PSR-LA doctors (left to right) James Dahlgren MD, Felix Aguilar MD MPH, Shilpa Sayana MD.
Hydraulic Fracturing, or “fracking,” pumps millions of gallons of water and sand—mixed with thousands of gallons of chemicals—into underground rock formations to release oil and gas deposits. In 2010, the LA Times reported that there were more than 3,000 active oil and gas wells in Los Angeles County. There are plans to drill thousands more as oil prices remain high and advances in technology allow the combination of drilling and fracking to extract oil much more cheaply than in the past.
In communities across the country, people have reported a range of health and environmental impacts from fracking, ranging from respiratory infections and rashes to miscarriages, benzene poisoning and cancer. Despite the extensive scope of oil extraction operations in the state, California has very little regulatory control over the activity generally or fracking in particular. PSR-LA is actively involved in California’s policy development, fighting to ensure that protecting health is a central focus.
In March, we launched the “Don’t Gag Docs” campaign to raise awareness about the big push by the oil and gas industry to label the content of the chemical cocktail used in fracking a “trade secret.” PSR-LA is working hard to ensure full and public disclosure of chemicals pumped into our environment and unfettered ability of doctors and public health researchers to treat, understand and track the impacts of these chemicals on our bodies. We’re also calling for a fracking moratorium until the oil and gas industry can prove that fracking will not negatively impact health.
makes it the policy of the State of California to elevate the financial gain of select oil and gas industry players over the health and environment of the people of California.
We also pointed out to Senator Pavley that:
this bill stands in stark contrast to that taken in Alaska where the Alaska Oil & Gas Conservation Commission (AOGCC) has proposed a fracking regulation that requires disclosure of “the amount and types(s) of material pumped during each treatment stage and the total amount and types of material pumped…”to the Commission, but does not grant trade secret protection to the oil and gas industry.
As a matter of a fact, this bill buys into the “oft repeated chant of oil and gas industry lobbyists” that somehow the law about trade secrets entitles them to withhold from the public the kinds and amounts of chemicals that are pumped into our soil, water, and air. This, however, is not true. As we pointed out to Senator Pavley:
Rather, this grant of trade secret protection should be seen as a policy decision based upon balancing the financial goals of the oil and gas industry with the public health and environmental goals of the people of California. We urge you to strike that balance in favor of the people and environment of California.
And finally, we:
completely reject[ed the] idea that it is proper for the State of California to force doctors, nurses, first responders, and other health professionals to enter into a contract with oil and gas companies–or a multi-national corporation like Halliburton–in order to access information necessary to provide competent medical treatment to their patients…
We prefaced our objections to SB 4 by pointing out that:
We believe that the experiences to date, and the data that have been collected thus far, clearly establish the need for California to engage in more thoughtful consideration of the threshold question of whether to extract oil and gas from shale before answering the question of how to extract oil and gas from shale. Until both those questions are answered, a moratorium is the most appropriate course of action.
Last month, we submitted a petition with several hundred signatures to the state agency that oversees oil and gas extraction explaining that we reject a government imposed gag rule on health professionals and we reject the effort to gut the public health research infrastructure by limiting our ability to know and to track the chemicals used in fracking.
We assure you that PSR-LA will not support any fracking regulation or legislation that gags docs or limits public health research. We will continue to advocate locally and in Sacramento to ensure that our voices are included in this conversation, and we remain hopeful that Senator Pavley and California’s oil and gas regulator will revisit the decision to gag doctors.
We all extend our deepest thanks to those who joined us in this petition. To you, and to those who missed the opportunity to join, we say: there will be other opportunities for you to add your voice to this effort. We hope you’ll join us. In fact, here are five things you can do right now:
Fumigant Free by 2020 – Help Promote Healthy and Sustainable Agriculture
by Martha Dina Argüello, Executive Director
PSR-LA is a member of the statewide coalition, Californians for Pesticide Reform (CPR), a strong coalition of over 185 public interest organizations aiming to protect public health, preserve environmental quality and support a sustainable and just agricultural system. As the chair of the steering committee for over 8 years, I have come to understand the growing body of scientific evidence connecting pesticide exposures to serious illnesses. We must change the way we manage pest in our homes, workplaces, and most importantly, our farms. California’s agricultural industry faces a range of pressures, not the least of which is finding safe alternatives to fumigant pesticides. CPR is calling on the state of California to develop a bold vision for phasing out these highly toxic pesticides by the year 2020.
Read “Investing in Innovation: A Policy Roadmap for Resilient, Prosperous Fumigant-Free Farming in California”
Fumigants make up 20% of the agricultural pesticides used in California and are some of the most dangerous pesticides on the market. They have a high propensity to drift away from fields and affect neighboring workers, schools, homes and businesses, causing mass community poisonings. On April 25th, PSR-LA joined farm workers, environmentalists and health leaders at the State Capitol to call for the phase out of soil fumigants.
