The Case for Transparency: Unveiling the Dirty Secrets of Industry

Breast Cancer Fund - August 22, 2014
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...
Categories: Health

Drought in Western U.S. Has Caused Land to Rise, Researchers Say

Yale Environment 360 - August 22, 2014
The western U.S. has lost so much water during the ongoing severe drought that the land has sprung up by

GPS station in California's Inyo Mountains as much as 15 millimeters (0.6 inches), according to a study in the journal Science. Water at the surface of the earth typically weighs down the land, but the region has lost enough water that the tectonic plate underlying the western U.S. has undergone rapid uplift, much like an uncoiling spring, researchers explain. California's water deficit over the past 18 months has caused some of its mountain ranges to rise by more than half an inch, and the West overall has risen by 0.15 inches, according to the study. Using ground positioning data from GPS stations throughout the region, researchers from the University of California, San Diego, estimate the water loss to be 240 gigatons (63 trillion gallons) — equivalent to a nearly four-inch layer of water spread out over the entire western U.S.
Categories: Environment, Health

Antarctica and Greenland Losing Ice at Fastest Rate Ever Recorded

Yale Environment 360 - August 21, 2014
Ice sheets in Greenland and Antarctica are losing mass at an unprecedented rate of 500 cubic kilometers per

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Antarctic ice elevation year — enough ice to cover the Chicago metropolitan area with a layer of ice 600 meters thick — according to German researchers. Using data from the European Space Agency's CryoSat 2 satellite from 2011 to 2014, the team created the most detailed maps to date of ice elevations across Antarctica and Greenland, accurate to a few meters in height. The results reveal that Greenland alone is losing ice volume by about 375 cubic kilometers per year, doubling since 2009, the scientists report. Ice loss in the West Antarctic Ice Sheet has increased by a factor of three over the same period. Combined, the two ice sheets are thinning at the highest rate observed since altimetry satellite records began about 20 years ago, the study found. Data show that East Antarctica is gaining ice volume, but at a moderate rate that doesn’t compensate the losses on the continent's other side.
Categories: Environment, Health

New herbicide and GE seeds: EPA and USDA poised to approve herbicide with insufficiently unexamined cumulative and long-term health effects

Pump Handle - August 20, 2014

If the US Environmental Protection Agency (EPA) and the Department of Agriculture (USDA) give their approval to a new herbicide called Enlist Duo and to corn and soybean seeds genetically engineered (GE) to resist that chemical, the United States could see a significant increase in what is already one of the country’s most widely used herbicides. Yet while the EPA seems poised to approve Enlist Duo and USDA, the GE seeds, about 50 members of Congress have written to EPA Administrator Gina McCarthy and Secretary of Agriculture Tom Vilsack expressing their “grave concerns” about “the multiple adverse human health, environmental, agronomic and socioeconomic harms that approval of 2,4D crops will likely cause.”

The EPA says that “on the basis of protective and conservative human health and ecological risk assessments,” it has “confirmed” the new herbicide’s safety “for the public, agricultural worker and non-target species,” but many questions remain about effects of cumulative and long-term exposure, particularly for farm workers and others living near where it’s used. What makes these questions particularly pressing is that the new product combines two of the country’s three most widely used herbicides.

Enlist Duo and the corn and soybean seed engineered to tolerate it – both produced by Dow AgroSciences – were developed in response to the explosion of herbicide resistant weeds that has resulted from the past 15 to 20 years’ rapid expansion in use of glyphosate (the active ingredient of the herbicide sold as Roundup), now the country’s most commonly used herbicide. Enlist Duo would combine glyphosate with what’s called a choline salt of the herbicide 2,4 D – the United States’ third most widely used herbicide. The seeds engineered to resist this combination would enable farmers to use 2,4D on weeds without also destroying the corn and soy plants. The new product, writes the EPA, would “provide an additional tool to reduce the spread of glyphosate resistant weeds.”

2,4-D use could increase by 300 to 700 percent

Yet at the top of the list of the Congressional Representatives’ concerns, and most of the more than 300,000 public comments submitted to EPA as part of the agency’s pesticide approval process, are the human and environmental health effects of the expected increase in 2,4D use that will result from planting 2,4D-resistant corn and soy. (And just to clarify, the term “pesticides, as the agency explains on its “About Pesticides” page, is used to include herbicides as well as fungicides and other substances used to control pests.)

