIorinotcd biphcnyIs (PLBs'. used in electrical trans
formers; banned in the late 19/s but still widely found in
lakes, rivers, soil, fish, and people.
4. Orgonophosphotc pcsticidcs. pesticides containing phospho
rous that work by disrupting the nervous system; used to
kill insects on crops and lawns, and in buildings.
5. OrgonochIorinc pcsticidcs. pesticides containing chlorine
that work by disrupting the nervous system; used to kill
insects on crops and lawns, and in buildings; many but not
all have been banned in the United 5tates.
. Lndocrinc disruptors. chemicals that disrupt the hormone
system, including phthalates and bisphenol A |both widely
used in plastics, PCBs, brominated flame retardants, per
fluorinated compounds, dioxins, organochlorine pesticides,
among others.
/. Automotivc cxhoust
B. PoIycycIic oromotic hydrocorbons. air pollutants from fuel
combustion in vehicles, coalfired power plants, heating,
and cooking; also found in tobacco smoke.
9. Brominotcd jIomc rctordonts. flame retardant chemicals
added to furniture, electronics, building materials, bedding,
and a wide range of other products.
1. PcrjIuorinotcd compounds. used in stainresistant and
nonstick products.
Lead, methylmercury, PCBs, some endocrine disruptors, bro
minated flame retardants, and perfluorinated compounds are
among chemicals subject to regulation by the 1oxic 5ubstances
Control Act.
9Z

THE HEALTH REPORT 10
The human brain: more
susceptible during
development
Much of what we know about
chemicals that can cause neu
rological problems comes from
studies of adults-often
in the workplace-and
from animal studies. For
example, lead, mercury,
and various organic sol
vents have been identi
fied in the peerreviewed,
scientific literature as
causing neurological
effects in adults, mostly
through occupational
exposures |see 1able Z.

Many of these chemicals
are in common use
and are produced in
high volumes,
/
but for
many, we have very little
knowledge about their
neurologic impact in children. A
large number of chemicals have
never been evaluated for their
neurological impacts in children or
adults.
ln the last few decades, extensive
evidence has accumulated showing
that neurotoxic chemicals can
have a profound effect on the
developing brain at levels that were
once thought to be safe, and that
may have little or no discernible
impacts in adults.
B
Beginning
in utcro and continuing through
adolescence, exposures to certain
chemicals during particular time
windows of vulnerability can disrupt
normal developmental processes
with profound and often lifelong
consequences.
9,/
Lead, mercury, arsenic, PCBs, cer
tain flameretardants |PBDEs, and
pesticides are among the chemicals
for which the special vulnerability
of the developing brain has been
extensively demonstrated.
/1,/Z
Our
understanding of the developing
brains unique vulnerability sug
gests that there may be hundreds
or even thousands of additional
chemicals that can have an impact.
We have no authoritative estimate
of the actual number, primarily
because relatively few chemicals
have been examined for effects in
the developing brain of laboratory
animals or children.
Toxic ame retardants
example
5cientists continue to identify
chemicals with enough evidence
to raise serious concern over their
effects on brain development. A
category of flameretardant chemi
cals called polybrominated diphenyl
ethers |PBDEs provides a clear
illustration of how current chemical
laws fail to protect public health.
PBDEs are used in many products,
including upholstery, electronics,
carpet, building materials, bedding,
and mattresses.
/3,/4
Despite some
regulatory restrictions on PBDEs,
these chemicals remain a serious
problem because they break down
into more toxic forms and are
used in many recycled products
like carpet padding. ln addition,
they persist in the environment for
a long time, build up in peoples
bodies and in breast milk, and
are often found at higher levels in
children than adults.
/5,/
An extensive body of scientific
literature documents the neurode
velopmental impacts of PBDEs
in laboratory animals. ln labora
tory studies, low doses of some
PBDEs cause deficits in learning,
memory and hearing, changes in
behavior, and delays in sensory
motor development in mice and
rats.
//,/B,/9,B,B1,BZ,B3
A landmark study pub
lished in Z1 provided
the first evidence of the
adverse effects of these
chemicals on human
brain development.
1he study tracked 3Z9
women who gave birth in
lower Manhattan hospi
tals following the terrorist
attacks of 5eptember 11,
Z1. 1he researchers
found an association
between levels of PBDE
flame retardants in the
babies cord blood and
delays in mental and
physical development
measured at 1, Z, 3, 4, and
years of age.
B4
ln Z4 and Z9, the U.5.
government reached a voluntary
agreement with chemical manufac
turers to begin phasing out three
commercial mixtures of PBDEs.
B5,B