PSR-LA also helped pressure Arysta LifeScience to take cancer-causing fumigant methyl iodide off the market last year, but unfortunately, fumigants like methyl bromide, chloropicrin, and Telone – linked to cancer, developmental, reproductive and neurological harm – are still widely used. The California Department of Pesticide Regulation (DPR) is about to review chloropicrin, the most widely used hazardous fumigant in the state. The legislature should ensure that DPR creates the most health-protective measures possible for chloropicrin.
Some fumigants emit greenhouse gases, meaning that they are contributors to climate change. Farmers who do not use fumigants use techniques like carbon sequestering, which helps mitigate and adapt to climate change. Unfortunately, earlier this year the California Environmental Protection Agency and the California Department of Food and Agriculture requested use of more hazardous and ozone depleting fumigant pesticide, methyl bromide, despite that it is banned under international treaty.
California has a unique opportunity to help farmers transition away from hazardous and volatile pesticide fumigants. DPR convened a panel of economic, labor and business experts who released a report earlier last month, saying that California should move quickly to take advantage of this opportunity and outlining next research steps to move the state towards safer replacements for fumigants. State regulators and legislators need to hear the public health and social justice voice supporting this vision of fumigants-free by 2020.
Over the next few years, we must establish a roadmap with enforceable benchmarks for transitioning to sustainable agriculture. The focus of this plan should be to ensure the health of farmers, farmworkers, and agricultural communities, while protecting natural resources and stemming climate change. PSR-LA would like to help pass resolutions in medical associations to support this healthy and sustainable vision. To learn more and get more involved in this effort, please contact Martha Dina Argüello, firstname.lastname@example.org.
Protecting CEQA – CA’s Landmark Environmental Bill
by Monika Shankar, Health and Environment Associate
Enacted in 1970, California’s landmark Environmental Quality Act law, commonly abbreviated as CEQA, institutes a statewide policy of mandatory environmental protection for both public and private development projects. It requires that proponents mitigate the negative environmental and public health impacts of their projects. Over the decades, CEQA has proven itself a valuable process for public disclosure and participation in land use decisions. In other words, it is an “environmental bill of rights”, especially for low-income and communities of color who experience development in their neighborhoods.
CEQA is an important tool in promoting a healthy built environment. Unfortunately, opponents label it as a job killer and an impediment to smart growth — both are arguably unsubstantiated claims. In Sacramento, the battle lines are drawn between social justice, environmental and labor groups on the one hand, and business and development entities on the other side. Representing the former, PSR-LA is working to protect and strengthen CEQA on multiple fronts, engaging with community organizations through education and skills building, as well as through policy advocacy at the state level. We also actively participate in a statewide coalition called CEQA Works, “a broad coalition… committed to shielding California’s landmark environmental laws from radical reforms that would limit public input into land use planning, threaten public health, and weaken environmental protections” (CEQAWorks.org). We believe CEQA is a relevant and strong framework from which to remedy and reverse environmental degradation and to strengthen the quality of life of low-income and communities of color.
One way to strengthen CEQA is to incorporate more robust requirements to analyze the public health impacts of both projects and plans. A common critique of CEQA is that it does not adequately incorporate a health impact assessment into its overall environmental review. Health outcomes or harm to public health for vulnerable communities is meant to result from the direct protection of the environment or the mitigation of environmental impacts. Reforming the law to include health assessments would greatly improve community health. Furthermore, it would allow us to better understand the externalities and trade-offs associated with major projects, with specific emphasis on inequitable distributions of burdens and benefits.
2013 has been a particularly active year for proposing CEQA reform. Of the 28 CEQA bills originally proposed in the legislature at the beginning of the year, 19 bills are out of their policy committees and moving through the legislature. PSR-LA is analyzing and monitoring all the bills, while actively supporting a handful and working to improve and stop others. We support the following bills:
AB 543 (Campos): would require a lead agency to translate certain documents when the impacted community has a substantial number of non-English-speaking people.
AB 953 (Ammiano): would require the lead agency to include in the EIR a detailed statement on any significant effects that may result from locating the proposed project near, or attracting people to, existing or reasonably foreseeable natural hazards or adverse environmental conditions.
SB 754 (Evans): looks to improve mitigation and transparency by (1) not letting project developers hire and supervise their own environmental reviews, (2) allowing mitigation for archaeological and cultural resources to proceed on case-by-case basis, (3) ensuring that EIRs used to make new decisions are under 7 years old, and (4) providing a clear process for public enforcement of mitigation.
