making the link: protecting health from environmental exposures vi waghiyi sarah petras...
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Making the Link:Making the Link:Protecting Health from Protecting Health from
Environmental ExposuresEnvironmental Exposures
Vi Waghiyi Sarah [email protected] [email protected]
(907) 222-7714 phone(907) 222-7715 fax
Our mission: Our mission: To assure justice by advocating for environmental and community
health. We believe everyone has a right to clean air, clean water and toxic-free food.
Core Values: Core Values: Community right-to-know Environmental justice Precautionary principle Elimination of the production and release of toxics Rights and sovereignty of Indigenous peoples Culture of caring and wellness
Environmental Health and Environmental Health and Justice in AlaskaJustice in Alaska
Addressing Environmental Addressing Environmental Health Issues in AlaskaHealth Issues in Alaska
Respond to community calls for assistance Conduct community-based participatory research (CBPR) Ensure community right-to-know Advocate for health and justice through prompting of protective,
precautionary local, state, national and international policy changes Field and community health investigations GIS computer mapping
Toxic Waste Sites in AlaskaToxic Waste Sites in Alaska
The north has become a hemispheric sink for pesticides and other industrial chemicals
Northern food webs favor the deposition and retention of persistent, bioaccumulative toxics
Contaminants in the north threaten the health of peoples that rely on traditional diets of fish and marine mammals
Global warming enhances the mobilization and transport of contaminants from local and distant sources
Contaminants in the NorthContaminants in the North
The North is a Hemispheric SinkThe North is a Hemispheric Sink
Formerly Used Defense SitesFormerly Used Defense Sites
Elder Annie Alowa from Savoonga, Alaska, pictured at Formerly Used Defense Site on St. Lawrence Island
Where is St. Lawrence Island?Where is St. Lawrence Island?
Located in the Pacific Ocean, between Russia and the U.S.
Disease PatternsDisease PatternsObserved on St. Lawrence Island Observed on St. Lawrence Island Cancers Thyroid disease Diabetes Heart disease Low birth weight babies, premature births, still births, miscarriages Other reproductive health problems
PCBs in Blood Serum of PCBs in Blood Serum of St. Lawrence Island PeopleSt. Lawrence Island People
Levels of PCBs in the blood of St. Lawrence Island Yupik people 6-9 times higher than average in lower-48 populations
Evidence of PCBs accumulating in the Arctic via global transport
Military contamination also a significant source
Published in the International Journal of Circumpolar
Health (Carpenter et al., 2005)
Total Average PCB
0
2000
4000
6000
8000
10000
12000
Gambell NE Cape Savoonga
Co
nce
ntr
atio
n (
pg
/g)
Average for populations in the lower-48
Formerly Used Defense Sites in Formerly Used Defense Sites in Norton Sound, AlaskaNorton Sound, Alaska
Specific AimsSpecific Aimsfor Environmental Health and Justice for for Environmental Health and Justice for
Norton Sound, Alaska Project Norton Sound, Alaska Project Identify sources of contaminants, including
those from military and long-range, atmospheric sources
Describe past and current health problems Increase the capacity of the health care
system in Norton Sound to properly diagnose and treat health effects linked with environmental contaminants
Work toward responsible cleanup of contaminated sites and prevent new sources of contaminants
Assist Norton Sound communities in securing training and tools needed to establish independent programs operated by the villages to monitor contaminants
Project partners: 15 Villages in Norton Sound Region State University of New York Alaska Community Action on Toxics Norton Sound Health Corporation Other researchers at Clarkson
University, St. Lawrence
University, Environment
Canada, Health Canada,
University of Alaska,
National Marine Fisheries
Service, and University of
California
Environmental Health and Justice Project Environmental Health and Justice Project for Norton Sound, Alaskafor Norton Sound, Alaska
(above) Morgan Apatiki, Community Health Researcher from Gambell, AK, collecting food samples for our Traditional Food Study
(upper right) Student testing water quality in Nome, AK during 2008 Field Institute
(right) Field sampling in Elim, AK, 2007
Environmental Health ProgramsEnvironmental Health Programs
Training for community health and field researchers
Field Institute Quarterly seminars for Village
Health Aides & other health care professionals
Environmental Health Care Toolkit Alaska Collaborative on Health and the
Environment
Independent research informs clean-up decisions
Promoting proper diagnoses and treatment of environmental health effects
Better oversight and holding military accountable for clean up
Influencing public health policy to prevent exposures from this and other formerly used defense sites and long-range transport
Community Health Implications of Community Health Implications of Norton Sound ProjectNorton Sound Project
Reproductive Health and the Reproductive Health and the EnvironmentEnvironment
“…exposure to low-level contaminants may be subtly undermining our ability to reproduce.”
