Inside Prevention

California poised to enact historic flame retardant labeling law

A statement by Breast Cancer Fund Director of Program and Policy Janet Nudelman

You have a right to know whether or not toxic flame retardants are in a couch you’re thinking about buying. And fortunately, people in the state of California may soon be equipped with that knowledge because of the passage of a bill in the assembly and senate this week.

Sen. Mark Leno’s bill, which next heads to Gov. Jerry Brown’s desk, requires disclosure of the use or absence of flame retardant chemicals on furniture labels. The Breast Cancer Fund has testified in favor of the bill in Sacramento and applauds Sen. Leno’s ongoing commitment to this issue in the face of unrelenting opposition from the chemical industry.

During the past several years there has been growing public outcry about flame retardants, which are ineffective at preventing fires and are linked to cancer, decreased fertility, hormone disruption, lower IQ, hyperactivity and other health concerns. A stunning investigative series in the Chicago Tribune, uncovered the devious industry tactics that propelled huge quantities of toxic flame retardant chemicals into American homes, and set the stage for a widely acclaimed HBO documentary Toxic Hot Seat.

As a result, several state legislatures have banned flame retardants in furniture. In March, Gov. Jerry Brown’s administration issued new rules requiring the evaluation of the safety of the flame retardant TDCPP (chlorinated Tris) and its alternatives used in children’s sleep products sold in the state. That followed a decision by Gov. Brown in 2013 to overturn Calif.’s TB 117, which required the use of toxic flame retardants in furniture. All of this progress has come in spite of years of efforts by the chemical industry to thwart any regulation of its multi-billion dollar flame retardant business.

In addition to children and families, it’s important to keep in mind other populations deeply impacted by these ubiquitous chemicals such as firefighters. When flame retardants burn, they produce extremely hazardous smoke. And as firefighters across the country face higher than average rates of cancer it’s imperative for us to remember the occupational hazards associated with these concerning chemicals.

We implore Governor Brown to sign this important bill into law: It will not only give Californians the information they need to avoid toxic ingredients in their furniture, but will also compel manufacturers to stop including these useless chemicals in the first place.

The right to know about fracking chemicals

A Q&A with Breast Cancer Fund Director of Science Sharima Rasanayagam

What do you see as the biggest problem with fracking?

We're in an uncontrolled experiment. We know, from a Congressional investigation, that companies sometimes use carcinogens such as benzene, formaldehyde, ethylene oxide in fracking, but companies do not share their use of these chemicals with nearby communities.   It’s a huge right to know issue, we don’t know which chemicals are being used when and companies should not be able to put carcinogens into our environment.

What else concerns you?

As well as the chemicals used in the fracking fluid itself, there is the waste water that comes back out, called flowback water. This can be contaminated not only with fracking chemicals but also with chemicals, including radioactive compounds,  that naturally occur deep underground but are now in the waste water which needs to be disposed of safely.

Who is affected by fracking?

Primarily rural communities who face fracking in their own backyards, but urban communities may be affected as well because of contamination of downstream groundwater sources. Rural communities are also adversely impacted by the industrialization of their local environment including a huge influx of diesel machinery and vehicles and the air pollution they bring.   

What is the Halliburton loophole?

The Energy Policy Act of 2005, a bill signed into law by George W. Bush, offered tax incentives and other programs for energy production. The bill created a loophole, also known in advocacy circles as the Halliburton loophole, which exempted fluids used in fracking from protections under the Clean Air Act, Clean Water Act and Safe Drinking Water Act. This means that companies do not have to disclose the chemicals involved in fracking that would normally be required under federal laws. It is called the Halliburton loophole because of former Halliburton CEO Dick Cheney’s role in passing the legislation.

What do you think has been lost in media coverage of fracking?

I think a lot of the attention to fracking has focused on the economic effects rather than the environmental and health effects.  That’s probably because people think there are things like the Clean Air Act and Clean Water Act to protect people and their environments. The short-term economic realities have mainly driven decision making so far.

There’s obviously a lot of powerful interests and money at play here. How do you think change can happen in spite of all that?
Changing the federal law would be a big hurdle to overcome because there’s an entrenched industry that’s quite happy being exempt from federal environmental provisions. In a number of states they are asking for either moratoriums on fracking until they know more, or for disclosure of all chemicals that are going into their water supplies. It doesn’t seem like a lot to ask.

I have great respect for Sandra Steingraber and her push to stop fracking. Because of people like her there are ongoing efforts throughout the country by state and local governments to stop fracking, at least until we know more, including more than 170 New York towns and cities.

What can people do about it?