At the center of the CEQA dialogue is Senate pro Tem Steinberg’s CEQA reform bill SB 731, also known as the CEQA Modernization Bill. PSR-LA opposes this bill in its current iteration. Although it includes several positive provisions that may increase administrative efficiency and information dissemination, PSR-LA is concerned with the bill’s wide promotion of infill development and smart growth, and its intent to revise thresholds of significance for land use related impacts including parking, noise and transportation. Expressing clarity around these provisions is important and imperative to balance the good elements of infill and transit oriented development with the often-unintended consequences of gentrification and displacement. For example, while infill development is praised as a means of reducing vehicle miles traveled, projects often fail to reach this milestone. Instead, the burden of increased travel time and increased fuel costs fall on low-income and displaced residents pushed out of their communities through housing and rental cost increases.
We are also opposing Senator Berryhill’s bill SB 787, yet another bill touted as CEQA modernization. SB 787 endeavors to integrate newer and stricter environmental planning laws through CEQA. This bill is particularly concerning because it would eliminate steps and evidence in the environmental review process by narrowing the definition of what impacts communities. This would decrease a community’s ability to argue for further analysis and potential mitigation of those impacts. However, the bill failed to pass its first committee hearing, but was granted a rehearing. We believe the bill is unlikely to move forward.
If you are interested in joining the fight to strengthen CEQA and advocate for the power of communities to determine the outcome of their environment and health, please consider getting involved! Here’s how: lend us your voice and support in Sacramento, write an Op-Ed or editorial for our newsletter, and/or help us raise funds for our members and allies to travel to Sacramento and visit legislators. For more information, contact Monika Shankar, email@example.com.
by Ana Mascareñas, Policy and Communications Director
Thanks to your hard work and the coordination of advocates around the state, California is poised to adopt a new furniture flammability rule for toxic-free fire safety! Over the past two years, PSR-LA has galvanized a diverse coalition of health advocates, firefighters, scientists, environmentalists, fire safety experts and businesses in support of updating this regulation so that it will better protect our health and environment. On March 26th, our coalition gave testimony and submitted more than 87,000 signatures to support the revision. Signatures represented people from every state, and public interest organizations from 36 countries also sent letters, urging California to quickly move forward for improved fire safety without relying on toxic chemicals.
For decades, toxic and untested flame retardant chemicals have been added to our furniture and baby products, but they haven’t worked to protect us from fires as promised. An obscure 1970s California regulation is a de facto national mandate to add these chemicals, which are linked to lower IQs in children, reduced fertility, cancer, and other adverse health effects, and have become global contaminants. Instead of preventing fires, these chemicals can actually make fires more deadly by increasing smoke and toxic gases, which are the major causes of fire deaths and injuries.
A landmark scientific consensus statement, signed by more than 200 scientists in over 30 countries, highlights the health and environmental harm of flame retardant chemicals. They continuously migrate out of furniture into dust, and are ingested by humans, pets, and wildlife. Levels of these chemicals have increased 40-fold in human breast milk since the 1970s and California children have among the highest levels recorded. Communities of color already bear a disproportionate burden of toxic chemicals in their homes, workplaces, and neighborhoods, and studies show flame retardant chemicals contribute to this disparity. Those with lower income, and especially children, have high levels of toxic flame retardant chemicals in their bodies compared to those in more wealthy households.
Infants are born with flame retardants in their bodies because these chemicals cross the placenta. Children’s behavior, such as crawling and hand-to-mouth activity means that they face even greater exposure. Consequently, young children have three times the levels of flame retardant chemicals in their bodies compared to their mothers. Flame retardants are also increasing in our food supply, and contaminate soil, wastewater, rivers, the ocean, fish, and marine mammals.
Unfortunately, we expect that flame retardant chemical industry representatives will do everything they can to continue fighting this common-sense change. Last year, the Chicago Tribune published a searing four-part series on flame retardants, illustrating the deceptive tactics the chemical industry uses to keep their toxic products on the market, and their close ties to the tobacco industry. The series describes a well-resourced campaign of dishonesty, manipulated scientific findings, and a phony watchdog group that misrepresented itself.
The proposed updated flammability standard, TB117-2013, will give companies better ways to provide fire safety – without the use of harmful flame retardant chemicals. After one more technical comment period, we expect this new rule to go in effect later this year. If you would like to learn more and get involved in this campaign, please contact Ana Mascareñas, firstname.lastname@example.org.
LA City Council Approves Resolution to Cleanup Santa Susana Field Laboratory
PSR-LA members and supporters helped pass a Los Angeles City Council resolution to oppose any legislation or administrative action which would transfer property at the Santa Susana Field Laboratory (SSFL) currently administered by NASA until the property is fully cleaned up. Thanks to our members and supporters who contacted their representatives, the resolution was approved on March 20, 2013.