5ince ZZ, at least twelve states
have banned one or more of these
flame retardants due to the mount
ing evidence of harm to human
health.
B/
5ome manufacturers
have responded by replacing the
three PBDE mixtures with different
chemicals that they claimed were
safer, with no publicly available
information to support their claims.
1hese replacement flame retard
ants are now showing up in the
environment, including in the
atmosphere, sediments, and seagull
eggs around the Great Lakes,
raising concerns that we have
simply moved from one danger
ous set of chemicals to another,
without adequate safety testing.
BB,B9

And, to the extent that these new
chemicals are also persistent and
bioaccumulative, we will be living
with their toxic consequences for
years to come.
How chemical policy
reform can help
1here is solid and mounting scien
tific evidence on a limited number
of chemicals, including those
described above, to show that they
are harmful to brain development.
Where the weight of the evidence
warrants concern, 15CA reform
should include swift action to
replace known toxic chemicals with
safer alternatives.
However, for most of the thou
sands of chemicals on the market,
we have virtually no information
about their effects on the develop
ing nervous system. Of the 3,
chemicals produced in highest vol
ume |over one million pounds per
year, few have been adequately
tested for toxicity to the develop
ing brain.
9
1o ensure healthy brain
development for future generations,
15CA must be updated to require
that all existing and new chemicals
are evaluated for their safety for
pregnant women, children, workers,
and other vulnerable populations.
Table 2: Some Chemicals Known to be Neurotoxic to Humans
91
*
Metals and
inorganic
compounds
Organic solvents Other organic substances
Aluminum compounds Acetone Methyl butyl ketone Acetone cyanohydrin Methyl chloride
Arsenic and arsenic
compounds
Benzene Methyl cellosolve Acrylamide Methyl formate
Azide compounds Benzyl alcohol Methyl ethyl ketone Acrylonitrile Methyl iodide
Barium compounds Carbon disulphide Methylcyclopentane Allyl chloride Methyl methacrylate
Bismuth compounds Chloroform Methylene chloride Aniline pNitroaniline
Carbon monoxide Chloroprene Nitrobenzene 1,ZBenzenedicarbo
nitrile
Phenol
Cyanide compounds Cumene ZNitropropane Benzonitrile pPhenylenediamine
Decaborane Cyclohexane 1Pentanol Butylatedtriphenyl
phosphate
Phenylhydrazine
Diborane Cyclohexanol Propyl bromide Caprolactam Polybrominated biphenyls
Ethylmercury Cyclohexanone Pyridine Cyclonite Polybrominated diphenyl
ethers
Fluoride compounds Dibromochloropropane 5tyrene Dibutyl phthalate Polychlorinated biphenyls
Hydrogen sulphide Dichloroacetic acid 1etrachloroethane 3|Dimethylamino
propanenitrile
Propylene oxide
Lead and lead com
pounds
1,3Dichloropropene 1etrachloroethylene Diethylene glycol
diacrylate
1CDD
Lithium compounds Diethylene glycol 1oluene Dimethyl sulphate 1ributyl phosphate
Manganese and
manganese compounds
N,NDimethylformamide 1,1,11richlo
roethane
Dimethylhydrazine Z,Z,Z1richlorotriethyl
amine
Mercury and mercuric
compounds
ZEthoxyethyl acetate 1richloroethylene Dinitrobenzene 1rimethyl phosphate
Methylmercury Ethyl acetate vinyl chloride Dinitrotoluene 1riotolyl phosphate
Nickel carbonyl Ethylene dibromide Xylene Ethylbis|Zchloroe
thylamine
1riphenyl phosphate
Pentaborane Ethylene glycol Ethylene
Phosphine nHexane Ethylene oxide
Phosphorus lsobutyronitrile Fluoroacetamide
5elenium compounds lsophorone Fluoroacetic acid
1ellurium compounds lsopropyl alcohol Hexachlorophene
1hallium compounds lsopropyl acetone Hydrazine
1in compounds Methanol Hydroquinone
' lt is important to note that the listed chemicals are industrial chemicals. 1able Z does not include neurotoxic
pesticides, which are regulated under a different federal statue.
A
n estimated 5.4 million
people in the United
5tates have Alzheimers dis
ease.
93
1wothirds of those
with the disease are women.
94

