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Endocrine Disruption and Health: The State of the Science and the Need for Primary Prevention

By Pamela Miller, Executive Director of Alaska Community Action on Toxics

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Over the past 25 years, scientists have made astonishing progress in elucidating how endocrine-disrupting chemicals (EDCs) in the environment affect humans – especially pregnant and nursing women, babies, infants, and children. Scientific understanding has far surpassed public policy, leaving us with chemical policies that are not protective of public health.

Confronted with this growing body of new research, the highly respected Endocrine Society set an important precedent for scientific and medical organizations in 2009 by taking a public stance on endocrine-disrupting chemicals and again in 2015 by issuing a comprehensive scientific statement. The Endocrine Society is the largest international membership organization representing scientists and health care professionals in the field of endocrinology. The Endocrine Society statements:

  • “Defined an EDC as a compound that, through environmental or developmental exposure, alters how an organism communicates and responds to the environment;
  • Asserted that there is no endocrine system that is immune to EDCs and that the effects may be transmitted to future generations (e., transgenerational);
  • Declared that the evidence for adverse reproductive outcomes is strong and mounting for effects in areas such as neuroendocrine, sexual development, obesity, metabolism, thyroid systems, and insulin resistance;
  • Highlighted the “precautionary principle” for informing decisions about exposure and risk: Chemicals must be tested before being introduced into the environment;
  • Encouraged scientific societies to partner with organizations with scientific and medical expertise to evaluate the effects of EDCs and communicate to other researchers, clinicians, community advocates, and politicians.”

Endocrine-disrupting chemicals are exogenous chemicals that can act in various ways to disrupt the delicate chemical messaging system of the body, including mimicking or blocking our normal hormone functions. They are found in our home, school, and work environments in such products as electronics, furniture foam and carpet padding treated with certain flame retardants, personal care and cleaning products, pesticides, food packaging, medical equipment, and toys. We are exposed to EDCs in our air, water, food, and through household dust. In a commentary in Environmental Health News,[i] Dr. Laura Vandenberg of the University of Massachusetts states:

“We also know that Americans today have hundreds of chemicals circulating in their bodies. Our babies are being born ‘pre-polluted’ with chemicals detectable in their blood, in the placenta, and in amniotic fluid because of exposure to EDCs and other contaminants during pregnancy and throughout the mother’s life. We now recognize that EDCs can act at low doses . . . It is also clear that the traditional adage ‘the dose makes the poison,’ used by toxicologists for decades, is outdated and too simplistic when it comes to understanding the health effects associated with EDCs; studying high doses often does not tell the full story about a chemical’s effects. And there are periods in our life when we are more sensitive to these chemicals; exposures during vulnerable periods of development can produce effects that might not manifest until adulthood.”

EDCs are implicated through laboratory and epidemiological studies in adverse health outcomes including infertility, thyroid impairment, neurodevelopmental harm, obesity, and certain cancers including testicular, breast, prostate, and ovarian.[ii] Pregnant and nursing women, babies, infants, children, and adolescents are particularly vulnerable. Several studies have highlighted the harmful exposures of premature babies in neonatal intensive care units who are exposed to certain endocrine-disrupting chemicals found in medical devices, such as phthalates and bisphenol A. Phthalates are chemical substances used as plasticizers in plastics such as polyvinyl chloride (PVC) and found in medical devices including blood storage bags, IVs, breathing tubes, feeding tubes, and catheters.

What Can You Do?

Some simple ways to prevent or reduce exposures include:

  • Wash hands frequently
  • Dust with a damp cloth and using a vacuum with a HEPA filter
  • Avoid personal care products with the word “fragrance” on the label
  • Use glass and stainless steel instead of plastic or Teflon for food storage and cooking
  • Choose fresh, frozen, or dried foods (such as beans) rather than canned foods
  • Choose organic foods as much as possible

But it’s clear we can’t “shop our way out of this problem.” Public policies that are based on our current scientific understanding of EDCs and prioritize protection of public health are vital to the health of current and future generations of Alaska’s children. Expecting our Alaskan hospitals and medical clinics to develop a plan for acquiring and using alternative medical devices, materials, and products that do not contain endocrine-disrupting chemicals is a great place to start.