SSFL was the site of a partial nuclear meltdown in 1959 and tens of thousands of rocket tests which left it grossly contaminated with toxics that can cause cancer and other harmful health impacts. In 2010, NASA signed an agreement with the State’s Department of Toxic Substances Control (DTSC) to cleanup its portion of the site to background levels.
Community members and advocates became concerned when NASA declared the land as excess federal property, which is the first step in transferring it to a new owner. A new owner may not be subject to the cleanup standards that NASA and DTSC have agreed upon.
LA Opposes San Onofre Reactor Restart Without Public Hearings
PSR-LA applauds the Los Angeles City Council April 23, 2013 vote to oppose restarting the San Onofre Nuclear Generating Station which was shutdown in January 2012 after a leak of radioactive steam revealed significant damage to its reactors’ replacement steam generators.
Edison has proposed to the U.S. Nuclear Regulatory Commission that it be allowed to restart reactor Unit 2 at partial power and run it as a five month test followed by two years of intermittent shutdowns and startups. Given the extent of the damage of both reactors, PSR-LA and other advocates believe this is a recipe for disaster.
The city voted unanimously to ask federal regulators not to allow the restart of the crippled San Onofre nuclear reactors before the formal public process to determine whether Edison’s experimental restart plan is safe and all needed repairs or replacements are completed.
On April 5, 2009, in the first foreign policy address of his presidency, President Obama expressed his vision of a world free of nuclear weapons. The realization of this vision, shared by a majority of citizens around the world, is vital to the very survival and future of our planet. We the people await the actions that are needed to make this a reality. Now is the time for the president and our leaders to put words into action. As we reflect on this vision and prepare to fund our budget and nation’s priorities the choice is ours.
Meanwhile, we see a nuclear budget so vast that, for example, in 2012 Los Angeles County taxpayers contributed $1.8 billion straight out of their pockets. New York City taxpayers were required to pay $1.6 billion. To find out your city’s or county’s share, visit www.c-p-r.net. In effect, we are made to pay for our own mortal risk. This is unconscionable.
It is time to ignore the dinosaurs of old thinking who feel that massive arsenals of nuclear weapons and the huge costs to our society somehow add to our safety. Even our own military planners have recognized that our arsenals could be massively reduced to as little as 300 weapons as a strong first step. The outmoded idea of deterrence now only fuels the arms race and the desire of other nations to have nuclear weapons themselves, thus increasing their potential use either by design or accident. Any use of these weapons risk the potential for devastating consequences. A recent report by the Nobel Prize Physicians for Social Responsibility has identified that the use of as few as 100 weapons would damage the global climate and agricultural production so severely that the lives of more than one billion people would be at risk in a Nuclear Famine. We are now confronted by the fact that even unilateral use of these weapons can result in a slow but assured suicide. We have moved from the insane cold war doctrine of MAD (Mutually Assured Destruction) to SAD (Self Assured Destruction). Is there any policy that makes less sense?
The theft of these dollars from every community in our nation could be more effectively spent on education, healthcare, infrastructure, energy conservation and development of renewable energy sources and many other programs that must compete for these.
by Ana Mascareñas, Policy and Communications Director
PSR-LA is tracking a large number of bills pertaining to our program areas this legislative session. Here’s a short list of ten bills that are of particular interest to our members and supporters. Our position may change as bills are amended in committees, so please contact us at (213) 689-9170 for the latest updates on each bill and look out for important action alerts in your inbox!
This bill attempts to regulate many aspects of hydraulic fracturing (fracking) in California. Unfortunately, as written, it will grant trade secret protections to the fracking chemicals pumped into our soil, air, and water. Also included is a doctor “gag order” that will force doctors, first responders, and other health professionals to enter a contract with oil and gas companies –or a multi-national corporation like Halliburton–in order to access information necessary to provide competent medical treatment to their patients. This provision would also gut our public health research infrastructure by severely limiting our ability to know and track the chemicals used in fracking. Read more about our fracking campaign, “Don’t Gag Docs”.
2) Fracking – AB 1301 (Bloom) – SUPPORT
This bill is a straightforward moratorium on fracking in the State of California. It prohibits fracking operations until the Legislature enacts subsequent legislation that determines whether and under what conditions fracking may be conducted while protecting the public health and safety and the natural resources of the state. PSR-LA strongly supports this precautionary approach.
3) Fracking – AB 1323 (Mitchell) and AB 649 (Nazarian) – SUPPORT
These bill are very similar — both call for a moratorium until a specified committee produces a report about fracking and its impacts on California. After the report is completed, the bills would give the Secretaries of the California Natural Resources Agency and the California Environmental Protection Agency the power to decide if and how fracking would proceed. PSR-LA recommends adding two representatives from the health community beyond the representatives from the Department of Public Health to the committee.
