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Center for Environmental Oncology

Winter 2008 • Volume 2 • Number 2 TABLE OF CONTENTS


Pregnancy and Environmental Health
Judith Balk, MD, MPH and
Michele Ondeck, RN, Med
Magee-Womens Hospital of UPMC
Page 4
Pesticides and Breast Cancer: A Wake Up Call
Meriel Watts, PhD
Page 6
Creating Better Breathing Space for Asthmatics
Page 9
The Allegheny River Stewardship Project:
A Call for Volunteers

The Unrecognized Risks


Conrad Dan Volz, DrPH, MPH
Page 10

of CT Radiation Additional Internet Resources


Page 12
Shaul Schwarz/Stringer/ News/Getty Images

by: Devra Lee Davis, PhD, MPH, Director, Center for Environmental Oncology of UPCI,
UPCOMING events
Adapted from The Secret History of the War on Cancer. February 13, 2008, 6:00 – 8:00 PM
Book Reading and Discussion:
Diagnostic radiation is a modern miracle three-dimensional look inside an old set of “Not Just a Pretty Face—
we have come to depend on. In 1979, The knees or cranky stomach, a patient does The Ugly Side of the Beauty Industry”
Nobel Prize in Medicine and Physiology not usually ask whether this remarkable Maryann Donovan, M.P.H., PhD., Scientific Director,
Center for Environmental Oncology
was awarded to Godfrey N. Hounsfield test might increase her long-term risk of
Talk by author Stacy Malkan
and Allen M. Cormack, the engineer and more serious ailments. Magee-Womens Hospital of UPMC
physicist who invented the system for cre- When my then eleven-year-old daughter To register, call
ating three-dimensional images of the hu- Magee’s education department at: 412-802-8299 or
was given a CT scan of her abdomen to visit magee.upmc.com
man body. Computerized imaging technol- see if she had a ruptured spleen, I was
ogy is now such a large, profitable industry just like most parents with a child in the
that it has its own futures market. Seven emergency room. All I wanted to know
times more CT scans are conducted today was that she would be okay. But when I
Visit our New and
than just ten years ago. (1) The leading asked the young radiologist if there was
manufacturer, Cardinal Health, is one of a way to shield my daughter’s chest, she
the twenty largest companies in the world, looked at me skeptically and asked, “Why? Improved Website!
with revenues of more than $81 billion a She doesn’t have any breasts.” I explained
year. (2) www.preventingcancernow.org
to her that we know that radiation expo-
New government regulations in the United sure to the chests of girls before puberty
States are shutting down what had been increases the chances that breast cancer Highmark Healthy Places, Healthy People
highly profitable ventures in which physi- will develop later on. The woman looked at
cians would prescribe tests on machines me as if I were slightly insane. Funding for this newsletter is provided by
they themselves owned. When offered a the Highmark Foundation and the Heinz Endowments.
Continued on page 2
www.environmentaloncology.org Helping to make prevention the cure for cancer.