The USDA’s Animal and Plant Health Inspection Service (APHIS) says that expected planting of new 2,4D-resistant seeds could prompt a nearly 300 to 700 percent increase in use of 2,4D by 2020. This is not a hyperbolic projection. According to the USDA, Between 1997 and 2014, the acreage planted in glyphosate-resistant soybeans rose from about 10 to 94 percent; glyphosate-resistant corn from about 10 to 89 percent; and cotton from about 10 to 91 percent of all such crops planted in the US. At the same time, glyphosate use climbed at a similarly steep rate.

The bottom line is essentially that as weeds develop resistance, the more herbicide is needed to control them. As Washington State University research professor and agricultural scientist Charles Benbrook pointed out in his comments to EPA, “There are now more than two-dozen glyphosate-resistant weeds covering perhaps 70+ million acres.” 2,4D resistant weeds have already been reported in the Midwest.

Human exposure concerns

When it comes to human exposure, pesticide drift is a major concern. USGS surveys have found glyphosate and 2,4D to be prevalent in streams throughout the Midwest which has some of the country’s highest concentration of use. These chemicals have also been found in groundwater.

The EPA explains that Enlist Duo is designed to “reduce volatility and off-site movement of the herbicide compared to other forms of 2,4-D.” Proposed conditions of the registration would require 30-foot buffers, and the product’s label instructions would specify that the herbicide not be used when winds are over 15 miles per hour. Aerial applications would be prohibited. The EPA also explains that because it has already approved glyphosate and 2,4 D and no new uses of glyphosate are expected to occur with use of Enlist Duo, no new health assessment is needed for that ingredient. But because use patterns of 2,4D are expected to change if Enlist Duo is approved, health impacts of 2,4D have been assessed as part of the EPA’s registration process.

Occupational and long-term exposure data gaps

 While the EPA’s assessment makes 2,4-D sound generally safe, the agency cautions that there is potential for “post-application” exposure for those working or otherwise present where 2,4D has been used. (This includes accidental ingestion by young children playing on “turf” where 2,4D has been applied.) As for occupational exposure, EPA says, “occupational risk handler estimates are not of concern…for all scenarios for use of 2,4D choline salt on GE corn and soybean.” Yet the agency did not investigate inhalation or dermal exposure, explaining that given the low acute toxicity via inhalation and “no potential hazard via the dermal route,” no assessment was done for either as part of EPA’s Enlist Duo review.

But 2,4 D is not only used on corn and soybeans. It is also used on wheat, rice, barley, oats and other grains, on sugar cane, on nut and fruit tree crops (almonds, apples, apricots, cherries, oranges, grapefruit, tangerines, hazelnuts, nectarines, peaches, pears, pecans, peanuts, pistachios, plums, and walnuts) as well as asparagus and sweet corn. It is also used on pasturelands, on turf used for lawns, on landscaping plants and to control weeds along roads, railroads, in managed forestlands and with other non-crop plants. Most of these uses involve greater worker presence in treated orchards and fields than do corn and soybean cultivation.

A DowAgro Sciences material safety data sheet for 2,4D says people should not reenter fields for at least 12 hours after the herbicide has been applied. It also says “do not permit lactating dairy animals to graze fields within 7 days after application,” to withdraw meat animals from treated fields at least 3 days before slaughter,  not to harvest “forage within 30 days of application” or harvest “treated mature crop” within 60 days of application. Incidental damage to vegetable crops is also a potential problem.

The National Pesticide Information Center at Oregon State University explains on its 2,4D fact sheet that “Breathing 2,4-D vapors can cause coughing, a burning feeling in the airway, and dizziness” and that “Sunscreen, insect repellents, and drinking alcohol may increase how much 2,4-D is absorbed through the skin.” Epidemiological studies of farm workers exposed to 2,4D and other pesticides found an increase in rates of non-Hodgkin’s lymphoma, but it has not yet been determined whether or how 2,4D may have contributed to this outcome, so EPA does not consider 2,4D a human carcinogen. Studies done in the 1980s and ‘90s of 2,4D used in combination with another pesticide found links to adverse reproductive effects that included birth defects and miscarriages.

