EDF Health

Selected tag(s): EPA

Pollution is responsible for 9 million deaths globally: Two-thirds are due to air pollution

Dr. Ananya Roy is a Health Scientist

Over the last few weeks as forest fires engulfed large areas of California, air quality in the Bay area plummeted. Doctors and pediatricians were on high alert to deal with the health impacts felt most acutely by children and the elderly. Pediatrician’s offices had phone messages that said “If you are concerned about air pollution and calling to make an appointment for your child’s asthma please dial …” and advised citizens to use face masks and air purifiers and stay indoors. News outlets compared air pollution levels there to winter days in Beijing or New Delhi where air pollution is a more consistent threat. These fires drive home the reality of the effect of pollution on health.

Time and time again pollution related news from across the country and globe have made headlines, ranging from lead and PFOAS in water Flint and Hoosick Falls, benzene in Houston, to the “Airpocalypse” in Beijing and New Delhi. Though these articles highlight the disastrous effects of pollution from major pollution and weather events, the constant and ongoing silent impact of air pollution on the lives of children and communities remains underappreciated.

GAHP, The Lancet Report

Today, the Lancet Commission on Pollution and Health, an initiative of The Lancet, the Global Alliance on Health and Pollution (GAHP), Pure Earth, and the Icahn School of Medicine at Mount Sinai, with additional coordination and input from United Nations Environment, United Nations Industrial Development Organization (UNIDO), the World Bank, and others provide the first comprehensive global analysis of the health and economic impacts from all forms of pollution (air, water, soil, occupational). My colleague Elena Craft and I were contributors to this report.

The analysis carried out through the Global Burden of Disease framework estimated that pollution across air, water, soil, and occupational exposures costs the global economy $4.6 trillion per year, approximately 6.2% of global GDP, and resulted in 9 million deaths in 2015. This is equivalent to 16% of all deaths worldwide. Three times more deaths than AIDS, tuberculosis, and malaria combined; and fifteen times more than all wars and other forms of violence.

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Posted in Air Pollution, Health Policy, Health Science / Also tagged | Comments are closed

New EPA model enables comparison of various sources of childhood exposure to lead

Tom Neltner, J.D.is Chemicals Policy Director and Dr. Ananya Roy is Health Scientist

This week, Environmental Health Perspectives published an important article by scientists at the Environmental Protection Agency (EPA) that sheds important light on the various sources of children’s lead exposure. Led by Valerie Zaltarian, the article shares an innovative multimedia model to quantify and compare relative contributions of lead from air, soil/dust, water and food to children’s blood lead level. The model couples existing SHEDS and IEUBK models to predict blood lead levels using information on concentrations of lead in different sources, intake and gut absorption. The predicted blood lead levels compared well with observed levels in the National Health and Nutrition Evaluation Survey population. Given the variety of independent sources of lead exposure, the model provides a critical tool that public health professionals can use to set priorities and evaluate the impact of various potential standards for all children and not just those with the greatest exposure.

This peer-reviewed article builds on a draft report EPA released in January 2017 evaluating different approaches to setting a health-based benchmark for lead in drinking water. The report has provided a wealth of insight into a complicated topic. Earlier this year, we used it to show that formula-fed infants get most of their lead exposure from water and toddlers from food, while the main source of lead for the highest exposed children is soil and dust. In our February blog, we provided our assessment of a health-based benchmark for lead in drinking water and explained how public health professionals could use it to evaluate homes. The information was also critical to identifying lead in food as an overlooked, but meaningful, source of children’s exposure to lead.

The new article reaffirms the analysis in the January 2017 EPA report and highlights that evaluating source contribution to blood lead in isolation versus aggregating across all sources can lead to very different answers and priorities. A health-based benchmark for lead in drinking water could vary from 0 to 46 ppb depending on age and whether all other sources of lead are considered. For example, a health-based benchmark for infants (birth to six months old) would be 4 ppb or 13 ppb depending on whether or not you consider all sources of exposure.

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Posted in Drinking Water, Emerging Science, EPA, Food, Health Policy, lead, Uncategorized / Also tagged , , , , , , , | Comments are closed

Progress takes vigilance to reduce children’s exposure to lead

Tom Neltner, J.D.is Chemicals Policy Director

The United States has made significant progress over the past fifteen years towards reducing children’s exposure to lead. While much more needs to be done to eliminate the more than $50 billion a year in societal costs from lead, the progress is good news for children since it is well known that there is no safe level of lead in children, and it can impair their brain development, contribute to learning and behavioral problems, and lower IQs.