4) Nuclear Energy – SB 418 (Jackson) – SUPPORT
This bill is a transparency measure that will require large utility companies who seek ratepayer funding to renew their federal license to file a report with the California Public Utilities Commission detailing the costs associated with radioactive waste storage, emergency planning, maintaining aging facilities, unplanned shutdowns due to seismic activity, permits and various federal requirements. Many of the assumptions about our state’s energy needs and the value of nuclear power generation are over 40 years old, and neither assess the full costs of nuclear power facilities, nor the grave health risks associated with nuclear energy.
5) Toxic Flame Retardants – AB 127 (Skinner) – SUPPORT
This bill calls for a code revision to reduce the use of flame retardant chemicals in building insulation while maintaining building fire safety and encouraging healthy building practices. It recognizes the potential adverse health effects of the chemical flame retardants commonly used in building insulation, and once implemented, will lead to safer and less toxic practices, without reducing fire safety for building occupants. PSR-LA has been a key leader in coalition efforts to eliminate toxic flame retardants from home furnishings and baby products, since studies show that instead of preventing fires, these chemicals can actually make fires more deadly for firefighters and fire victims by increasing smoke and toxic gases, which are the major causes of fire deaths and injuries.
Enacted in 1970, California’s landmark Environmental Quality Act law (CEQA), institutes a statewide policy of mandatory environmental protection for both public and private development projects. PSR-LA opposes Senate pro Tem Steinberg’s CEQA reform bill SB 731, also known as the CEQA Modernization Bill, in its current iteration because of its wide promotion of infill development and smart growth, and its intent to revise thresholds of significance for land use related impacts including parking, noise and transportation. Expressing clarity around these provisions is important and imperative to balance the good elements of infill and transit oriented development with the often-unintended consequences of gentrification and displacement.
7) Air Quality and Transportation – SB 811 (Lara) – SUPPORT
This bill calls for the I-710 Corridor Expansion Project to operate with the interest and safety of neighboring communities. Its approach is consistent with the 2006 Goods Movement Action Plan which promised that infrastructure expansions and mitigation would occur simultaneously. PSR-LA is a founding member of the Coalition for Environmental Health and Justice, which successfully stopped the ill-conceived expansion of the I-710 freeway nearly ten years ago, and we continue to advocate for transportation decisions that improve health outcomes for all communities living along the I-710 corridor.
8) Hazardous Waste Siting – AB 1329 (VM Perez) – SUPPORT
This bill requires DTSC to identify racial and economic inequities in siting hazardous waste facilities and develop enforceable strategies to eliminate that disparity. AB 1329 also protects communities from the most dangerous operators by ensuring that those who repeatedly violate laws that protect public health and safety do not operate on expired permits or receive permits for new facilities. This measure also increases the accountability of regulators and the hazardous waste industry by requiring information on permit statuses and enforcement actions to be publically available and posted online.
9) Chemicals in the Workplace – SB 193 (Monning) – SUPPORT
This bill would require chemical manufacturers, suppliers, distributors, importers and their agents, when requested to do so by the Hazardous Evaluation System and Information Service (HESIS) maintained jointly at the Department of Industrial Relations (DIR) and the Department of Public Health (CDPH), and under conditions of confidentiality, to provide names and addresses of customers who have purchased chemicals or products containing those chemicals, and their proportions, to the repository maintained by the HESIS. PSR-LA has a long history of working to eliminate health inequalities caused by environmental exposures and promoting safe workplaces, and this bill would provide critical information on chemical hazards in the workplace.
10) Air Quality and Pesticides – AB 304 (Williams) – SUPPORT
The Toxic Air Contaminant Act was passed about 30 years ago (in 1983) to protect the public from toxic air contaminants, including pesticides. The Department of Pesticide Regulation has ignored their responsibilities to reduce exposure to pesticides in the air while the Air Resources Board has been working hard to reduce air levels of many other toxic chemicals. AB 304 (Williams) will set enforceable timelines for DPR to list pesticides as TAC and to adopt use controls to reduce the public’s exposure to these pesticides.
Dr. James Dahlgren is an internist with a sub-specialty in toxicology. We appreciate him taking time to answer several questions about being a physician and PSR-LA member.
Why did you become a physician?
Dr. Dahlgren: I became a physician because it is an occupation that helps people and is interesting. After medical school and a five year residency in internal medicine I specialized in toxicology. I have been practicing in that field for the last 40 years. I have published dozens of articles on toxicology and evaluated and treated thousands to patients with toxic chemical exposures.