While acute effects of 2,4D appear to be few, Science and Environmental Health Network Science Director* Ted Schettler points out that the compound’s non-acute effects on thyroid hormone function may contribute to health effects that would take time to become apparent but that can lead to significant health problems. “Adequate maternal, fetal, and infant thyroid levels are necessary for normal brain development,” says Schettler. Even slightly abnormal thyroid hormone levels during pregnancy “are associated with adverse impacts on brain development and function in children measures several years later,” he explains. Further, according to the US Centers for Disease Control and Prevention (CDC) about one-third of US women of reproductive age aren’t getting enough iodine for healthy thyroid hormone production and “most of us,” says Schettler, are exposed to “environmental chemicals that can disrupt thyroid hormone function in a variety of ways.”

“Thus, as I see it,” says Schettler, “within the general population, there is a significant subset with marginal or frankly inadequate thyroid status at baseline.  That’s a very different population than a bunch of healthy rats eating a healthy diet at baseline.”

“We are…concerned that EPA failed to thoroughly examine all of the significant health and environmental risks of 2,4-D including that of inhalation and aggregate exposure… The risks of approving 2,4-D crops are simply too great and the benefits too few to jeopardize public health, the environment and the long-term sustainability of our food supply. We therefore request EPA not register Enlist Duo for use on 2,4-D crops and USDA the regulated status for 2,4-D resistant crops,” wrote Representatives Chellie Pingree (D-ME), Peter DeFazio (D-OR) and colleagues in their July 31st  letter to EPA and USDA.

USDA’s final environmental impact statement on the Enlist Duo-resistant corn and soybean seeds is open for public comment until September 8th.  The EPA’s comment period closed June 30th. As of this writing neither EPA nor USDA had responded to the Congressional representatives’ letter. Unless the agencies have a dramatic reversal, we’re likely to see a dramatic increase in use of an herbicide with largely unexamined cumulative and long-term environmental health impacts.


*Ted Schettler also serves as Science Director for the Collaborative on Health and the Environment but SEHN is, he points out, his home institution; an earlier version of this piece omitted Schettler’s affiliation with SEHN.


Elizabeth Grossman is the author of Chasing Molecules: Poisonous Products, Human Health, and the Promise of Green ChemistryHigh Tech Trash: Digital Devices, Hidden Toxics, and Human Health, and other books. Her work has appeared in a variety of publications including Scientific AmericanYale e360Environmental Health PerspectivesEnsia, The Washington Post, Salon and The Nation. 


Categories: Health

Exporting Coal to Korea Could Slash Emissions by 21 Percent, Analysis Finds

Yale Environment 360 - August 20, 2014
Exporting U.S. coal to South Korean power plants could cut greenhouse gas emissions by 21 percent compared to burning it at less efficient U.S. plants, according to researchers at Duke University. The strategy could also generate more than $25 billion in economic activity in the U.S. and cut emissions of sulfur dioxide, nitrogen oxide, and particulate matter, the researchers say. For those benefits to occur, however, U.S. plants would need to replace the exported coal with natural gas, and South Korea must use the imported coal to replace dirtier sources of coal. South Korea's coal-fired power plants are newer and significantly more efficient than those in the U.S. — efficient enough to offset emissions associated with shipping the coal across the globe, the researchers say. However, they also caution that further studies are needed to assess the scenario's full environmental impacts, including water use, land use, and the degradation of vital habitats.
Categories: Environment, Health

Interview: Drones Are Emerging As Valuable Conservation Tool

Yale Environment 360 - August 20, 2014
Ecologist Lian Pin Koh is co-founder of a project called, which is pioneering the use of Lian Pin Koh low-cost drones in conservation efforts and biological research across the globe. In an interview with Yale Environment 360, Koh, a researcher at the University of Adelaide, explains how drones – also known as unmanned aerial vehicles (UAVs) – can help monitor protected areas, collect data in inaccessible regions, and even deter poachers. “In just the last couple of months,” he says, “there has been tremendous interest from universities and other research institutes that finally see the value in this technology.”
Read the interview.
View a gallery.
Categories: Environment, Health

New study finds link between mass job losses and teen suicide behaviors

Pump Handle - August 19, 2014

Previous research has documented a link between downturns in the economy and suicide among adults. But how do those downturns ripple throughout families and communities, and in particular, how do massive job losses affect the mental health of teens? A new study has found that, sadly, many teens are not immune to the stress of a struggling economy.