By Z5, researchers es
timate that the number of
people with the disease will
nearly triple to 1 million.
95
Of
Americans aged 5 and over,
1 in B has Alzheimers disease,
and nearly half of people
aged B5 and older have the
disease.
9
Deaths from Alzhe
imers disease increased %
between Z and ZB.
9/
Parkinsons disease affects
approximately 5,
Americans, with about 5,
new cases annually.
9B
1he
prevalence of the disease
is expected to double by
Z3.
99
Lack of Parkinsons disease
registries, however, make it difficult
to estimate the true incidence and
trends over time.
1
1he Alzheimers Association
estimates that national direct and
indirect annual costs of caring for
individuals with Alzheimers disease
are S1B3 billion.
11
Estimates of the
costs of Parkinsons disease range
from S13 billion to SZB.5 billion
per year.
1Z
exposure
1he risk of cognitive decline,
dementia, and Parkinsons disease
increases with age, and most
cases are likely to arise from
multiple contributing factors. ln
recent years, the extent to which
exposures to environmental chemi
cals and contaminants throughout
the lifespan may play a role has
received increased attention.
ln one study, Z1% of more than
a thousand patients with cognitive
disorders had medical histories
that suggested they may have
been exposed to chemicals either
in their workplace or from some
other environmental source.
Clinicians found that a history of
toxic exposure was associated with
cognitive decline at significantly
younger ages.
13
Unfortunately, few
of the more than 1 industrial
chemicals that are known to be
toxic to the nervous system gener
ally have been studied for specific
impacts on the adult brain, but
those few are illustrative.
14
Pesticides
ln the 19Bs, case reports
of individuals who developed
Parkinsonlike symptoms
after injecting a synthetic drug
contaminated with 1methyl4
phenyl1,Z,3,tetrahydropyridine
|MP1P sparked interest in looking
for environmental chemicals that
might have similar effects.
15
Early
studies focused on chemicals with
structural similarities to MP1P or
its breakdown products, including
the pesticide rotenone and the
herbicide paraquat. Extensive
laboratory and epidemiologic
evidence now shows that exposure
to certain kinds of pesticides
increases the risk of Parkinsons
disease.
1,1/
Although less well
studied, pesticide exposures may
also increase the risk of cognitive
decline and dementia.
1B,19
Solvents
5olvents are another class of
chemicals that appear to increase
the risk of Parkinsons disease in
exposed workers. 5olvents are used
for cleaning, degreasing, extraction,
surface coating, and laboratory
work. 1hey are components of
paints, inks, glues, adhesives,
and hydrocarbon fuels. Occupa
tional exposure to solvents such as
carbon disulfide, methanol, n
hexane, and trichloroethylene |1CE
is associated with an increased
risk of Parkinsons disease.
11,111,11Z

1CE is a particular concern. Not
only is it frequently used as a
degreasing agent in industry, but
it is also a common surface and
groundwater contaminant, resulting
in widespread, lowlevel exposures
in the general population.
113
Alzheimers and Parkinsons Diseases
Lead and other metals
Lead, which is notorious for its
impacts on the developing brains
of children, also now appears likely
to increase the risk of neurodegen
erative disorders in people as they
age.
A study of older men in the
general population found that
increasing levels of lead in their
bones was associated with acceler
ated cognitive decline. 1he group
with the highest lead levels had
15 years of additional cognitive
aging compared to the group with
the lowest levels when they were
retested several years later.
114

5imilar findings are also reported
in women.
115
Elevated bone lead levels are also
associated with an increased risk
of Parkinsons disease.
11
5tudies in rodents designed to
examine mechanisms by which
earlylife lead exposure might
contribute to latelife neurodegen
eration show that prenatal lead
exposures modify the expression
of certain genes later in life,
resulting in increased production
of Alzheimerassociated abnormal
brain proteins.
11/
1he same
delayed, latelife increase in Alzhe
imers diseaserelated proteins was
reported in aged monkeys exposed
in infancy to low levels of lead.
11B
New animal studies also have
resurrected the 19s controversy
about the role of aluminum in neu
rodegenerative disease. One small
study showed that when rodents
were chronically exposed to dietary
aluminum |similar to typical human
exposure levels, aluminum ac
cumulated in the brain.
119
A larger
followup study in rats showed that
the more aluminum a rat received
in its diet, the more memory loss
the rat exhibited.
1Z
Excessive inhalation of manganese
containing fumes also can
increase the risk of Parkinsonlike
symptoms.
1Z1
Polychlorinated biphenyls
(PCBs)
Before they were effectively banned
under 15CA in the late 19/s,
polychlorinated biphenyls |PCBs
were used for many years as flame
retardants, plasticizers in paints,
lubricants and coolants in electrical
equipment, and adhesives.
1ZZ,1Z3