Add your voice to the rising chorus of people concerned about this issue. Tell your representatives in Congress that you have a right to know about toxic fracking chemicals being released in your own backyards.  The Fracturing Responsibility and Awareness of Chemicals Act (FRAC Act) would remove the exemption for fracking from the Safe Drinking Water Act and require disclosure of the chemicals used in fracking wells. 

Anything else to add?

In California, as we face one of the worst droughts on record, we need to be aware of how much water we’re using for fracking. Fracking contaminates water, and the millions of gallons of water used to frack a well can’t be used for anything else. 

Learn more about this issue during our FREE Fracking Web Chat with the amazing Sandra Steingraber on Wed., Sept. 3, 2014 at 4 p.m. PT./7 p.m. ET

About Sharima Rasanayagam, Ph.D., Director of Science

As the director of science, Sharima oversees the Breast Cancer Fund’s science-related activities, including monitoring and interpreting emerging research, and developing and managing science-related program and policy initiatives. She also serves on the advisory committee of the California Breast Cancer Research Program, the largest state-funded breast cancer research effort.  Sharima holds a Ph.D. in microbiology from the University of Kent at Canterbury, U.K.

The Case for Transparency: Unveiling the Dirty Secrets of Industry

Guest blog by Breast Cancer Fund Senior Policy Strategist Nancy Buermeyer

On Thurs., Aug. 21, the Breast Cancer Fund joined Earthjustice and 4 other health, labor and environmental groups in filing a petition with the Environmental Protection Agency (EPA) requesting that the agency establish time limits for confidentiality claims regarding chemical information submitted by industry under the Toxic Substances Control Act (TSCA).

Under TSCA, industry has wide latitude to claim chemical information is confidential, meaning companies can hide chemical information from state and local governments, medical professionals, health organizations, research institutions and the general public. Companies frequently designate the very identity of the chemicals they use as confidential business information (CBI). The EPA has limited authority and even fewer resources to challenge these designations, so the vast majority of CBI claims are simply accepted without serious review of their legitimacy.

As a result more than half of the 24,000 chemicals approved for use in commerce since 1982 are secrets!

And once designated as CBI, this information remains secret indefinitely, regardless of whether or not there ever was or there remains justification for this secrecy. We believe that the identity and basic safety information on ALL chemicals in commerce should be made available—and industry should bear the burden of proof to show that chemicals are safe.

The lack of access to this information impedes the right of the public to know what chemicals we are exposed to as well as the ability of government and academic scientists to further study the potential health risks.

Industry abuse and lack of EPA enforcement has led to reams of data about potentially toxic chemicals being shielded from public scrutiny. It’s past time for the EPA to more fully exercise its authority under TSCA to, at the very least, limit the duration of these “confidentiality claims.” Weighing corporate secrecy versus the health of our families is an easy call; it’s time for the EPA to act to protect families. 

Q&A: NIEHS scientists explain findings of breast cancer study

A recent study conducted by scientists at the National Institute of Environmental Science found that women who work with organic solvents had a greater risk for developing breast cancer. Researchers used data on women taking part in the Sister Study, which has followed more than 50,000 women whose sisters had breast cancer. Lead authors, Christine Ekenga and Dale Sandler, answered our questions about the meaning and significance of the study.

What are organic solvents and why should we care about them?
Organic solvents are chemicals that are used to dissolve other compounds. Some of the health hazards associated with solvent exposure include respiratory irritation, reproductive damage, heart damage, and liver and kidney damage. Solvents have also been associated with some cancers. Health effects are more likely to occur with higher levels of exposure. The health effects of low level exposures (one time or over a long time period) are less well established.

Millions of workers are exposed to organic solvents on a daily basis. What kinds of jobs expose people to them?
Solvents are found in a variety of products, such as cleaning products, degreasers, detergents, paint thinners and dry cleaning solutions. For example, women who work as clinical laboratory technicians, maids, and factory workers, may be exposed to organic solvents on the job.

Could you explain the methods used in this study?
The Sister Study is a long-term study of more than 50,000 women who have had a sister with breast cancer. When the study began, none of the participants had been diagnosed with breast cancer. At enrollment, we collected information about their lifestyle, reproductive history, and work history, including solvent exposure at different time periods. For this analysis, we analyzed data from approximately 47,000 women who provided detailed work histories. Our analysis was designed to identify associations between solvent exposure before they entered the study and the development of breast cancer afterward.

What did your study find specifically?
We observed that women who started working with solvents before their first full-term birth had a greater risk for breast cancer.