Published online last week in the American Journal of Public Health, researchers found that increases in statewide job losses are associated with heightened suicide-related behaviors among adolescent girls and black teens. Specifically, the study found that job losses among 1 percent of a state’s working-age population increased the probability of young girls and black teens reporting suicide-related behaviors by 2 to 3 percentage points. The same job losses did not have an impact on the suicide behaviors of boys, whites or Hispanics. To conduct the study, researchers examined Youth Risk Behavior Survey data as well as Bureau of Labor Statistics data between 1997 and 2009. The study noted that youth suicide is a “serious public health concern,” with suicide being the third leading cause of death for young people ages 10 to 24 years old.

Anna Gassman-Pines, a lead author on the study and an assistant professor public policy, psychology and neuroscience at the Center for Child and Family Policy at Duke University, said that on one hand, the results weren’t entirely unexpected, considering previous research on adults. On the other hand, Gassman-Pines told me that the results were somewhat surprising, as the uptick in teen suicide behavior was an indirect effect of job loss — in other words, it’s very unlikely that it was the affected teen who lost the job.

So, if the results tell a story of mostly indirect effects, how can researchers be sure of a link? Gassman-Pines responded that if the study only examined one period of time, researchers might be worried that the uptick in suicide behaviors was due to other variables. However, this study gathered more than a decade worth of data, and researchers consistently found the same unfortunate trends. Gassman-Pines also noted that the data covered periods of economic boom and recession, and so the findings are “not just a story about recession – it’s really a story about when these mass layoffs and closings occur, what are some of the consequences?”

Gassman-Pines and her colleagues found that job losses among 1 percent of the working-age population increased the probability of teen girls reporting suicidal ideation by 2 percentage points and suicide plans by 2.2 percentage points. Among black adolescents, the same job losses increased self-reported suicidal ideation by 2.3 percentage points, suicide plans by 3.1 percentage points and suicide attempts by 2 percentage points. The study noted that job losses seemed to exacerbate pre-existing gender gaps, as girls are more likely than boys to engage in suicide-related behavior and experience serious mood or anxiety disorders. Also, while black youth tend to experience lower levels of suicide-related behaviors and mental illness overall, the study results are consistent with previous research finding that local job losses are associated with a disproportionate use of emergency psychiatric care among black teens. Gassman-Pines and study co-authors Elizabeth Oltmans Ananat and Christina Gibson-Davis write:

Follow-up analyses increased our confidence that the association between statewide job loss and adolescent suicide-related behaviors was not attributable to other aspects of states’ economic circumstances, including the unemployment rate, poverty rate, gross domestic product, or home mortgage delinquency rate. These results suggest that our measure of job loss was not simply a proxy for other aspects of a state’s economic climate but instead represented a meaningful economic shock that led to changes in girls’ and black adolescents’ suicide-related behaviors.

“I think most importantly, we should all be thinking about the widespread effects of these kinds of layoffs and business closings,” Gassman-Pines told me. “We tend to think about the people who have been laid off as the only affected people who may need services and while certainly they’re the most affected, we’d benefit from thinking about the needs that go beyond the directly affected workers.”

She said the study findings may be particularly useful to schools, social service workers, after-school programs and other community stakeholders who regularly work with young people and at-risk youth.

“These are big enough job losses that people are generally aware of them, so just knowing about this link might help (stakeholders) intervene early and prevent suicides down the road,” she said.

To request a full copy of the study, visit the American Journal of Public Health.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.