Environmental Health Perspectives, journal of the
National Institute of Environmental Health Sciences 2006
Health of Arctic Children Health of Arctic Children ThreatenedThreatened
““Alaska Native infants Alaska Native infants have a much higher rate of have a much higher rate of
hospitalization for infection than hospitalization for infection than any other group of U.S. infants… any other group of U.S. infants…
Prenatal exposure to Prenatal exposure to contaminants, which are known contaminants, which are known to affect the developing immune to affect the developing immune
system, could play a role, system, could play a role, and that possibility is and that possibility is now being examined.”now being examined.”
-Dr. Jim Berner, pediatrician, Alaska Native Dr. Jim Berner, pediatrician, Alaska Native Tribal Health ConsortiumTribal Health Consortium
Birth Defects in AlaskaBirth Defects in AlaskaData from the Alaska Birth Defects Registry
shows: Birth prevalence of major congenital anomalies in
Alaska is twice as high as in the United States as a whole
Alaska Native infants have twice the risk of MCAs as white infants born in Alaska
Recommendations for women include: Avoid contact with known or suspected
environmental teratogens
“…even independent of differences in cigarette smoking, alcohol consumption and maternal age—which is a well-known
risk factor for birth defects—Alaska Natives still have an increased risk ... that we don't really know how to explain."
Dr. Bradford Gessner, Maternal and Child Health Epidemiology unit
Adverse Birth Outcomes Adverse Birth Outcomes Associated with Open Dumpsites Associated with Open Dumpsites
in Alaskain AlaskaMothers residing in villages with high hazard ranking were: 43% more likely to have a low birth weight baby 45% more likely to give birth prematurely More likely to have babies afflicted with intrauterine growth retardation
Gilbreath, S. and Philip Kass. 2006. American Journal of Epidemiology.
Chemicals Associated with Chemicals Associated with Reproductive Health EffectsReproductive Health Effects
Commonly-used pesticides Polychlorinated biphenyls (PCBs) Chemical additives (used in production
of plastics, e.g., bisphenol A) Perfluorinated compounds (used in
production of stain-resistant, water-repellant, or non-stick surfaces)
Chemical additives to beauty and self-care products (e.g. phthalates)
Polybrominated diphenyl ethers (PBDEs) (used as flame retardants in household upholstery and electronics)
Health Concerns associated Health Concerns associated with Metals Miningwith Metals Mining
Blasting, crushing operations mobilize toxic air emissions
Leaching of heavy metals into streams and rivers can harm fish and drinking water sources
Cyanide used in leaching process is lethal at very small doses
Negative effects on quality of life, social, cultural and emotional impacts
Lone Tree and Marigold Mines in NV—photo by Peter Essick
Toxics Release Inventory—Mines are Toxics Release Inventory—Mines are Among Largest Industrial Polluters Among Largest Industrial Polluters
of Toxic Chemicalsof Toxic Chemicals Red Dog Mine
533,421,591 lbs of toxic chemicals released in 2007 with increasing trend
Largest polluter in the nation, 4 times that of any other facility in the U.S.
Red Dog Mine-Ikalukrok Creek Junction
Environmental Health Care Environmental Health Care ToolkitToolkit
Designed for Village Health Aides in Alaska for use in clinics Purpose: To promote proper diagnosis, treatment, and prevention
of health problems linked to environmental contaminants in Alaska A work in progress… We welcome your feedback!
