CDC Issues
New Guidelines on Interpreting and Managing Blood Lead Levels Less than 10 Micrograms
per Deciliter in Children
On November 2, the U.S. Centers for Disease Control and
Prevention (CDC) published new guidelines for interpreting and managing blood
lead levels below 10 micrograms per deciliter (µg/dL) in children. In
1991, the CDC defined the blood lead level (BLL) that should prompt public health
actions as 10 µg/dL. At the same time, CDC also recognized that a BLL
of 10 µg/dL was not the lowest level at which harmful effects of lead
in blood would be seen. Research conducted since 1991 has strengthened the evidence
that children's physical and mental development can be affected at BLLs lower
than 10 µg/dL. Some advocates have criticized CDC for declining to redefine
its blood lead level of concern as a lower concentration, and they hold that
CDC’s standard itself wrongly encourages parents and health professionals
to believe that BLLs 10 µg/dL are safe. In part, the new CDC guidance
is an attempt to address these concerns and provide a more nuanced picture of
lead exposure.
Because most medical and environmental interventions still
occur at levels of 10 µg/dL or greater, the new CDC guidance seeks to
assist doctors where knowledge may be less: treating and managing blood lead
levels below the level of concern. The report, published in Morbidity and
Mortality Weekly Report, summarizes the findings of a review of clinical
interpretation and management of BLLs below 10 µg/dL conducted by a CDC
advisory committee. The report also provides information to help doctors understand
BLLs below 10 µg/dL, identifies gaps in knowledge concerning lead levels
in this range, and outlines strategies to reduce childhood exposures to lead.
In addition, the report summarizes scientific data relevant to counseling, blood
lead screening, and lead exposure risk assessment.
Legislation
Intended to Ban Asbestos Does No Such Thing
Leading Democratic senators appear to have caved to industry
lobbyists in watering down legislation that was originally intended to completely
ban asbestos. According to observers, the legislation, which passed the Senate
in October, no longer bans the extremely hazardous substance in a variety of
products.
Sens. Patty Murray (D-WA) and Barbara Boxer (D-CA) claim
that EPA and others support the bill as passed. They also claim that the concessions
they made to powerful lobbyists were necessary in order to get the bill through
the Senate and to meet with President Bush’s approval.
However, EPA staff say they don’t support the legislation
as written because they’re worried it doesn’t go far enough. EPA
officials even took the extraordinary step of drafting a letter to the House
Committee on Energy and Commerce, which is poised to take up the Senate’s
bill. The letter was to say, “To protect public health and the environment
from asbestos hazards, the ban should target any products in which asbestos
is intentionally added or knowingly present as a contaminant.” However,
the White House Office of Management and Budget (OMB) overruled the independent
agency, telling EPA it could not submit the letter.
Victims of asbestos exposure and public health experts
are even more adamant, outraged that Democratic leaders gave in to special interest
demands and put the health and lives of Americans at risk. Even minute exposure
to asbestos fibers can cause severe disease, including several rare forms of
cancer.
In early November, the House-Senate Appropriations Conference
Committee approved the appropriation for the Departments of Transportation and
Housing and Urban Development and related agencies for FY 2008. Included in
this bill is the appropriation for HUD's Office of Healthy Homes and Lead Hazard
Control. On November 15, the House voted to approve this bill by a margin of
270-147. This is not quite a veto-proof (two-thirds) majority, and President
Bush has threatened to veto this bill because it appropriates $3 billion more
than he proposed ($50.9 billion versus $47.9 billion). It's not yet clear whether
the Senate will vote on this soon; the chamber may wait until December, amid
rumors that the Transportation-HUD appropriations bill will be wrapped into
a larger “omnibus” package with up to ten other appropriations bills.
In summary, the Transportation-HUD bill would provide $145
million for all lead hazard control and healthy homes programs in FY08. (By
comparison, the appropriation in FY 2007 was $151 million. Bush had proposed
an appropriation of only $116 million for FY08.) The healthy homes demo, technical
studies, Operation LEAP and Lead Outreach grant programs would each be provided
with $8.8 million. Another $48 million would be provided for the lead hazard
reduction demonstration program (for places with "highest lead paint abatement
needs"). Bush’s FY08 budget proposed to eliminate this program.
In early November, Bush vetoed the Labor-Health and Human
Services-Education appropriations bill, which, among other things, contains
the budget for the Centers for Disease Control and Prevention, an agency on
the front lines of lead poisoning prevention, and the Administration for Children
and Families, which provides part of the funding for the Low Income Home Energy
Assistance Program (LIHEAP). The House subsequently failed to override the veto.