Categories: Health

Wind Energy Prices at All-Time Low, According to U.S. Report

Yale Environment 360 - August 19, 2014
The cost of wind power in the U.S. is at an all-time low of 2.5 cents per kilowatt hour, according to a new report

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Major U.S. wind farms from the U.S. Department of Energy, and utility companies are in some cases electing to use wind as an energy source over fossil fuels because of its low cost. Although wind power grew modestly in 2013 — installations were only 8 percent of those seen in the record year of 2012 — it now meets 4.5 percent of U.S. energy needs, producing enough electricity to power 16 million homes. The country ranks second only to China in installed wind capacity, the report says, and wind power accounts for 33 percent of all new U.S. electric capacity additions since 2007. That progress has been heavily dependent on federal, state, and local incentives, however, and wind power's growth could slow if those incentives expire. Its viability could also fall if natural gas becomes more affordable than wind, the report cautions.
Categories: Environment, Health

“Alcohol was the weapon of choice for these men”: Peer groups may be key to stopping campus rape

Pump Handle - August 18, 2014

On NPR’s Morning Edition earlier today, Laura Starecheski reported on efforts to use peer groups to prevent young men from becoming rapists. She set the stage by talking with psychologist David Lisack about a study he (and colleague Paul M. Miller of Brown University School of Medicine) conducted among male University of Massachusetts Boston students and published in Violence and Victims in 2002. Knowing that the majority of rapes are never reported to authorities, and wanting to know whether serial rapists were responsible for many of them, Lisack and Brown took a direct approach: They asked men to tell them about any rapes they had committed. Starecheski summarizes their findings:

He surveyed about 1,800 men, asking them a wide range of questions about their sexual experiences. To learn about sexual assault, he asked things like, “Have you ever had sex with an adult when they didn’t want to because you used physical force?” When the results came back, he was stunned.

All told, 120 men in the sample, or about 6 percent of the total, had raped women they knew. Two-thirds of those men were serial rapists, who had done this, on average, six times. Many of the serial rapists began offending before college, back in high school. … Together, the 120 men in Lisak’s study were responsible for 439 rapes. None was ever reported.

The questions didn’t ask “have you committed rape”; instead, rapists were identified by their “yes” answers to questions like “Have you ever had sexual intercourse with someone, even though they did no want to, because they were too intoxicated (on alcohol or drugs) to resist your sexual advances (e.g., removing their clothes)? Of the 120 men whose responses identified them as rapists, 81% reported raping women who were incapacitated by drugs or alcohol, while smaller percentages admitted to using force.

Lisack interviewed men who’d committed rapes, and they described tactics such as preparing punch with sweet juice and a potent mix of alcohol, so young women would become drunk quickly. (The current online text version of the story doesn’t contain all the chilling quotes; listen to the audio version for more on how rapists scope out their victims and get them into situations where they’ll be vulnerable.) Starecheski summarizes the rapists’ thinking:

Alcohol was the weapon of choice for these men, who typically saw themselves as college guys hooking up. They didn’t think what they had done was a crime.

“Most of these men have an image or a myth about rape, that it’s some guy in a ski mask wielding a knife,” says Lisak. “They don’t wear ski masks, they don’t wield knives, so they don’t see themselves as rapists.”

In fact, they’d brag about what they had done afterwards to their friends. That implied endorsement from male friends — or at the very least, a lack of vocal objection — is a powerful force, perpetuating the idea that what these guys are doing is normal rather than criminal.

If such tacit acceptance from male peers is preventing rapists from understanding that they are criminals, perhaps explicit condemnation could prevent men from becoming rapists. That’s the thinking behind the intervention Starecheski profiles: Mentors in Violence Prevention, or MVP. At a few Sioux City, Iowa high schools, older students are matched with incoming students, and the older students facilitate discussions about relationships, alcohol, and sexual assualt. Younger students have a chance to think about what they’d do in situations where a rape might occur, and discuss responses. Starecheski talked to one former MVP mentor, Tucker Carrell, who’s now a junior at Iowa State University:

Tucker says that he’s not afraid to confront his Delta Tau Delta fraternity brothers when they talk about women in a way that makes him uncomfortable. He’ll sit down with them, sometimes even bringing a woman they’ve hit on into the conversation.

The day we talked, Tucker said he’d used his MVP training to intervene in a situation just the night before.

This was at a going-away party at a bar in Ames, Iowa. Tucker noticed that a friend’s female cousin was pretty drunk. She was over by the jukebox with two guys who weren’t part of the party. They were strangers. Tucker says he was paying attention to her body language, and something didn’t look right. She looked almost cornered.

Carrell and a friend went over to the jukebox, picked out a song, and then casually asked the young woman if she’d like to head back over to the table to see her cousin. She did, and that was the end of the situation.