With about 1,000 pounds of dental equipment, a Dental Health Aide Therapist awaits a ride after traveling to Point Hope, AK by airplane.
Collaborative EffortCollaborative Effort
Village Health Aides provide village-specific information on prevalent exposures and diseases to cover in toolkit materials
EHC Toolkit Advisory Group (comprised of Community Health Aides, local physicians, and community field researchers) contributes to and reviews all toolkit materials
Annual Community Health Aide Program (CHAP) Forum Annual Alaska Tribal
Conference on Environmental Management (ATCEM)
Toolkit ContentsToolkit Contents Foreword Introduction Environmental Health History and Assessment Resources for More Information Environmental Health Care Fact Sheets
Household Toxics Hazardous Waste
Reference Cards on prevention of exposure for patients
Map of Villages and Federal Defense Facilities
Protecting Our Health in Alaska: a poster for clinics and homes
Symptoms of environmental exposures can be misdiagnosed as common symptoms of other diseases
Exposures can occur in the home, at work, from food and water, from hobbies, and from outdoor activities
Taking an environmental health history is important in determining if patients had an environmental exposure and making a correct diagnosis
Environmental Health History & Environmental Health History & Assessment FormAssessment Form
Environmental Health Care Environmental Health Care Fact SheetsFact Sheets
Fact sheets contain information about: what the contaminant is how exposure occurs symptoms of exposure what to do for patients showing exposure symptoms how to prevent or reduce exposure
Toolkit will 25-30 contain fact sheets on chemicals of concern in the Norton Sound region, including chemicals associated with household toxics, hazardous waste, mining, and FUDS
Reference CardsReference Cards Tips on how to prevent or reduce exposure Handouts for patients Example:
REDUCING YOUR EXPOSURE
You can minimize your exposure to bisphenol-A in the following ways:
• Use glass, stainless steel, or polyethylene bottles (PETE, PET, or #1; HDPE or #2; LDPE or #4) instead of polycarbonate (PC or #7) bottles.
• Avoid heating foods in polycarbonate containers, as bisphenol-A tends to leach faster with higher temperatures. Use glass or ceramic containers instead.
• Cut back on consumption of canned foods to reduce exposure to bisphenol-A contamination from the interior coating of the container. Also, avoid canned foods with higher fat content, which may have higher levels of bisphenol-A.
• Before getting dental sealants, check with your dentist about the ingredients in the products they use, as some formulations may leach bisphenol-A.
PosterPoster
Provides information on potential exposures
Tips on how to reduce exposures
Designed for clinics, waiting rooms, community buildings, and homes
Now available!
MapsMaps
Contains the Map of Villages and Federal Defense Facilities in the Norton Sound Region
Other statewide and regional maps of toxic waste in Alaska are available on ACAT website: www.akaction.org/Mapping.htm
Resources ListingsResources Listings Non-governmental organizations (NGOs) Government agencies Publications and other materials (books, websites, online
databases, etc.) Scientific journal articles and ACAT Health Bulletins
For Example:Alaska Community Action on Toxics (ACAT): www.akaction.org
Collaborative on Health & the Environment (CHE): www.healthandenvironment.org Access the CHE Toxicant and Disease Database:
database.healthandenvironment.org
Agency for Toxic Substances and Disease Registry (ATSDR): www.atsdr.cdc.gov
Pediatric Environmental Health Editor Ruth A. Etzel, MD and Associate Editor Sophie J. Balk, MD
Skin Deep Cosmetics Safety Database: www.cosmeticsdatabase.com
For more information, see full resources listings in toolkit
Additional ResourcesAdditional Resources
Journal Articles Polychlorinated Biphenyls in Serum of the Siberian Yupik People
from St. Lawrence Island, Alaska (Journal of Circumpolar Health) Adverse Birth Outcomes Associated with Open Dumpsites in
Alaska Native Villages (American Journal of Epidemiology) Health & the Environment Bulletins
Body of Evidence: Reproductive Health and the Environment Diabetes: The Role of Persistent Toxic Chemicals in this
Complex Disease
Any Questions?Any Questions?
Thank you!