Why did you decide to get involved with PSR-LA’s work?
Dr. Dahlgren: I became involved with PSR because I saw so many failures to protect people from toxic chemicals by government agencies. Being a member of PSR gives me the opportunity to promote public health in a broad context that cannot be done treating individual patients.
What are your health concerns about oil extraction and fracking?
Dr. Dahlgren: Oil and natural gas fields are sources of serious environmental contamination to anyone living near such places. Fracking increases the amount of air, soil, soil gas and water contamination from these sites. Fracking is a very serious public health emergency. Literally millions of people will be sickened if current practices continue.
The most pressing issue from fracking is the neurological, developmental, endocrinological, and immunological injury that oil/gas field exposed fetuses, infants, children, and adolescents will experience from the increased oil/gas fields emissions. The most susceptible people to injury from low level toxic exposure are the next generation. The lax government oversight of the oil/gas industry is serious and must be changed. However, the exemption of fracking activity from all environmental laws is a disaster. Adverse health experience from fracking has already been reported. Thousands of studies of the chemicals present in oil fields reveals greater toxic injury will occur as the fracking and all well stimulation practices increases the amount of pollution from oil/gas fields. We need to educate physicians about this issue immediately so they can help their patients receive proper counseling and treatment. We need a massive public outcry to overcome the big money forces that are exploiting the oil/gas resources without regard to public health.
In the absence of federal policies that protect environmental health, Californians have developed a set of tools for addressing the problems of toxic chemicals. While some progress has been made, these tools fall painfully short of a comprehensive chemical policy approach. Notable state victories in environmental policy have helped elevate the conversation of toxics in our homes, workplaces, and communities to a national and international platform. We’ve seen measurable progress in right-to-know initiatives, bans on specific toxic substances, and efforts to fix outdated laws that create a dangerous dependency on toxic chemicals. Yet within any given year in California, environmental policies depend largely on the annual makeup of the legislature and the ability of education and advocacy groups like PSR-LA to maintain a presence in important policy discussions.
For example, California is fast becoming the new frontier for hydraulic fracturing, or “fracking,” a process that will introduce hundreds of thousands of gallons of chemicals—many of which are toxic—into the environment. Oil and gas companies are not only bringing new oil and gas extraction technologies, but also their lawyers, lobbyists, and public relations firms to convince California’s regulators and legislators to keep the contents of their “fracking chemical cocktail” protected as a “trade secret” and hidden from the public. Even more alarming is a proposed gag rule that prevents doctors from sounding the alarm about the harm that fracking chemicals cause. This situation highlights the susceptibility to industry lobbying pressures and the constant need for health professionals to be strong advocates for environmental health and justice.
In 2007, the California legislature was frustrated with chemical by chemical ban bills and the lack of action in DC to reform our outdated national chemicals policy law, the Toxic Substances Control Act (TSCA), and attempted a comprehensive state chemical policy approach. This resulted in the adoption of the Green Chemistry Initiative, which included adoption of a bill calling for safer alternatives to chemical-product combinations, now known as the Safer Consumer Products Program. As this program becomes finalized, we recognize that it advances assessments for safer alternatives, but also fails to shift the burden of proof to chemical manufacturers.
When PSR-LA sponsored legislation to remove the endocrine disrupting chemical, bisphenol-A (BPA), from baby bottles and sippy cups, our members not only sent letters, made calls to legislators, but also visited legislators offices and walked the halls of Sacramento. These actions were critical in ensuring the 2011 passage of the bill, and set the groundwork for the recent announcement from our state’s environmental health scientific review board that BPA is recognized as a reproductive toxin by the state of California this year. This list, commonly referred to as “Proposition 65,” is an authoritative chemicals list that mandates labeling of products and places containing chemicals known to cause cancer, birth defects or other reproductive harm, enacted as a state ballot initiative in1986. Although the American Chemistry Council immediately filed a lawsuit to have BPA removed from the list, continued state scrutiny and public attention can provide much needed support regulating BPA at the federal level.
Flame retardants provide a glaring example of the failure of TSCA. For decades, toxic and untested flame retardant chemicals have been added to our furniture and baby products. Why? An obscure 1970s California regulation called Technical Bulletin 117 (TB 117) was the de facto national mandate to add these chemicals, which are linked to lower IQs in children, reduced fertility, cancer, and other adverse health effects. In California, children carry flame retardant chemicals in their bodies at concentrations amongst the highest in the world. When certain flame retardants came under scientific and public scrutiny, chemical manufacturers simply introduced new, often similarly hazardous chemicals because TSCA fails to require adequate safety testing before chemicals are pushed onto the market. PSR-LA is a key leader in the diverse coalition of health advocates, firefighters, scientists, businesses and manufacturers, environmentalists, and fire safety experts who have come together in support of updating this regulation, to protect our health and environment. Regulators proposed a fix to this problem, called TB 117-2013, which would provide improved fire safety without relying on flame retardant chemicals and is set to be adopted later this year.