What struck me in listening to Tucker Carrell’s description of the jukebox situation is that his ability to pick up on non-verbal cues from across the room is impressive and, I’m guessing, not something every male college student possesses. (In the recorded version of the story, Carrell gives more examples of the young woman’s body language and also notes that his friend didn’t pick up on those cues the way he did.) Such an ability can be useful not only in bars and at parties, but in personal relationships and the workplace.

In young adulthood, it can be especially hard for young men to stand up to their peers and tell them that their approach to sexual conquests is wrong. I admire the young men like Tucker Carrell, and I’d like to see more young men doing the kinds of things he is. When our society is such that 6 – 10% of men think it’s okay to rape, we have to ask both men and women to take measures that might be difficult or uncomfortable at times. (See the Daily Show’s Jessica Williams for a funny-but-not-really rundown on some of the measures women take to protect themselves.) The burden shouldn’t fall entirely on women.

It’s encouraging that researchers like those behind the MVP program are exploring ways to engage in primary prevention, in addition to the secondary-prevention efforts that many of us have seen. Anyone who’s attended college over the past couple of decades has probably heard tips about looking out for one’s friends at parties — but that’s only preventing individuals from falling victim to the rapist risk that’s already widespread. Primary prevention, in this case, means preventing men from getting to the point where they think getting partygoers extremely drunk is an acceptable way to assure a successful sexual conquest. That’s the goal, and I hope in the coming years we’ll see more work to develop, evaluate, and disseminate successful primary-prevention interventions to stop men from becoming rapists.

Categories: Health

Recent Glacier Losses Are Mostly Driven by Human Activity, Study Says

Yale Environment 360 - August 18, 2014
Roughly one-quarter of the global glacier mass loss between the years 1851 and 2010 can be attributed to

Artesonraju Glacier in Cordillera Blanca, Peru human activities, and that fraction increased to more than two-thirds between 1991 and 2010, according to research published in the journal Science. The study is the first to document the extent of human contribution to glacier mass loss, which is driven by both naturally caused climate factors, such as fluctuations in solar radiation, and anthropogenic influences. “In the 19th and first half of 20th century we observed that glacier mass loss attributable to human activity is hardly noticeable but since then has steadily increased,” the lead researcher said. The analysis was based on data from the recently established Randolph Glacier Inventory and included all glaciers outside of Antarctica. Changes in glaciers in the Alps and North America were particularly well documented and seem to be definitively influenced by human activities, the researchers said.
Categories: Environment, Health

Recent Glacier Losses Are Mostly Driven by Human Acitivity, Study Says

Yale Environment 360 - August 18, 2014
Roughly one-quarter of the global glacier mass loss between the years 1851 and 2010 can be attributed to human activities, and that fraction increased to more than two-thirds between 1991 and 2010, according to research published in the journal Science. The study is the first to document the extent of human contribution to glacier mass loss, which is driven by both naturally caused climate factors, such as fluctuations in solar radiation, and anthropogenic influences. “In the 19th and first half of 20th century we observed that glacier mass loss attributable to human activity is hardly noticeable but since then has steadily increased,” the lead researcher said. The analysis was based on data from the recently established Randolph Glacier Inventory and included all glaciers outside of Antarctica. Changes in glaciers in the Alps and North America were particularly well documented and seem to be definitively influenced by human activities, the researchers said.
Categories: Environment, Health

A New Frontier for Fracking: Drilling Near the Arctic Circle

Yale Environment 360 - August 18, 2014
Hydraulic fracturing is about to move into the Canadian Arctic, with companies exploring the region's rich shale oil deposits. But many indigenous people and conservationists have serious concerns about the impact of fracking in more fragile northern environments. BY ED STRUZIK
Categories: Environment, Health

Twenty-three years and millions served: CDC’s National Breast and Cervical Cancer Early Detection Program

Pump Handle - August 15, 2014

Next time someone asks you what exactly public health does, repeat this number: 4.3 million. That’s the number of women — mothers, sisters, wives, aunts, grandmothers, daughters and friends — who might have otherwise gone without timely breast and cervical cancer screenings if it weren’t for public health and its commitment to prevention.