As a result of their widespread
use, many people and wildlife
throughout the world have been
exposed.
1Z4
More than 3 years after they
were effectively banned, PCBs
continue to contaminate the
environment because they are
persistent, or not easily broken
down, and move readily from land
to air and water. 1hey also bioac
cumulate and continue to enter
and contaminate the food supply,
which is an ongoing source of
human exposure.
1Z5

Biomonitoring data from the CDC
show that the American public
is still widely contaminated with
PCBs.
1Z
Although the levels of
PCBs in the general population are
decreasing, certain subpopulations
remain highly exposed, especially
those regularly consuming contami
nated fish.
1Z/
ln the years following 15CAs
passage, we learned that, like
most chemicals, PCBs can cross
the placenta, directly exposing
the fetus.
1ZB
Numerous studies
show that prenatal exposure to
PCBs interferes with normal brain
development.
1Z9,13,131
More recently,
we have learned that PCBs may in
crease the risk of both Alzheimers
disease and Parkinsons disease.
1hree published epidemiologic
studies have explored the effects
of PCBs on cognitive decline or
dementia, and each found that
higher levels of exposure are as
sociated with an increased risk of
dementia or cognitive impairment.
While PCB exposures were relatively
high in two of the studies,
13Z,133
exposures in the third were closer
to those in the general popula
tion.
134
A retrospective mortality study
of more than 1/, workers
occupationally exposed to PCBs
reported a nearly threefold
excess of Parkinsons disease
related deaths and twice as many
dementiarelated deaths in women
most highly exposed to PCBs.
135

Another postmortem study found
higher levels of PCBs in the brains
of people with Parkinsons disease
than in control subjects.
13
Animal
and cellular studies also have
shown that some PCBs produce
Parkinsonlike changes in the brain
or brain cells.
13/
1hus, PCBs tell a cautionary tale:
introduction of persistent, bioac
cumulative, and toxic chemicals
into commerce will predictably
have adverse health and economic
consequences for many years, even
after they are banned.
How chemical policy
reform can help
1o be effective, 15CA reform must
recognize the unique dangers
posed by exposure to persistent,
bioaccumulative, and toxic pollut
ants |PB1s, such as PCBs, PBDEs,
and heavy metals, and include
provisions to ban them except
for critical uses. Communities and
populations that bear dispropor
tionately high burdens of PB1
contamination must be the focus
of exposure reduction efforts.
ln addition, it is now clear that
environmental chemicals can
contribute to neurodegenerative
changes in the adult and aging
brain. 1hus, in order to protect
public health, 15CA reform also
must include provisions for as
sessing the effects of industrial
chemicals on the brain throughout
the lifespan.
I
n the U.5. today, there is
increasing concern that envi
ronmental contaminants may be
harming the reproductive health
and fertility of women and men.
Reproductive and fertility problems
appear to be on the rise.
In women:
At least 1Z% of women
reported difficulty in conceiving
and maintaining pregnancy in
ZZ, an increase of 4% from
19BZ.
13B,139
From
19BZ to 1995,
the prevalence
of infertil
ity almost
doubled in
younger women,
ages 1B-Z5.
14,141

A recent update
concludes that the
trend may have
leveled off, although
there is disagreement
on this.
14Z,143
Fibroids and other
fertilityrelated
diseases, like
endometriosis and polycystic
ovarian syndrome, are diag
nosed more frequently now,
which may be the result of a
true increase, better detection,
or both.
144
In men:
According to a large study of
men from the Boston area,
testosterone levels in adult men
are declining. 1his decline is
not explained by an increase in
age or other health or lifestyle
factors such as obesity or
smoking.
145
1esticular cancer increased by
% between 19/3 and Z3 in
the U.5.
14
5perm counts have declined in
men in some areas of the U.5.,
Europe, and Australia.
14/
In children:
ln U.5. girls, puberty is begin
ning earlier than in the past.
14B