The president’s veto and unwillingness to budge on the funding levels
in the bill puts the health of millions of children and low-income people at
risk, especially given rapidly rising home heating prices that are poised to
impact the United States this winter.
Clinton
Introduces New Lead Poisoning Prevention Legislation
Sen. Hillary Clinton (D-NY) announced on October 26 the
introduction of a far-reaching bill to significantly increase funding for and
improve coordination among federal, state and local government agencies; require
pre-lease and pre-sale inspections and risk assessments for lead paint hazards
and repair of any hazards identified; create a federal requirement for building-wide
risk assessment and hazard abatement in all properties that are the primary
residence of a child with an elevated blood lead level; create interagency task
forces on both lead hazards and children’s environmental health and safety;
require at least five percent of federal Low-Income Housing Tax Credit funds
to be spent on lead hazard control; and establish pilot projects to target areas
of high incidence of lead poisoning in children, including “repeat offender”
properties. The bill would increase funding for HUD’s Office of Healthy
Homes and Lead Hazard Control to $230 million per year for the next three years.
The bill is known as the Lead Elimination, Abatement, and Poisoning Prevention
(LEAPP) Act (S. 2244).
As CPSC Reform
Bill Advances, New Allegations of Industry Influence Arise
The CPSC Reform Act of 2007, S. 2045, advanced in the Senate
in late October. On October 30, the Senate Commerce Committee approved the bill,
which is sponsored by Sen. Mark Pryor (D-AR). Among other things, the legislation
would dramatically expand the budget and staffing of the Consumer Product Safety
Commission (CPSC), which is responsible for product safety and keeping lead
and other dangerous substances out of children’s toys. By 2014, the bill
would double the agency's budget and increase staffing levels to 500, from current
levels of 420.
The bill would also expand the agency's regulatory authority
by officially limiting to trace amounts the presence of lead in children's products
and enabling the agency to levy stiffer civil penalties against violators of
federal regulations. To ensure greater safety, the bill would require children's
products to be certified by "a nongovernmental independent third party
qualified to perform such tests." Companion legislation in the House is
also making progress in that chamber; the House bill would require third-party
testing of toys and set an even stricter limit on lead than S. 2045.
The movement of the twin pieces of legislation comes at
a time when the agency is under intense and well-deserved scrutiny from Congress,
the media, and the public. Countless toy recalls over the summer and fall plagued
the agency and the nation’s largest toy manufacturer, Mattel. Again and
again, toys, mostly made in China, have been found to contain high levels of
lead or lead-based paint, posing a danger to American children. One such recall,
which did not affect Mattel, involved fake Halloween teeth called Ugly Teeth.
The teeth were found to be coated with lead-based coloring.
CPSC’s previous lax enforcement of product safety
regulations and the recent spate of recalls may be explained in part by the
influence that industry has been exerting on the agency since President George
W. Bush took office in 2001. CPSC’s current acting chair, Nancy Nord,
and her predecessor, Hal Stratton, accepted more than 30 trips financed by industry.
Industries, some of which had immediate business before the CPSC, footed the
bill for nearly $60,000 in airfare, hotel, and food for Nord and Stratton. Nord
has strongly opposed the House and Senate legislation to reform and strengthen
her agency.
EPA Staff Says Amount
of Lead in Ambient Air Should Be Reduced
On November 1, scientists at the U.S. Environmental Protection
(EPA) agency recommended cutting the current air pollution limit for lead, or
National Ambient Air Quality Standard (NAAQS) for lead, by up to 96 percent.
The scientists’ recommendation comes as part of a
long-overdue review of the lead NAAQS. The standard is supposed to be reviewed
and updated every five years; however, EPA hasn’t updated the lead limit
since 1978, despite a myriad of studies showing that even very small amounts
of lead can impact the development and IQ of children and the health of adults.
EPA officials have not committed to a firm timetable to
release a proposed new standard, though they have mentioned to the media that
it’s possible that they will have something ready by March 2008. The officials
did not signal whether they would listen to their own experts and adopt the
staff recommendations.
New
Federal Asthma Guidelines Stress Importance of Safe Pest Control
New guidelines from the National Asthma Education and Prevention
Program (NAEPP) for diagnosing and treating asthma emphasize safer pest control,
including integrated pest management (IPM), as an important part of the solution.
Asthma is one of the most common health problems in the
United States and significantly affects peoples' lives at school, at work, at
play, and at home. More than 22 million people in the United States have asthma,
including 6.5 million children under age 18, according to the Centers for Disease
Control and Prevention (CDC). The disease kills 4,000 Americans each year.