Moving forward, we recognize that meaningful policy must be formed with questions such as: How do we protect those most impacted? How do we move beyond consumer based approaches to more systemic solutions that do not create dual markets where safer alternatives are only available to those with higher income, leaving toxic legacy products to those with lower income, often communities of color? We know this starts with making sure those who are most affected are at the table. In the case of chemical policy reform, we often invoke mothers, children and infants, but far too often we do not include workers, fence line communities and the poor who cannot buy their way out of a polluted neighborhood or afford the newest “toxic-free” products.
Continuing to engage physicians and health professionals in this conversation is critical. To achieve real protections, we must take a public health and social justice approach to chemical policy reform.
Member Corner: Antibiotic Resistant Bacteria Are Not Due Only to Over-Prescribing
Thank you to John M. Ackerman M.D. and Edo McGowan Ph.D., for submitting this article to PSR-LA’s newsletter. We encourage members to submit articles of interest and analysis for sharing with the PSR-LA network. For more information, please contact Rebecca Bravo, email@example.com.
One of the most essential tools of modern medicine is at risk. The discovery and use of antibiotics hailed a new era in the treatment of bacterial illnesses. However, the multiplication of antibiotic resistant bacteria that may include multi-antibiotic resistant pathogens (MAR) and their multi-antibiotic resistant genes might be threatening this life saving tool. Scientists have documented the presence of antibiotic resistant bacteria (ARB) and their antibiotic resistant genes (ARG) in the three byproducts of wastewater treatment plants: 1) biosolids often used as a fertilizer additive on agricultural land; 2), recycled water sometimes used to irrigate leafy green crops consumed raw as well as grass in public parks and other playing fields; and 3) effluent that is discharged to lakes, rivers, and oceans. The presence of these contaminants should be a call for federal, state, and local policy makers to take action regarding our wastewater treatment plants to reduce the spread of ARBs, their resistant genes, and their water delivery systems.
As physician advocates, we must make the case for redesigning our existing water treatment systems and their water delivery pipe systems in order to continue to protect public health particularly from water borne antibiotic resistant pathogens and their antibiotic resistant genes. The presence of these contaminants should spur more physicians to become knowledgeable about how antibiotic resistant pathogens multiply in wastewater treatment plants and also within their delivery pipe systems. Given this ever increasing threat to the effectiveness of antibiotics, medical professionals must once again show leadership by pushing for improved potable water, waste water treatment and the waste water treatment plant water delivery systems.
Medical professionals have considerable experience giving direction for public health policy how to decrease ARB in clinical settings by eliminating excessive prescriptions of antibiotics, utilizing adequate hand washing technique plus proper disposal of antibiotics. While private practice, clinics and hospitals have focused on this issue, the inadvertent proliferation of ARB by waste water treatment plants and their distribution to the environment vis-a-vis wastewater treatment byproducts remains unaddressed.
The Medical Hydropathology Working Group, which includes a physician and two other researchers, tested recycled water from two wastewater treatment sewer plants in southern California. That testing verified data found in the scientific literature. There is a growing body of published scientific evidence that ARBs are becoming more virulent, prevalent and resistant. Other published scientific data regarding one of the nation’s most modern wastewater treatment facilities documented the presence of ARB and their antibiotic resistant genes in its effluent. Such contaminated effluent puts people living downstream of these facilities at public health risk. Clearly, this is unsatisfactory stewardship of our water resources.
Modern medicine without antibiotics?
Since penicillin was first discovered in 1929, antibiotics have been a critical tool of modern medicine. During WWII, penicillin was widely used to treat bacterial infection. Today, other antibiotics are commonly utilized after surgery as well as for the treatment of various wounds. Prior to the availability of antibiotics, doctors were forced to amputate limbs to prevent the spread of infections. Minor cuts or strep throat were sometimes fatal.
The sewage treatment process inadvertently promotes the lateral transfer of pathogenic antibiotic resistant genes from antibiotic resistant pathogens found within untreated waste water to digestive bacteria purposefully utilized by and necessary in sewage treatment. Such lateral transfer of antibiotic resistant genes continues within our open environment outside of waste water treatment plants between different living types of strains and even various species.
Wastewater is treated to meet minimal federal standards. Although the three byproducts of the wastewater treatment plants are not intended for direct human consumption, we still might be eating both crops fertilized with biosolids as well as animals that graze on pasture lands (treated with biosolids).We play on public grass irrigated with treated (and still contaminated) recycled water and eat leafy greens, sometimes irrigated with recycled water. In essence, humans are inadvertently, indirectly, and regularly in contact with recycled water and thus exposed to ARB.