A weightoftheevidence
evaluation of human and animal
studies suggests that endocrine
disrupting chemicals, particularly
estrogen mimics and anti
androgens, as well as increased
body fat and certain social
circumstances, can advance the
onset of puberty.
149,15
Reproductive tract abnormalities
are increasing in certain popula
tions. ln one analysis of two
U.5. surveillance systems,
cryptorchidism |undescended
testicle|s increased Z%
between 19/ and 1993.
151

ln some surveillance systems,
the incidence of hypospadias
|deformity of the penis has
increased, whereas in others,
increases have leveled off.
15Z,153
1esticular dysgenesis
syndrome |described
below, resulting from
in utcro exposure to
endocrinedisrupting
chemicals, has been
proposed as an
integrating explana
tion for the observed
increases in testicu
lar cancer, congenital
abnormalities of the
male reproductive
tract, and decreases
in sperm count.
154

lndeed, a growing
and compelling body
of evidence sug
gests that chemical
exposures are likely
to be influencing
many of these trends
in females and
males.
155,15,15/
1he financial con
sequences of these
conditions are highly significant.
ln ZZ, U.5. patients and their
insurers spent an estimated SZ.9
billion on infertility treatments
alone.
15B
exposure
1he CDC has published data show
ing that exposures to endocrine
disrupting chemicals like phthalates,
bisphenol A |BPA, perfluorinated
compounds, and cadmium are
common. 1he CDC reports that al
most everyone has these chemicals
in their bodies, some at levels near
or above those shown in scientific
studies to cause adverse effects
on reproductive health.
159,1,11

Recent investigations show that
higher levels of exposure to
Reproductive Health and Fertility Problems
endocrinedisrupting chemicals are
associated with adverse effects on
reproductive measures and birth
outcomes in the general popula
tion, including reduced sperm
quality in men, premature birth,
low birth weight, and behavioral
changes in children.
1Z,13,14,15,1,1/

1hese findings are consistent
with a large body of experimental
laboratory data.
1he examples below illustrate the
reason for concern about exposure
to some chemicals and the poten
tial impacts on reproductive health.
Unfortunately, there are far more
chemicals about which we have
little or no data on the potential
for negative impacts.
Bisphenol A
Over the past decade, a wealth of
new studies has shown that some
chemicals can act as endocrine
disruptors-chemicals that interfere
with normal hormone function and
regulation. Among these are animal
studies that link prenatal and
earlylife exposures to BPA, which
is found in polycarbonate plastic
and some food and beverage can
linings, to permanent reproductive
changes and increased risks of
later reproductive health problems,
such as infertility and early
puberty.
1B,19
Animal studies also
show that prenatal
exposures to BPA
at levels similar to
those experienced
by people in the
general popula
tion alter the
development of
the prostate and
mammary glands,
increasing the
susceptibility for
developing cancer
later in life.
1/,1/1
ln laboratory
animals, includ
ing nonhuman
primates, BPA previously
was shown to affect
the development of the
brain, causing changes
in gender specific
behaviors.
1/Z
Recently,
a human study re
ported that the higher
a pregnant womans
BPA levels were during
her first 1 weeks of
pregnancy, the more
likely her child was to
later show behavior
somewhat atypical of
its gender at age two.
Girls engaged in more
masculinized behaviors,
while boys were more feminized.
1/3
Phthalates
Prenatal exposure to phthalates
commonly found in personal care
products, as a food contaminant,
and in items made from PvC
plastic, or vinyl, has been linked to
altered development of the male
reproductive system and feminized
behaviors in boys. 5ome research
ers now group the male birth
defects-undescended testicle|s
and deformity of the penis-with
two other conditions of the male
reproductive tract-low sperm
counts and testicular cancer. 1hese
four medical conditions are col
lectively called testicular dysgenesis
syndrome |1D5. Animal studies
suggest that a 1D5like condition
can be observed after fetal expo
sure to phthalates.
1/5
ln November Z9, a study of
mothers and their children found
that boys born to mothers with
higher levels of phthalates in their
urine during pregnancy were more
likely to exhibit feminized behaviors
than boys whose mothers had
lower levels of exposure.
1/
Peruorinated chemicals
5tudies of perfluorinated chemicals,
commonly used in stainproof
and nonstick products, also may
negatively affect reproductive
health. 5ome studies have found
that higher
levels of maternal
exposure to these
compounds are
tied to lower birth
weight in new
borns.
1//,1/B,1/9,1B