An IPM approach to pest control can effectively reduce
pest populations while simultaneously reducing pesticide exposure in indoor
environments. IPM is a safer, more effective, and scientific approach to managing
pests. IPM uses knowledge of pests’ habits and needs to help residents
implement pest prevention tactics as a first line of defense. Because pesticides
are poisonous, they are chosen only as a temporary tool in IPM and may not have
to be used at all. Only pesticide products that pose the least toxic, least
risk of exposure to residents are chosen in an IPM program.
Recent studies suggest that mouse and rat allergen exposure
and sensitization are common in urban children who have asthma. The NAEEP suggests
mouse allergen exposure can be reduced by a combination of IPM tactics such
as blocking access, low-toxicity pesticides, traps, vacuuming, and cleaning.
Cockroach sensitivity and exposure are also common among
patients who have asthma and live in inner cities. In a study of asthma in an
inner-city area, asthma severity increased with increasing levels of cockroach
antigen. The NAEPP guidelines recommend that cockroach control measures such
as good sanitation and using low-toxicity poison baits, gels, boric acid, and
traps are preferred to sprayed chemical agents, because the latter can trigger
asthma attacks. IPM practitioners also know that using pesticide sprays against
cockroaches is ineffective, only killing those insects that come in direct contact
with the spray and scattering the rest. The roaches that only receive non-lethal
doses or that flee the spray often return, producing offspring that are more
resistant to pesticides.
National
Center for Healthy Housing Updates Guidance on IPM in Affordable Housing
The National Center for Healthy Housing in November released
an updated webpage devoted to integrated pest management (IPM) in affordable
housing.
The web resource includes:
Model request for IPM-based pest control services for
public housing authorities and private sector affordable housing property
managers;
Analysis of HUD's Guidance on IPM reissued on May 24;
Guidance on finding an IPM contract by helping property
managers compare the five major programs that recognize pest control leadership
(GreenShield, QualityPro,
Safety Source for Pest Management, EcoWise, and IPM
Registry);
IPM in Multi-Family Housing training course materials;
Global
Green Publishes Second Edition of Blueprint for Greening Affordable Housing
Global Green, a U.S.-based green building organization,
recently released the second edition of its comprehensive Blueprint for
Greening Affordable Housing. The publication is available for order on
the organization’s website for $20.
The Blueprint for Greening Affordable Housing
offers housing developers, designers, advocates, public agency staff, and the
financial community specific guidance on green practices and innovative strategies
for incorporating green building into the design, construction, and operation
of affordable housing.
Topics addressed include:
How green building adds value to affordable housing
The integrated design process
Best practices in green design for affordable housing
Green operations and maintenance
Innovative funding and finance
Emerging programs, partnerships, and policies
The Blueprint also includes 12 case studies of
model developments, including rental, home ownership, special needs, senior,
self-help, and cohousing from around the United States. Each case study describes
the unique green features of the development, discusses how they were successfully
incorporated, considers the project’s financing and savings associated
with the green measures, and outlines lessons learned.
Paint
Companies Prevail in Major Milwaukee Lead Poisoning Suit
On November 5, a jury in Milwaukee found several former
lead pigment manufacturers not guilty in a lawsuit filed against them by teenager
Steven Thomas. The jury said that while Thomas proved that he had ingested white
lead carbonate, the toxic ingredient in lead-based paint, it was not convinced
that the lead had caused brain damage or other adverse health effects. The jury’s
findings go against current lead poisoning prevention science, which shows that
even small amounts of lead are harmful to children.
The companies, including Sherwin-Williams, believe they
have been vindicated by winning the lawsuit. However, the companies lost a major
decision at the Wisconsin Supreme Court in 2005, when the court ruled that Thomas
had the right and standing to sue the corporations for causing his injuries.
Though the court did not rule on the merits of the case, the decision sent a
clear signal to the lead industry that, if a plaintiff can prove harm using
a “market-share” theory of liability, judges and juries in Wisconsin
have the authority to hold the industry accountable.
One of Thomas’s attorneys has vowed to appeal the
jury’s verdict.
New
Research Published on Lead Exposure and Violent Crime
New research conducted at Amherst College on lead exposure
and violent crime was recently published in the B.E. Journal of Economic
Analysis and Policy. Titled “Environmental Policy as Social Policy?
The Impact of Childhood Lead Exposure on Crime,” the research combed through
numerous studies on the psychological and behavioral impacts of childhood lead
poisoning and examined the social results of decreased lead exposure in children
in the 1970s and 1980s.