Achieving this progress has required a diligent and ongoing commitment from all levels of government. If we expect to continue to make progress – and not backslide – the federal government needs to remain committed to reducing sources of lead exposure. So far what we’ve seen from the Trump Administration raises serious concerns about any real commitment to protecting children’s health, including from lead.

Lead has a toxic legacy from decades of extensive use in paint, gasoline, and water pipes. As long as lead is in the paint, pipes, and soil where we live, work and play, progress is far from inevitable. Protecting children from lead takes constant vigilance, especially when the paint or plumbing is disturbed. Flint provided a tragic example of what happens when we turn away. Without vigilance, the positive trends we have seen in blood lead levels could all too easily reverse course and go up. That is why the proposed cuts to the Environmental Protection Agency's (EPA) budget, which would eliminate the agency’s lead-based paint programs, are yet another indication that this Administration is turning its back on protecting children’s health.

Mean blood lead levels in young children dropped 56% from 1999 to 2014

Data from the Centers for Disease Control and Prevention (CDC) demonstrates that from 1999 to 2014 the levels of lead in children’s blood or “blood lead levels” (BLL) dropped preciptiously. Average BLLs in young children declined by 56% during that period with the rate of decline increasing after 2010. For children with a BLL greater than 5 micrograms of lead per deciliter (µg/dL), the reduction was an impressive 86%. Read More »

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EPA's Children’s Health Protection Advisory Committee recommends four top priorities for EPA to protect kids from lead

Tom Neltner, J.D.is Chemicals Policy Director

For the past 20 years, the Children’s Health Protection Advisory Committee (CHPAC), with its diverse members that include pediatricians and industry toxicologists, has been responding to requests for guidance from Environmental Protection Agency (EPA) administrators. In December 2016, EPA’s Administrator asked CHPAC to provide the agency with its “highest priority advice” on lead. Citing the children’s health risks posed by lead, the economic and racial disparities and the demonstrated effectiveness of national leadership on the issue, on April 6, CHPAC sent the new administrator, Scott Pruitt, a letter with its four recommended priorities:

  1. Strengthen the Agency’s Lead-Based Paint Hazards Standard for lead in paint, dust, and soil. CHPAC stated that the “best evidence shows that a young child living in a home meeting the current lead dust standard still has a 50% chance of exceeding the CDC reference level for blood lead.” The EPA standard is so insufficient and outdated that on February 1, 2017, the Department of Housing and Urban Development said it would require its lead hazard control grantees to meet a more protective level that is one-fourth of EPA’s standard.
  1. Revise the Lead and Copper Rule to reduce lead in drinking water. CHPAC highlighted several high profile incidents of high levels of lead in drinking water and called for EPA to overhaul its 1991 Lead and Copper Rule to better protect children, especially infants dependent on formula for nutrition. CHPAC recommended the revisions be consistent with the recommendations from the agency’s National Drinking Water Advisory Committee and the lessons from recent water system lead contaminations.
  1. Improve risk communication efforts to provide clarity and consistency. CHPAC asked that EPA revise its “Protect Your Family from Lead In Your Home” booklet that is given to every family buying or renting a home built before 1978 so that it more effectively helps families make decisions regarding the risks posed by lead. The committee cited three problems with the booklet, it:
    • insufficiently describes other important lead sources including, but not limited to, drinking water faucets, plumbing, traditional and cultural products, and take-home exposures from work”;
    • treats all homes built before 1978 as equal and does not explain that the likelihood of having lead-based paint varies dramatically based on the age of the home”; and
    • “relies heavily on text rather than graphics making it less effective for some audiences.”
  1. Encourage the Administration’s infrastructure investment program to support healthy housing, childcare facilities, and schools, and safe drinking water. CHPAC recommended that EPA work closely with other federal partners on the President's Task Force on Environmental Health Risks and Safety Risks to Children to help ensure that all Administration infrastructure investment programs make housing, childcare facilities, and schools healthier, and drinking water safer.

The letter was sent a day after the Washington Post reported on a leaked March 21, 2017 agency memo that details how EPA plans to execute the 31% cuts to its overall budget called for in the President’s proposed budget. The article’s headline says it all: “Trump’s EPA moves to dismantle programs that protect kids from lead paint.” If Congress goes along with these cuts, it is difficult to imagine how the agency could fulfill its basic responsibilities much less implement CHPAC’s recommendations to protect kids from lead.