This year marks the 23rd anniversary of the National Breast and Cervical Cancer Early Detection Program, which the Centers for Disease Control and Prevention launched in 1991 to ensure that low-income women would have the same opportunity to detect cancers in their earliest stages and when treatment is often easier and more effective. The program and its success are the subject of the most recent supplement of Cancer, a journal of the American Cancer Society, and represents the first time such detailed information about the program’s success and strategies has been published. According to the published research, more than 4.3 million women with limited access to health care received breast and cervical cancer screening and diagnostic services in the first 20 years of the CDC program, which provided more than 10.7 million screening examinations. The number of women screened has grown from 82,000 in the early years to more than 500,000 every year.

Also in the program’s first two decades, program providers detected 56,662 breast cancers, 3,206 cervical cancers and 152,470 precancerous cervical lesions. More than 90 percent of women in whom cancer or lesions were detected received appropriate and timely follow-up care. In 2012 alone, the CDC program screened more than 340,000 women for breast cancer, diagnosing nearly 6,000 cancer cases, and more than 251,600 women for cervical cancer, diagnosing 261 cancer cases and about 12,400 premalignant cervical lesions. And providing these screening and diagnostic services to those who might not otherwise have had access cost just $145 per person.(Unfortunately, funding cuts at both state and federal levels do threaten the program’s reach — learn more about that at the Cancer Action Network.)

In addition to opening access to screening and diagnostic services, the CDC program, which funds health agencies in all 50 states, Washington, D.C., five territories and 11 tribal organizations to implement the program on the ground, also connects women to timely follow-up testing, treatment and case management. The CDC program was designed to address a critical service gap: While research had shown that regular cancer screenings could reduce the risk of dying from cancer, poor and uninsured women were less likely to receive the potentially life-saving services and were often diagnosed with cancer at a later stage in the disease cycle. As such, the CDC program is well positioned to positively impact disparities in cancer. For example, in one of the Cancer journal studies, the authors noted that Hispanic women experience the highest rate of developing cervical cancer, and black women experience a disproportionate rate of breast and cervical cancer mortality.

The National Breast and Cervical Cancer Early Detection Program takes a decisively public health approach to providing this traditionally clinical service, designing localized programs that reach low-income women where they are and reducing social and economic barriers that often impede access. In one of the journal studies, authors Jacqueline Miller, Vivien Hanson, Gale Johnson, Janet Royalty and Lisa Richardson write about the Wisconsin Well Woman Program (WWWP), which launched in 1992 with funding from CDC. The Wisconsin program zeroes in on reaching women ages 45 to 64 years old who are underinsured or don’t have any insurance and who are living at or below 250 percent of the poverty level. It also aims to reach Hispanic, black and Native American women as well as women in rural communities. The decentralized state program engages local agencies to tailor education, outreach and enrollment activities that resonate with their residents. The authors write:

The WWWP has developed a network of more than 1,060 provider sites statewide for breast and cervical cancer screening in order to maintain screening services within a 50-mile radius of a woman’s residence. The WWWP provider network includes ambulatory surgery centers, family planning clinics, federally qualified health centers, hospitals, independent laboratories, mammography facilities, pathologists, radiologists, nurse practitioners, rural health clinics, and tribal health clinics. Covered services are available from participating providers at no cost to WWWP clients.

The WWWP has provided more than 490,000 examinations to more than 70,000 Wisconsin women since the program began providing screening services on June 1, 1994. Program data indicate that over the last 18 years, 74% of the women receiving program mammograms were white, 12% were black, and almost 3% were Native American. Hispanic women accounted for 11% of program mammograms. Over this period, the WWWP has diagnosed 1,023 invasive breast cancers and 94 invasive cervical cancers.

However, the same study notes that many more women need to be reached. The authors write that the CDC program only reaches about 13 percent of women who are eligible for the program’s breast cancer screening and 9 percent of women eligible for cervical cancer screening. Of course, with the implementation of the Affordable Care Act (ACA), access to such screenings is likely to change. Still, in one of the journal studies examining the impact of health reform, authors estimated that even with full implementation of ACA — which assumes all 50 states expand their Medicaid programs — 4.5 million women would still be eligible for cervical cancer screening via the CDC program and 1.7 million would be eligible for breast cancer screening. In reality, only about half of states decided to expand Medicaid eligibility.