According to the research abstract, “Childhood lead
exposure can lead to psychological traits that are strongly associated with
aggressive and criminal behavior. In the late 1970s in the United States, lead
was removed from gasoline under the Clean Air Act. [The researcher] uses the
state-specific reductions in lead exposure that resulted from this removal to
identify the effect of childhood lead exposure on crime rates.... Mixed evidence
supports an effect of lead exposure on murder rates, and little evidence indicates
an effect of lead on property crime. Overall, [the researcher] finds that the
reduction in childhood lead exposure in the late 1970s and early 1980s was responsible
for significant declines in violent crime in the 1990s and may cause further
declines in the future. Moreover, the social value of the reductions in violent
crime far exceeds the cost of the removal of lead from gasoline.”
Toxic
Chemical Research Funneled to Industry-Sponsored Groups
In September, EPA awarded two toxic chemical exposure risk
grants to nonprofit research organizations that are supported by the chemical
industry. A total of $1.5 million flowed to the Hamner Institute; the Chemical
Industry Institute of Technology (CIIT), which is part of Hamner; and The LifeLine
Groups. Hamner and CIIT are heavily funded by the chemical and pharmaceutical
industries, and LifeLine has ties to chemical industry giants including Monsanto.
Some of the chemicals to be studied are present in the home as they exist in
and can possibly escape from cookware.
One of the grants was issued for the study of carbaryl,
a common pesticide manufactured by Union Carbide, the company responsible for
the Bhopal, India, chemical disaster in the 1980s. The other grant will fund
research into perfluorooctanoate (PFOA) and perfluorooctanesulfonate (PFOS),
chemicals manufactured by DuPont and used to produce Teflon and other non-stick
products; independent scientists have raised a growing number of red flags about
the toxicity of both PFOA and PFOS.
Neither Union Carbide nor DuPont currently directly fund
any of the research institutes. However, both companies are members of the American
Chemistry Council (ACC), the chemical industry’s powerful lobbying arm.
ACC is a major support of the Hamner Institute. Before its merger with Hamner,
CIIT was directly funded by both Union Carbide and DuPont.
The chemical industry’s financial support of all
three groups calls into question their independence and objectivity, as well
as EPA’s decision to award important toxic chemical research grants to
organizations that are largely funded by the very industry EPA is charged to
regulate.
Study
Links Asthma with Household Cleaners, Air Fresheners
On October 15, the American Journal of Respiratory
and Critical Care Medicine published a study that demonstrated links between
household cleaners and air fresheners and asthma.
The study found that people who used spray cleaners such
as glass cleaners, furniture cleaners and polish, and air fresheners were 50
percent more likely to develop or have increased asthma symptoms compared to
those individuals who did not use such cleaners or used them only infrequently.
The study also showed that as the frequency of spray cleaner use increased,
so too did the risk of asthma symptoms. Non-spray cleaning products were not
associated with asthma symptoms, nor were spray products that were used very
infrequently.
The study’s authors cautioned that limitations of
the study include the fact that information about cleaner use and symptoms is
based on participants’ memories, not on actual observation of people cleaning
their homes and developing symptoms. Nevertheless, they concluded that sprays
may be more likely than other cleaning products to induce asthma because it’s
far more likely that spray particles will reach the airways and lungs.
In September, the Alliance for Healthy Homes, the National
Center for Healthy Housing, the Sierra Club, and the Natural Resources Defense
Council filed a petition urging the EPA and the Consumer Product Safety Commission
to more strictly regulate the chemicals in air fresheners because many contain
known human carcinogens and potent respiratory irritants. For information about
the petition, see www.afhh.org/res/res_alert_archives_septoct07.htm#airfresheners.
Research:
Lead Exposure Accelerates Chronic Kidney Disease
A study published in early October finds that lead exposure
accelerates chronic kidney disease by raising blood pressure and accelerating
injury to kidney tissues and blood vessels. The findings were published in the
American Journal of Physiology–Renal Physiology.
Lead exposure has long been associated with high blood
pressure (hypertension), arteriolosclerosis, kidney disease, and gout. Studies
in workers exposed to lead have confirmed these associations. Other studies
have suggested that even low levels of lead in the blood can be associated with
higher frequencies of high blood pressure and chronic kidney disease.
The new study, the first of its kind in an animal model,
shows that low level lead exposure accelerates chronic renal disease, primarily
by raising blood pressure and accelerating certain kinds of cellular injury.
New
Environmental Health Resources Database Now Available
The Institute for Children's Environmental Health recently
launched a searchable database of resources on environmental health for various
audiences. The database is designed so that users can select not only the medium
(books, journals, videos, etc.), the environmental and toxics issues, and the
health issues of interest, but also the target audience. Once users make specific
selections, links to online resources are provided.