Are there other studies that demonstrate a link between organic solvents and breast cancer?
Yes. Solvents have been shown to cause breast tumors in animals.

There’s a difference in risk for women who have had children and those who have not. Could you explain that?
We know that the time period between puberty and before first birth is an important period of development when the breast may be more vulnerable to chemical exposures. We also know the breast undergoes changes during pregnancy. Our findings support the hypothesis that chemical exposure during a vulnerable period of breast development may increase the risk of breast cancer in women.

What first attracted you to this area of research and what spurred this specific study?
Few studies have looked at occupational exposures in women. What is unique about the Sister Study is that we have collected a large amount of information about occupational and environmental exposures from more than 50,000 women. Because solvents have been shown to cause breast tumors in animals, we were interested in looking at the relationship between solvents and breast cancer in humans.

Tell me about the Sister Study- why is this study important?
The Sister Study is a long-term study of more than 50,000 women who have had a sister with breast cancer. The women come from all over the country and Puerto Rico, from all walks of life. Its goal is to examine the impact of environmental and occupational factors on breast cancer risk. When we began the study, many other large breast cancer studies were already in progress, but most of them focused on dietary, lifestyle, and reproductive factors. We wanted to not only concentrate on associations between environment and breast cancer risk, but also study the combined effects of genetic and environmental factors that may increase the chances of getting breast cancer.

Sisters of women with breast cancer have about twice the risk of developing breast cancer as other women, so by studying large numbers of them for at least 10 years, the Sister Study is much more powerful than other breast cancer studies.

How does this study differ or compare with the Brophy study?
The Brophy paper examined breast cancer risk associated with endocrine disruptor chemicals in the workplace. While both studies identified several occupations in which solvent exposure was associated with an elevated risk of breast cancer, including production occupations, there are several differences.

The Brophy paper examined endocrine disrupting chemicals as a group, while our study focused on solvents. The Brophy study was a case-control study, which compared women with breast cancer to a control group of women without breast cancer. In contrast, the Sister Study was a prospective cohort study, which means we collected exposure information before the women were diagnosed with breast cancer. Brophy and colleagues used experts to classify jobs based on how likely they were to include the use of specific chemicals, while we relied on what women told us about their use of solvents on the job. Despite these differences, both studies are important first steps toward understanding the relationship between work-related chemical exposures and breast cancer in women.

Dale P. Sandler, Ph.D is a senior investigator and Branch Chief of the Epidemiology branch at the National Institute of Environmental Health Sciences (NIEHS). She is Principal Investigator of the Sister Study and other large prospective cohort studies, including studies of pesticide applicators and their families and persons who helped clean up after the 2010 Deepwater Horizon oil spill in the Gulf of Mexico.

 

Christine C. Ekenga, Ph.D. is a Postdoctoral Fellow in the Epidemiology Branch at NIEHS. At NIEHS she studies risk factors for breast cancer and health effects of the Gulf of Mexico oil spill.

Has the tide turned on BPA? (Storify)

UCSF develops game-changing method to translate research on toxic chemicals and prevent disease

By David Tuller, Dr.PH.

Everyone wants to know more than we currently do about the long-term effects of everyday exposures to toxic chemicals. Even obstetricians, who could be expected to have a handle on the science, report not knowing how to advise their pregnant patients, according to a recent survey led by colleagues at the University of California at San Francisco’s (UCSF) Program on Reproductive Health and the Environment.

Why has it been so difficult to draw authoritative conclusions about the impacts of toxic exposures? For one thing, we lack data. In the case of pharmaceuticals, drug companies are required to prove safety and efficacy with clinical trials in which some participants are given the medication and others are not. Such experiments are impossible with chemicals. The kinds of data that the Food and Drug Administration uses to make decisions about pharmaceuticals is simply not available—and not obtainable—for chemicals.

That means relying on other sources of information. Laboratory and animal experiments can demonstrate a chemical’s negative impacts on living organisms, but interpreting what those findings mean for human beings is difficult. Human observational studies provide solid evidence of associations between chemical exposures and specific health outcomes but drawing conclusions about causes is more challenging. That’s because of the possibility that some other, unmeasured factor—another environmental exposure, a genetic predisposition, or something else—was responsible for the outcomes observed.

In the field of medicine, the push for “evidence-based” decision-making—clinical care based on solid reviews of the available data rather than on doctors’ hunches and instincts—has transformed practice in recent decades. Without the same kind of evidence base as medicine, environmental health has lagged behind in applying findings from the science to public policy. The field lacks a rigorous method for assessing the quality and strength of the data streams from both laboratory experiments and human observational studies—and emerging with conclusions that are solidly grounded in the scientific literature.