Another study
found that Danish
men with higher
levels of perfluori
nated compounds
had fewer normal
sperm and lower
sperm concentra
tions.
1B1
A recent
study of children
living near a
perfluorinated
chemical produc
A wide range of wildlife populations
has been adversely aected by
exposure to endocrine-disrupting
contaminants. Impacts among
birds, sh, shellsh, mammals, and
reptiles include decreased fertility
and increased reproductive tract
abnormalities, feminization and
demasculinization in the males, and
masculinization and defeminization
in the females.
174
tion plant found both boys and
girls had delayed puberty.
1BZ
1hese
findings are particularly concerning,
since exposure to perfluorinated
chemicals is nearly ubiquitous in
the general population, including in
women who are pregnant.
1B3,1B4
Cadmium
Cadmium, a metal used in batter
ies, pigments, metal coatings, and
plastics, is a known testicular toxi
cant and is linked to gynecological
disorders such as endometriosis.
1B5

lt also has been found to have
hormonal properties.
1B
How chemical policy
reform can help
ln June Z9, 1he Endocrine
5ociety, a professional association
devoted to research on hormones
and the clinical practice of
endocrinology, issued a scientific
statement on endocrinedisrupting
chemicals, which stated:
1B/
Thc cvidcncc jor odvcrsc
rcproductivc outcomcs (injcrtiI-
ity, conccrs, moIjormotions' jrom
cxposurc to cndocrinc disrupting
chcmicoIs is strong, ond thcrc is
mounting cvidcncc jor cjjccts on
othcr cndocrinc systcms, incIuding
thyroid, ncurocndocrinc, obcsity
ond mctoboIism, ond insuIin ond
gIucosc homcostosis.
Among the statements recom
mendations for the future is this
suggestion:
As cndocrinoIogists, wc suggcst
thot Thc Lndocrinc Socicty octivcIy
cngogcs in Iobbying jor rcguIo-
tion sccking to dccrcosc humon
cxposurc to thc mony cndocrinc-
disrupting ogcnts.
ln November Z9, the American
Medical Association |AMA passed
a resolution introduced by 1he
Endocrine 5ociety that calls for
the AMA to work with the federal
government to enact new federal
policies to decrease the publics
exposure to endocrinedisrupting
chemicals.
1BB
1hese new federal policies would
come through effective reform of
15CA. Authoritative bodies have
listed more than 5 industrial
chemicals as causing reproductive
toxicity.
1B9
15CA reform should
prioritize action on these and other
chemicals-including bisphenol
A, phthalates, and perfluorinated
chemicals-which have been identi
fied as harmful to reproduction
and development. 15CA reform
also should require evaluation of
the effect of chemicals on repro
duction and child development
before they are introduced into
the market and as a condition for
remaining on the market.
T
he number of people in the
United 5tates with asthma
roughly doubled from 19B to
1995 and continues to rise.
19