That Medicaid gap is just one of the many reasons why there’s still a significant need for a public health approach to cancer screening. As one of the journal studies noted: “Limited health literacy or self-efficacy, language barriers, lack of knowledge about screening, fear of cancer, and geographic isolation are common patient barriers that will not be addressed by improved health insurance coverage alone. …These factors (and others) call for partnerships between public health, communities and the health care system to leverage each other’s expertise, connections, and resources to implement more organized and coordinated efforts to increase use of clinical preventive services, which include cancer screening.”

To learn more about the National Breast and Cervical Cancer Early Detection Program, visit CDC or the Cancer journal. And for a handy infographic on the program’s success, click here.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.

Categories: Health

New Citizen Science Software Aims to Document and Curb Illegal Fishing

Yale Environment 360 - August 15, 2014
Citizen scientists can now report — and potentially help stop — illegal fishing with the snap of a photo thanks to

Illegal shark fin catch a new smartphone app developed by the Nature Conservancy. The software, called ShipWatch, was developed this summer during a "Fishackathon," a series of workshops hosted by the U.S. State Department to foster technology development and collaboration among computer programmers. ShipWatch allows users to upload photos of illegal fishing activities to a database, where they are labeled with date and location information and plotted on a central map. The developers hope the data will help authorities enforce existing fishing laws by, for example, developing flight maps for surveillance drones or strategically deploying enforcement authorities. "There are laws in place to say [the fishing] is illegal. The problem is they lack any kind of reporting mechanism," developers told Fast Co.Exist.
Categories: Environment, Health

Fatal work injury that killed Erik Deighton, 23, was preventable, MIOSHA cites Colonial Plastics

Pump Handle - August 14, 2014

Erik Deighton’s work-related death could have been prevented. That’s how I see the findings of Michigan OSHA (MIOSHA) in the agency’s citations against his employer, Colonial Plastics (here, here). The 23-year-old was working at the firm’s Shelby Township, Michigan location in March 2014 when he suffered fatal traumatic injuries involving a stamping press. I wrote about the incident shortly after it was reported by local press.

MIOSHA conducted an inspection of the worksite following Deighton’s death. The agency recently issued citations to Colonial Plastics for seven serious violations and proposed a $20,850 penalty. Those violations include failing to comply with several of MIOSHA’s safety regulations which specifically address plastic molding operations, such as:

R 408.16211: An employer shall provide training to an employee regarding the operating procedures,  hazards, and safeguards of any assigned job.

R 408.16226(5) When used, interlocks shall be installed to minimize the possibility of accidental operation or tampering.

R 408.16227(2) …each employee doing the work shall lock out the power source of the machine or equipment to be repaired or serviced if unexpected motion would cause injury. Any residual pressure which would be hazardous shall be relieved before and remain relieved during work by an employee doing the work.

R 408.16234(6) When purging an injection molding machine, an employee shall be protected from the purging splatter by a shield that is fixed, portable, or worn on the employee. The same guarding shall be used when servicing a heated runner manifold nozzle.

When the incident was initially reported, Shelby Township Police Captain Stephen Stanbury told the press,

“This is totally an accident.”

He added:

“I don’t think it’s a sloppy operation from what our guys found at Colonial Plastics.”

MIOSHA’s findings tell a different story. Call it sloppy, call it poor management, call it breaking the law. Whatever you want to call it, Erik Deighton’s work-related death could have been prevented.

Categories: Health

Some Chemicals in Fracking Fluids Raise Red Flags, Researchers Say

Yale Environment 360 - August 14, 2014
Of the more than 200 compounds used in hydraulic fracturing fluids, eight are toxic to mammals and the

A Marcellus Shale fracking operation health risks of roughly one-third are unknown, according to researchers at Lawrence Berkeley National Lab. Hydraulic fracturing, also known as fracking, is a drilling technique that releases natural gas and oil by injecting fluids with chemical additives deep into rock formations. The research team tracked down substances commonly used as fracking additives and found they include gelling agents to thicken the fluids, biocides to inhibit microbial growth, and compounds to prevent pipe corrosion. The industry claims the additives are non-toxic and food-grade, and while that is true in some cases, the researchers note, most fracking compounds require treatment before they can be safely released into the environment. Moreover, a number of chemicals that could pose health risks, such as corrosion inhibitors and biocides, are used in reasonably high concentrations in fracking fluids, the researchers note.
Categories: Environment, Health
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