To address that methodological gap, UCSF’s Program on Reproductive Health and the Environment has been leading an initiative to develop such a method, with participation from other academic centers, government agencies, and non-governmental organizations. In four papers just published by Environmental Health Perspectives, the researchers describe the method, called the Navigation Guide, and road-test it with a widely used chemical that virtually everyone in the U.S. is routinely exposed to—perfluorooctanoic acid, or PFOA.

The goal of the Navigation Guide is to help reduce the time lapse between scientific discoveries and the development of appropriate health policies. Speeding the process of translating findings into action could help to significantly reduce disease prevalence and health care expenditures. The U.S. health care system, for example, was estimated to have spent more than $75 billion on childhood illnesses associated with environmental exposures; changed policies leading to lower exposure levels could both improve health outcomes and trim costs.

“Due to deficiencies in the current regulatory structure for manufactured chemicals, a failure or delay in acting on the science means that exposure to toxic chemicals persists while evidence of harm mounts,” reports one of the papers. “To the extent that science informs public policy to prevent harm, a robust method to synthesize what is known about the environmental drivers of health in a transparent and systematic manner is a necessary foundational step to making the science actionable.”

In the series of EHP papers, the researchers tackled the question of whether PFOA exposure affects fetal growth in humans. The chemical has been used widely in industrial and consumer products for more than 50 years, and it persists in the environment. Virtually all Americans are exposed to it, and numerous studies have examined its relationship to fetal growth.

The Navigation Guide methodology involves four steps:

1. To specify a study question relevant to decision-makers about the health risks posed by a chemical or class of chemicals
2. To conduct a systematic search for published and unpublished evidence regarding the study question
3. To rate the quality and strength of the evidence of toxicity, including integrating separate reviews of the human and non-human evidence
4. To grade the overall strength of the recommendations for proposed public health policies by integrating the evidence of toxicity with information about other factors, such as exposure levels, the availability of less toxic alternatives, and public values and preferences.

In the PFOA case study, the team was able to synthesize the human and non-human findings and issue a clear, “strength-of-evidence” conclusion: developmental exposure to PFOA, wrote the researchers, “adversely affects human health based on sufficient evidence of decreased fetal growth in both human and non-human mammalian species.” The chemical, they determined, is “known to be toxic.”

So what are the health policy implications of that direct, evidence-based statement? That question—the heart of Step 4 of the Navigation Guide—has not yet been fully explored. Creating policy from science is always a messy business, given that people approach the problem from a vast array of political, social and economic perspectives. But no effective action is possible without a neutral, authoritative statement of what the science tells us. And now, at least in the case of PFOA’s effects on fetal growth, we know.

David Tuller, Dr.PH. is academic coordinator of UC Berkeley's joint masters program in public health and journalism. He was a reporter and editor for 10 years at the San Francisco Chronicle, served as health editor at Salon.com and frequently writes about health for The New York Times.

 

The North Face climber gains new perspective on climb

When Marlyss Bird signed up to represent The North Face at Climb Against the Odds, she didn't really know what she was getting herself into. She's not a breast cancer survivor and nobody in her immediate family has had the disease. Summiting a mountain was on her bucket list and she wanted to do it for a cause.

But after arriving at Mt. Shasta and learning about some of the stories driving her teammates, she started to understand the significance of the Climb.

Her rope team included Leslie Kelly and Bridget Vanoni, a mother-and-daughter pair from Sonoma, Calif. Leslie has survived two breast cancer diagnoses and has climbed Mt. Shasta three times with the Breast Cancer Fund.  

Marlyss was inspired by Leslie's determination and strength. "Just to see her strength out there- after what she’s been through and going through. And just to see Bridget’s quiet strength and to think about how scary that must be to have your mom go through that twice and to see mom sick and struggling. It was really impressive to see them work so hard to get to the top."

Marlyss, Leslie and Bridget were the first to summit Mt. Shasta that day.

"I was not aware that we were on our way to being first to the summit until our guide, Eric, said something at the top of the West Face," Leslie said.  "It made me smile; not in a competitive way, but at the ease of which it was happening."

The three women barely spoke.

"There was this quiet focus about the three of us...almost eerie, but beautiful," Leslie said.  "Marlyss and I didn’t know each other well, we barely spoke the entire climb, but we know each other now. I don’t know how to explain that feeling; there were no words, we didn’t need them."