Between Z1 and Z9, asthma
prevalence increased 1Z.3% from
Z.3 million to Z4. million
Americans. By Z9, nearly 1 in 1Z
people suffered from the disease.
191
Asthma is one of the most
common childhood chronic
diseases, and a higher percent
age of children than adults have
asthma. Nearly one in ten |9.%,
or about seven million children in
the U.5. have asthma. Diagnoses
are especially high among boys.
1he greatest rise in asthma rates
from Z1 to Z9 was among
black children, with a nearly 5%
increase in prevalence. 5eventeen
percent of nonHispanic black
children had asthma in Z9,
the highest rate among
racial,ethnic groups.
19Z
1he annual costs associ
ated with asthma grew
from about S53 billion in
ZZ to about S5 billion
in Z/, an increase of
5./%. 1hese costs include
medical expenses |S5.1
billion per year, loss
of productivity resulting
from missed school or
work days |S3.B billion
per year, and premature
death |SZ.1 billion per
year.
193
exposure
1he doubling of asthma
rates over the last two
decades has prompted
researchers to examine
the role that various
environmental factors may
play in this trend. Genet
ics alone cannot explain
such dramatic increases
in prevalence over such a short
time.
Asthma is highly likely to result
from the interaction of a complex
mixture of underlying risk factors.
Maternal nutrition, exposures to
environmental contaminants, and
stress can alter fetal lung and
immune system development, not
only prenatally but also after birth
during infancy and childhood.
Postnatal exposures to allergens
and indoor and outdoor air pol
lution also can increase asthma
risk.
194,195
One theory holds that
altered bacterial composition in the
intestine and living in environments
that are too clean can increase
risk as well.
But whatever the explanations
of this troubling trend, extensive
evidence from occupational and
general population epidemiological
studies and medical case reports
documents that hundreds of
chemicals can cause asthma in
individuals previously free of the
disease or can put asthma patients
at greater risk for subsequent
attacks.
19,19/
A Z/ literature review found Z1
studies linking indoor residential
chemical emissions with respira
tory health or allergy problems
in infants or children.
19B
1he
study identified formaldehyde |in
particleboard, phthalates |in plastic
materials, and recent interior
painting as the most frequent risk
factors. Elevated risks also were
reported for renovation, cleaning
activities, new furniture, carpets,
and textile wallpaper. 1able 3
provides an overview of the indoor
sources identified in this study.
A Z4 5wedish study compared
19B young children with asthma
and allergies to ZZ healthy
control subjects. 1he home
environment of every child was
examined, with air and dust
samples taken in the room where
the child slept. 1he children whose
bedrooms contained higher levels
of the phthalate DEHP were more
likely to have been diagnosed with
asthma by a physician.
199
Current
studies are reexamining the possi
ble association between phthalates
and asthma with more rigorous
prospective study designs.
How chemical policy
reform can help
Consumers, retailers, and
other downstream users of
chemicals-including manufactur
ers and distributors of toys and
other products-have a problem
in common: they cannot gain
access to basic information about
the chemicals used to make their
products. Because federal law
does not ensure the right to know
Asthma
what we are exposed to, we dont
have the information we need to
identify all the sources of indoor
air pollution that may be causing
asthma or triggering symptoms.
How can an expectant mother
determine if there is formaldehyde
in the particleboard used to make
cribs and other nursery furnishings?
How does a new father decide
which baby shampoo may contain
phthalates? Why should new par
ents have to worry about whether
potentially dangerous chemicals are
in the products they choose for
their newborn children?
1o be effective, 15CA reform
should include a requirement that
chemical manufacturers publicly
disclose information on the uses of
and health hazards associated with
their chemicals, and the ways that
people could be exposed in their
homes, schools, or places of work.
Table 3: Examples of Chemical Pollutants from Indoor Sources Implicated in Asthma or
Its Symptoms
200
Compounds Example Sources
Aldehydes
Formaldehyde Composite wood and other products with urea
formaldehyde resin, some architectural finishes,
tobacco smoke, and other combustion processes
Aromatics
Benzene, toluene, xylenes,
styrene, ethylbenzene, ethyltol
uenes, and naphthalene
Motor vehicle exhaust, gasoline,fuel, tobacco smoke,
solventbased paints, floor adhesives, PvC flooring,
carpeting, printed material, solventbased consumer
products
Dichlorobenzene Moth balls, bathroom deodorizers
Chlorobenzene Possibly solventbased paints
Aliphatic hydrocarbons
Hexane, nonane, decane, unde
cane, and dodecane
5ome architectural finishes, floor adhesives, PvC
flooring, waxes, aerosol air fresheners
Aliphatics |general Carpet padding, adhesives, caulks, paint
volatile organic compounds |vOCs, other
Methylcyclopentane Motor vehicle exhaust and evaporative emissions
Butanol 5ome architectural finishes
Limonene Cleaning products, air fresheners, many consumer
products
1etrachloroethylene Drycleaning solvent and drycleaned clothing
1richloroethylene Aerosol paints, adhesives, lubricating oils, paint
removers
Phthalate esters
BBZP vinyl flooring, carpet tile, adhesives
DEHP vinyl flooring, PvC plastics
E
PA Administrator Jackson
offered a commonsense
equation in her speech to the
American Public Health Association:
a decline in exposure to toxic
chemicals will result in a decline in
chronic disease and lower health
care costs.
While it is difficult to quantify
how much money would be saved
under 15CA reform, some sense of
the potential savings and economic
gains can be gleaned from sources
that have used sophisticated
modeling to project costs and
savings.
Health and social costs of
hazardous environmental
exposures in children
Researchers estimated that the
annual cost of environmentally
attributed diseases in American
children was S/. billion per
year, or 3.5% of U.5. health
care costs, in ZB.
ZZ
1his is a
conservative estimate, as it only
looked at pediatric lead poisoning,