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EDF’s assessment of a health-based benchmark for lead in drinking water

Tom Neltner, J.D.is Chemicals Policy Director

Health professionals periodically ask me how they should advise parents who ask about what constitutes a dangerous level of lead in drinking water. They want a number similar to the one developed by the Environmental Protection Agency (EPA) for lead in dust and soil (which is the primary source of elevated blood lead levels in young children). I usually remind them that EPA’s 15 parts per billion (ppb) Lead Action Level is based on the effectiveness of treating water to reduce corrosion and the leaching of lead from plumbing; it has no relation to health. Then I tell them that EPA is working on one and to hold tight. Admittedly, that is not very satisfying to someone who must answer a parent’s questions about the results of water tests today.

On January 12, EPA released a draft report for public comment and external peer review that provides scientific models that the agency may use to develop potential health-based benchmarks for lead in drinking water. In a blog last month, I explained the various approaches and options for benchmarks that ranged from 3 to 56 ppb. In another blog, I described how EPA’s analysis provides insight into the amounts of lead in food, water, air, dust and soil to which infants and toddlers may be exposed. In this blog, I provide our assessment of numbers that health professionals could use to answer a parent’s questions. Because the numbers are only a start, I also suggest how health professionals can use the health-based benchmarks to help parents take action when water tests exceed those levels.

EDF’s read on an appropriate health-based benchmark for individual action on lead in drinking water

When it comes to children’s brain development, EDF is cautious. So we drew from the agency’s estimates calculated by its model to result in a 1% increase in the probability of a child having a blood lead level (BLL) of 3.5 micrograms of lead per deciliter of blood (µg/dL).

EDF's assessment of a health-based benchmark for individual action on lead in drinking water
Age of child in home and type of exposureHouses built before 1950¹Houses built 1950 to 1978²Tests show no lead in dust or soil³
Formula-fed infant3.8 ppb8.2 ppb11.3 ppb
Other children 7 years or younger5.9 ppb12.9 ppb27.3 ppb

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When it comes to lead, formula-fed infants get most from water and toddlers from food, but for highest exposed children the main source of lead is soil and dust

Tom Neltner, J.D.is Chemicals Policy Director

On January 19, the Environmental Protection Agency (EPA) released a major new draft report proposing three different approaches to setting health-based benchmarks for lead in drinking water. We applauded EPA’s action and explored the implications for drinking water in a previous blog. One of the agency’s approaches provides useful, and surprising, insights into where the lead that undermines the health of our children comes from. Knowing the sources enables regulators and stakeholders to set science-based priorities to reduce exposures and the estimated $50 billion that lead costs society each year.

The EPA draft report is available for public comments until March 6, 2017, and it is undergoing external peer-review by experts in the field in support of the agency’s planned revisions to its Lead and Copper Rule (LCR) for drinking water. Following this public peer-review process, EPA expects to evaluate and determine what specific role or roles a health-based value may play in the revised LCR. With the understanding that some of the content may change, here are my takeaways from the draft:

  • For the 20% of most exposed infants and toddlers, dust/soil is the largest source of lead. Since we know that 21% of U.S. homes (24 out of 114 million) have lead-based paint hazards, this should not be surprising.
  • For most infants, lead in water and soil/dust have similar contributions to blood lead levels, with food as a smaller source. If the infant is formula-fed, water dominates.
  • For 2/3 of toddlers, food appears to provide the majority of their exposure to lead. This result was a surprise for me. EPA used data from the Food and Drug Administration’s (FDA) Total Diet Study collected from 2007 to 2013 coupled with food consumption data from the National Health and Nutrition Examination Survey collected from 2005 to 2011. In August 2016, FDA reported on levels of lead (and cadmium in food) commonly eaten by infants and toddlers based on a data set that is different from its Total Diet Study. FDA concluded that these levels, “on average, are relatively low and are not likely to cause a human health concern.”
  • For all children, air pollution appears to be a minor source of lead exposure. We think it is most likely because exposure is localized around small airports and industrial sources.

For a visual look at the data, we extracted two charts from the draft EPA report (page 81) that show the relative contribution of the four sources of lead for infants (0-6 month-olds) and toddlers (1 to <2 year-olds) considered by the agency. The charts represent national exposure distributions and not specific geographical areas or age of housing.

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Posted in Drinking Water, Emerging Science, EPA, FDA, Food, Health Policy, lead / Also tagged , , , , , | Comments are closed