As the supply of potable water decreases, public pressure to identify alternative ways to use recycled water increases. Federal, state and local officials and administrators are eager to use recycled water to irrigate both municipal grass and crops consumed raw and for other uses where it is assumed that it will not be consumed (such as water used to extinguish forest fires and in the process of hydraulic fracturing). Additionally, there is much talk about using even more recycled water as drinking water. It is in the nature of water to move and thus we cannot be assured that these uses will not end in human exposures to ARBs. Wastewater treatment plants are expected to remove harmful bacteria and other micro-organisms. Unfortunately, our current wastewater treatment facilities and technologies are inadequate to this task. Such inadequate treatment of ARB is possibly putting public health at serious risk. (In both lakes and rivers, drinking water is taken from the same areas where presumably treated sewage is discharged.) Therefore, it is essential that we increase our monitoring of ARB in both byproducts (effluent and recycled) of released waste water and also in drinking water. The monitoring should take place both at the end of the wastewater treatment plant and at the end of the water delivery pipes.
Physicians and other healthcare professions must begin to appreciate and subsequently publicly raise this issue. Health professionals must call for the redesign, upgrade, and monitoring of sewage treatment plants and their delivery pipe systems. This will also present opportunities for innovation and updating of our infrastructure and create a great many jobs. Policy changes will be critical to assist in the prevention of illness. Once properly treated, recycled water could be reconverted to potable water, utilized to irrigate crops consumed raw, fight fires, or irrigate parks and playgrounds. It is time that we start monitoring and set public health based standards that will eliminate ARB and their antibiotic resistant genes.
As physicians, we understand the need to treat clinical problems and our broader duty to identify new public health issues so that we can also prevent future illness. The State of California and our elected officials must do the same. They must improve our waste and drinking water treatment facilities and water delivery systems so they can eliminate ARB while simultaneously developing methods to quantify ARB and their resistant antibiotic genes in all of our water resources. It is our job as health care professionals to educate and build political will in order to mobilize public agencies and other reclaimed water advocates to act toward this end.
We are at a critical juncture that could lead to the loss of one of modern medicine’s greatest tools. We must take a preventative approach with new strong policy actions. While we posses much of the technology needed to adequately treat waste water, what is lacking is the political will to fund more research (Is the above contamination dangerous to our public health?) and subsequently redesign our water treatment and delivery systems. It is and has been the role of physician advocates to call for action, please join us in our efforts to educate, engage, and mobilize our colleagues. Also please join our Medical Hydropathology Working Group as we will be hosting a series of conference calls to develop a strategy for eliminating ARB and their antibiotic resistant genes in effluent, recycled water, potable water and biosolids. Please contact John M. Ackerman, M.D. (firstname.lastname@example.org) if you have comments and and/or questions.
Angela Johnson Meszaros is General Counsel at PSR-LA where she works to ensure that public health professionals are engaged in environmental public health policy and supporting community-based efforts to protect public health.
Angela has nearly 20 years of experience working with communities and organizations on environmental justice issues in the Los Angeles region. During this time, Angela has used a range of tools to enhance the health, safety, and quality of life of low-income communities of color negatively impacted by environmental hazards. Her efforts have been focused on policy development, implementation, and enforcement in a variety of environmental issues including: the impacts climate change policy on communities of color, enforcement of the provisions of the Clean Air Act, enhanced public participation in environmental decision-making, reducing childhood lead poisoning, defending against destructive freeway siting, stopping inappropriate siting of sources of air pollution, understanding land use policies and their impact on community health, reducing health impacts of air toxics from mobile and stationary sources, and air permit development and compliance. Read Angela’s full biography.
Monika Shankar is the Health and Environment Associate at PSR-LA where she directs programs focusing on climate change and healthy land use by mobilizing and engaging health professionals, community groups and advocates in policy advocacy.
Prior to joining PSR-LA, Monika worked with a team of community planners and environmental justice activists at the Ironbound Community Corporation, whose goal was to create a safe, healthy, thriving and sustainable neighborhood in a primarily immigrant section of Newark, NJ. Through collaborations with community members, local organizations, city officials and environmental experts, the team addressed both at the local and policy level ways to resolve a multitude of issues including the remediation of one of the dirtiest rivers in the US; the Passaic River. Read Monika’s full biography.
Rebecca Bravo is a Program Associate at PSR-LA. Rebecca works on expanding PSR-LA audience through social media tools including Facebook and Twitter. She collaborates on the production of the PSR-LA newsletter and membership updates and also provides key staff support in organizing PSR special events.