asthma, childhood cancer, prenatal
methylmercury exposure, intellectual
disability, autism, and attention
deficit hyperactivity disorder.
ln addition to estimating the
significant costs attributed to
environmental exposures in
children, the analysis illustrates
the financial benefits that can be
traced to policy initiatives that led
to reductions in childhood lead
exposure over the past decade.
After Congress passed laws
requiring the removal of lead from
gasoline, paint, food containers,
childrens toys, and municipal
drinking water systems, there was
an B% decline from the 19/s
to the 199s in human exposure
to the heavy metal. Likely because
of the decreased lead exposures,
the researchers identified a 1%
decrease in the annual costs
associated with childhood lead
exposure, as compared to a
previous analysis at the end of the
199s.
Z3
Moreover, the improvement in
cognitive ability associated with
decreased lead exposure is pre
dicted to result in increased worker
productivity, with an estimated
economic benefit to the U.5. of
between S11 and S319 billion
dollars each year.
Z4
Removing lead from gasoline, paint,
and other sources continues to be
one of the most successful efforts
to prevent disease and disability
in the U.5. 1he numbers not only
show that regulation of lead was
directly linked to a drop in blood
lead levels, but the legislative
action saved significant health care
costs and will result in economic
gain due to increased worker
productivity.
What would happen if we did
something similar with the other
known hazardous chemicals in
the marketplace? What kind of
money could the United 5tates
save by preventing exposures
to known harmful chemicals like
formaldehyde, 1CE, and hexavalent
chromium?
We have a significant opportunity
to save Americans money and
eliminate suffering associated with
chronic disease and illness. Re
forming federal law could dramati
cally reduce Americans exposure
to harmful chemicals, as well as
the skyrocketing health care costs
in this country.
If our students are getting sick because weve built schools
in polluted areas, they are going to fall behind. The poor who
get sick because of toxins in their neighborhoods are the
same people who typically seek treatment in emergency
rooms. That drives up health care costs for everyone. And
environmental health issues hold back economic growth.
Let me repeat that, because there are a lot of people who
think that we cant address these issues and strengthen
our economy. In fact, we must address these issues to
strengthen our economy. Environmental health issues hold
back economic growth.
EPA Administrator Lisa Jackson at the American Public Health Association, November 8, 2009
201
Reducing Our Health Care Costs
Conclusion
W
hen the 1oxic 5ubstances Control Act became law in 19/, smoking was permitted in airplanes, hospi
tals, and all other public places. 1here were no laws requiring that children or adults wear seat belts.
Lead was still being added to gasoline. ln the last few decades, Americans and their elected officials have
taken action on all of these issues and witnessed significant improvements in public health.
1he last 3 years of environmental health studies make clear that 15CA reform presents another opportunity
to dramatically improve public health:
Lonccr. Recent research on the timing of chemical exposures and later development of breast cancer
demonstrates why EPA needs the authority to restrict human carcinogens and other toxic chemicals to
which people are exposed. 15CA reform should require that chemical manufacturers demonstrate the safety
of their products.
Lcorning ond dcvcIopmcntoI disobiIitics. New studies demonstrating the ability of small amounts of
chemicals to permanently harm the developing brain illustrate the critical need to reduce or eliminate toxic
chemical exposures, especially during particular time windows of vulnerability. 15CA reform should ensure
that all existing and new chemicals are safe for pregnant women, children, workers, and other vulnerable
populations.
AIzhcimcr`s ond Porkinson`s discoscs. Research suggesting linkages between chemical exposures and
neurodegenerative diseases highlights the unique dangers posed by exposure to persistent, bioaccumulative,
and toxic chemicals |PB1s. 15CA reform should provide for the phase out of PB1s, except for critical uses.
Communities and populations that bear disproportionately high burdens of legacy contamination should be
the focus of exposure reduction efforts.
Rcproductivc hcoIth ond jcrtiIity probIcms. Findings on reproductive health and fertility problems make the
case for prioritized regulatory action on bisphenol A, phthalates, perfluorinated compounds, and other
endocrinedisrupting chemicals that new science identifies as harmful to reproduction and development.
Asthmo. 1he growing body of research linking asthma to chemical exposures demonstrates why 15CA
reform should require chemical manufacturers to publicly disclose information on the uses of and health
hazards associated with their chemicals, and the ways that people could be exposed in their homes,
schools, or places of work.
We know that chronic diseases are the result of multiple, interacting risk factors. 5tudies increasingly show
that exposures to environmental chemicals are among them. 1he interplay of variables begins before concep
tion and continues for an entire lifetime. While we have undertaken public health measures to address many
of the risk factors that lead to common diseases, we are constrained by an antiquated statute-unchanged for
more than thirtyfive years-that interferes with our capacity to reduce exposures to harmful chemicals and to
learn about the hazards of chemicals before fetuses, infants, children, and adults of all ages are exposed to
them. 1his must change.
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The Safer Chemicals, Healthy Families coalition includes nurses, parents,
advocates for the learning disabled, scientists, environmental health
advocates, and concerned citizens from across the nation. These diverse
groups are united by their common concern about toxic chemicals in our
homes, places of work, and products we use every day.
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.$",/(0&1")*,*$-
www. SaferChemi cal s. org

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