Resources:

  • The Endocrine Society’s Second Scientific Consensus Statement on Endocrine-Disrupting Chemicals, 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4702494/
  • Introduction to Endocrine-Disrupting Chemicals: A Guide for Public Interest Organizations and Policy Makers, 2014. A Publication of the Endocrine Society and the International POPs Elimination Network (IPEN): http://ipen.org/documents/introduction-endocrine-disrupting-chemicals-edcs.
  • Alliance of Nurses for Healthy Environments: Promoting healthy people and healthy environments by educating and leading the nursing profession, advancing research, incorporating evidence-based practice, and influencing policy. http://envirn.org/
  • Health Care Without Harm – an excellent resource for health care providers interested in environmentally responsible health care: https://noharm-europe.org/issues/europe/edcs-infographic
  • The Endocrine Disruption Exchange – a helpful source of information on the latest science concerning endocrine disruption: https://endocrinedisruption.org/.
  • Alaska Community Action on Toxics (ACAT) – an information source about community-based research, science and health in Alaska. ACAT hosts free monthly teleconference seminars with leading science and policy experts on environmental health topics: akaction.org
  • Safer Chemicals Healthy Families – a national coalition of health professionals, parents, advocates for people with learning and developmental disabilities, reproductive health advocates, environmentalists and businesses: http://saferchemicals.org/

[i] Vandenberg, L. 2016. Commentary: 25 years of endocrine disruptor research – great strides, but still a long way to go. Environmental Health News: http://www.environmentalhealthnews.org/ehs/news/2016/sept/commentary-25-years-of-endocrine-disruptor-research-2013-great-strides-but-still-a-long-way-to-go

[ii] The Endocrine Disruption Exchange Fact Sheet on Endocrine-Disrupting Chemicals: https://endocrinedisruption.org/assets/media/documents/EDC%20Fact%20Sheet%2020170705.pdf

What is Help Me Grow?

Rachel author headshotBy Rachel Boudreau, intern with Help Me Grow Alaska & the All Alaska Pediatric Partnership

Alaska is a large state with a small population. While we are fortunate to have many services to support families and children, sometimes the services a family needs are not available or, if they are, access to them can often be challenging. This can be an extremely frustrating and exasperating barrier for families trying to do their best raising happy, healthy kids.

For the last three years, a diverse group of professionals from the field of early childhood and pediatrics have worked together to find a solution, a “glue” if you will, that connects providers, community-based services, and families to ensure easier access and to help guide what new services still need to be created or expanded. That glue is a system called Help Me Grow, and we are excited to finally bring it to families here in Alaska.Help_Me_Grow_logo_update

What is Help Me Grow Alaska?

Help Me Grow Alaska (HMG-AK) is a resource and referral system that provides care coordination services and links families with services and supports throughout the state. HMG-AK is based on a national model developed in Connecticut in 2005 out of a need for a better way to connect families with community-based resources. HMG-AK is not an agency designed to offer more services, but it is intended to connect families with the resources that are already in place in communities across the state, and to help identify where more services are needed. Help Me Grow’s mission is to identify children who are at risk for developmental delays and/or behavioral problems, and then to link these children and their families to community-based and statewide resources.

Why do families need to be connected to developmental screenings?

As part of its mission, the Help Me Grow system promotes and provides a standardized tool to screen children ages 0-5 for developmental delays or disabilities. Periodical developmental screening monitors a child’s developmental milestones, such as walking, using words, expressing emotions, playing with peers, etc. Answers to the screening questions show what the child’s strengths are and will identify any areas where the child may need support or extra practice.

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The screening tool is easy to complete and can offer fun ideas for interacting with children in an age-appropriate way. HMG-AK provides families with free access to this developmental screening tool on paper or online, and the care coordinators work with the family to connect them to further evaluation, should there be any concerns of a developmental delay. When reviewing the screening results together with the parent, the care coordinator will also provide additional activities to do at home to help support the child’s healthy development while enjoying fun, free and high quality time with the child.

A child does not need to have a delay or disability to receive services or activity ideas from a Help Me Grow coordinator. The service is available and free to all families with children.

Why would a family contact the Help Me Grow call center?

HMG-AK is designed to assist families with young children looking for a broad range of support. This could be anything from questions or concerns about their child’s development or behavior to helping a family who recently moved to a community find a medical provider and social supports and community activities such as parenting groups or organized play time for kids. The care coordination model is set up to help families navigate complex situations through follow up and continued support to ensure the family feels comfortable and confident in the next steps for their child and themselves.

How do I access HMG-AK?

HMG-AK is available to anyone raising a child as well as medical providers, childcare providers and community members. All it takes is one call to the HMG-AK call center to speak with a trained care coordinator. HMG-AK’s care coordinator will answer questions a family might have and then link the family with the needed resources or find alternative supports to assist the family until the appropriate services are available. The care coordinators will follow up with the family to ensure a connection was made to the recommended resources and to discuss any additional concerns the family might have.

As Alaska’s Help Me Grow system develops, families can expect to see local Help Me Grow family-friendly events in their communities and useful educational materials to help parents understand more about their child’s development, how to manage stress (both for the parent and the child), managing difficult behaviors and more.

When will HMG-AK be available in my community?

We are currently in the very beginning phase of launching Help Me Grow in Alaska and still have a lot of work ahead of us. The first phase is focused on three regions: Norton Sound, Kodiak and Mat-Su. We are working hard and putting a lot of effort and thought into the planning, and hope to expand the program statewide, shortly after. Stay tuned through the Help Me Grow mailing list for updates!