The 2015 team is forming! Reserve your spot: www.breastcancerfund.org/climb

Guest blog: Breast cancer survivor, Leslie Vanoni, on climbing Mt. Shasta

The sun still shining, the inside of our tent warm and bright, we are told to at least rest even if we can't fall asleep. Bridget whispers to me "I am nervous". I whisper back, "Me too". Earlier she told me she wished people would stop treating us like we were the experts because we have climbed before. I agreed; all it really meant was we knew how much work was ahead.

On the hard, uneven ground in my sleeping bag beside Bridget - I can't sleep; the tent flapping in the heavy wind holds my attention. I will the wind to stop but it keeps blowing. I turn on my side, my face inches from Bridget's. She is asleep. My eyes fill with tears looking at her bleach blond curls and tanned face peaking out of a bright blue mummy sleeping bag. Was I crazy to bring my young daughter not once, but twice, with me to climb Mt. Shasta? Or am I the luckiest mom in the world? I decide I am both.

Frederique (a close friend of my sister's and now like a sister to me) emailed me the day we started our climb last year to tell me she'd been diagnosed with breast cancer. In passing, I told her we were climbing again this year and suggested she join us, and bam!, she and her son signed up. I have been so grateful to share this experience with her, her son Arthur, as well as Bridget this year.

With the wind howling and head lamps lighting the way, our team of six left base camp at 3 AM. Slowly and methodically we followed our guides up the mountain, split into groups of three. We roped ourselves together and changed to crampons and ice axes. Frequent but short breaks for water and food kept us warm as we progressed. On one break, we sat under the Red Banks with the sun just coming up and our guide asked how long I'd been in remission. Two and a half years since my second diagnosis, I told him. Eric then shared that his mother was diagnosed a second time with metastatic breast cancer (just like me) when he was in the 7th grade (young, like Bridget). For a few moments there was only silence - each one of us acutely aware of why we were there, roped together. Finally I gathered the courage to ask if she survived. When he replied "it's been over twenty years, and she will be at the dinner Thursday night"...my heart filled with hope. 

Eric, Marlyss, Bridget and I reached the summit first. Totally spent, Bridget and I laid on the ground, barely aware of our photo being taken, and a fellow climber asked how it felt to reach the top this time. With relief, I realized I hadn't thought about reaching the summit at all this year. The following morning - dirty, dazed and euphoric - we hiked back down. Arthur said "you're my Aunt Leslie now". 

My spirit continues to heal with every step on every Climb Against the Odds with the Breast Cancer Fund. 

Thank you for supporting the work of the Breast Cancer Fund to prevent Breast Cancer before it starts.

It feels good to be cheered down a mountain by a throng of friends, supporters and family members

Our Climb Against the Odds 2014 team made it back to civilization today in high spirits. Twenty of the 25 climbers made it to the top of the 14,179-foot Mount Shasta. The remaining five climbers made it to at least 11,500 feet, which is also an amazing feat. 

As they arrived at Bunny Flat they were greeted by friends, family and supporters after having transformative experiences up on the mountain with their teammates. 

Jill Zastko, a breast cancer survivor who carried Breast Cancer Fund Founder Andrea Martin's talisman up the mountain called the Climb the most incredible experience of her life. At one point, other people on her rope team had turned back and her guide wasn't sure whether or not she could keep going. She decided she to go on, and as she approached the West Face of Mt. Shasta, another rope team that was farther ahead started cheering for her. It was an emotional and inspiring moment, which helped her push through and make it to the top. Congratulations to Jill and all the other climbers.  

Jill Zastko on Mt. Shasta (photo by Cathy Ann Taylor)

For Ruth Walter, a cheese shop owner from Bronxville, N.Y., the climb was humbling. She climbed Mt. Shasta to mark her five year anniversary from treatment and reached the top. "I couldn't have done it without my teammates,

"I have never been drawn to the walk for the cure or anything like that. I don’t really like pink or ribbons or self identifying as a breast cancer survivor. I feel like it’s kind of inundated our lives and I really like  the Breast Cancer Fund's emphasis on prevention." 

Ruth Walter on Mt. Shasta (Photo by Cathy Ann Taylor)

Stay tuned as more pictures from the mountain are posted to Flickr and as we wrap up this year's Climb Against the Odds.

Climbers slide back in to base camp

Many of the climbers glissaded, or slid, back to base camp as you can see below.

 

Leslie Kelly, Bridget Vanoni, Marlyss Bird, Lucas Parsons, Arthur Morgan, Lindsey Dal Parto, Tessa Montgomery, Cathy Ann Taylor, Frederique Mary, Barbara Winter and Maryann Maineri are all relaxing at base camp.

We expect the final last group to arrive at base camp in the next 30 minutes.

Everyone is doing great despite their tired feet.