The Unrecognized Risks of CT Radiation Continued From Page 1


My colleague Dr. Dwight Heron, Vice around 500 Roentgen doses within several
Chairman for Clinical Affairs, Department minutes of radiation from the Chernobyl
of Radiology, University of Pittsburgh Can- explosion in 1986. Conservative estimates
cer Institute and Chairman, Department are that as a result of this massive explo-
of Radiation Oncology, UPMC Shadyside, sion there will be 30,000 to 60,000 more
UPCOMING events spends his days diagnosing and treating cancer deaths that would not otherwise
Continued from page 1
cancer patients with the help of modern have occurred. (4)
March 3, 2008, 4:30 - 6:00pm computerized diagnostic scanning sys-
Talk by Arlene Blum, PhD Concerns about unnecessary medical ra-
tems. I asked him what he thought about diation in young children today are now
“The Fire Retardant Dilemma”
Carnegie Mellon’ University the current enthusiasm for CT and PET ricocheting throughout the medical com-
136A Baker Hall scans of healthy people. munity. A group of Yale researchers, look-
Pittsburgh, PA
Heron says, “It’s a big problem. Radiolo- ing at current patterns, estimates that in
March 26, 2008, 7 PM gists appreciate that we could be creat- one year, 700 people will die from cancers
Dr. Devra Davis
ing more cancer in young people by what associated with head CTs and 1,800 will
Talk and Book Signing
The Secret History of the War on Cancer happens in emergency rooms all over the die from radiation-induced cancer from
United Jewish Federation country today.” abdominal examinations carried out when
Phipps Conservatory they were infants. (5) Reduced brain func-
Heron referred me to the 2007 white paper
Botany Hall
on radiation in medicine, where the Ameri- tion, learning problems and lowered IQ
March 27, 2008, 7:00 PM - 8:30 PM can College of Radiology (ACR) noted that from such potentially unnecessary and
Lecture and book signing by Devra Davis, PhD, MPH
in the past quarter century, the amount of inappropriate exams is not easily calcu-
The Secret History of the War on Cancer’ lated, but it cannot be trivial.(1)
South Park Library radiation the U.S. population receives each
2575 Brownsville Road year from medical imaging has increased Most physicians and the rest of us are un-
South Park, PA 15129 fivefold. A single computerized scan of the aware of the dangers shown in Table 15-2
Free event, open to the public
stomach today can give half the dose that (see page 3)
Call 412-623-1175 for more information.
was shown to induce cancer in those who To put these doses into perspective, even
survived the atomic bomb blasts in Japan. a properly calibrated CT scan of a child’s
The ACR advises that “the current annual stomach can be equivalent to six hun-
collective dose estimate from medical ex- dred chest X-rays, while one of an infant’s
posure in the United States has been cal- head can be equivalent to a few thousand.
culated as roughly equivalent to the total Imagine a lifetime of emergency room vis-
worldwide collective dose generated by its, with repeated scans, and it becomes
the nuclear catastrophe at Chernobyl.” (3) clear that these risks could create a major
Let me translate this. Modern America’s cancer burden of the future.
annual exposure to radiation from diag- Emergency room physicians have not yet
nostic machines is equal to that released gotten the message. A survey of emergen-
by a nuclear accident that spewed the cy room doctors at a major medical center
equivalent of hundreds of Hiroshimas found that none of them was aware that
across much of Russia and Eastern Eu- some of the diagnostic procedures they
rope. In 2005, the Chernobyl Forum, an or- were ordering increased the risk of cancer
ganization led by the International Atomic for their patients thirty years later. (1)
Energy Agency and the World Health Or-
ganization, estimated that about 6.5 million Of the more than 10 million cancer survi-
Winter 2008 people were exposed to 5.6 Roentgen per vors in this nation, those who underwent
Volume 2 • Number 2 second (R/s). This is equivalent to 20,000 extensive radiation to treat or find their
Roentgen per hour (R/h). A lethal dose is disease, like Elizabeth Edwards, wife of

2 Center for Environmental Oncology — University of Pittsburgh Cancer Institute


CEO-UPCI www.environmentaloncology.org

Sen. John Edwards, and Tony Snow, for- in the Lancet in 1956, flew in the face of as-
mer press secretary to the White House, surances from obstetricians that the prac-
or those who had the disease as young tice was harmless. Stewart’s findings also
children, face lifetime risks of other can- upset those advocating the continued use
cers as a result. Other studies show that of nuclear weapons and testing. The year
the risks of cancer from radiation in can- 1956 was the peak year for above-ground
cer patients treated for Hodgkin’s disease nuclear weapons and testing and radio- Recent Expert Warnings on
could even be greater than those of the active fallout. Obstetricians and nuclear the Risks of CT Scans:
atom bomb survivors. This apparently weapons advocates alike maintained that The American College of Radiology calls
greater vulnerability of the weakened to small doses of radiation were harmless. for national standards for training and
certification of CT technologists and improved
the damaging effects of radiation is some- In fact, Stewart’s findings showed that a medical education programs regarding risks
thing that researchers like Alice Stewart single dose of diagnostic x-rays early in and benefits of radiological procedures
and Rosalie Bertell warned about nearly pregnancy more than doubled the child’s and non-radiological alternatives.
half a century ago. (6) The world is catch- risk of leukemia. (7) E. Stephen Amis, Priscilla F. Butler, Kimberly E.
ing up with them. Appelgate, et al., “American College of Radiology White
There is no question that in medical emer- Paper on Radiation Dose in Medicine,” Journal of the
Stewart’s work on the dangers of radiation gencies, CT scans save lives and eliminate American College of Radiology 4 (2007): 272-284. (www.
in England was simple and powerful. She exploratory surgery. But, experts increas- devradavis.com/6%20-%20ACRWhitePaper.pdf)
visited every county and county borough ingly agree (see sidebar) that the number Current uses of CT scan are expected to increase
health department in the country, hand- of scans can be reduced without compro- the rates of radiation-related cancer, especially
in children and young adults and should be
ing out questionnaires that asked mothers mising the ability to deliver health care.
reduced in non-emergency situations.
of children born between 1953 and 1955 For healthy individuals, and especially
David J. Brenner, Eric J. Hall, “Computed Tomography—
about things that happened to them when children, if a CT scan is recommended, it
An Increasing Source of Radiation Exposure,” The
they were pregnant. Within a year, she had is important to consider whether another New England Journal of Medicine 357:2277-2282
determined that the mothers of leukemic diagnostic tool, such as Magnetic Reso- (November 29, 2007): Number 22 http://content.
children were three times more likely to nance Imaging or ultrasound, neither of nejm.org/cgi/content/full/357/22/2277

have had routine x-rays of their abdomens which involves radiation, could be used
during pregnancy. These results, published instead. References for The Unrecognized
Risks of CT Scans:
Table 1 Radiation Risks of CT Scans Table 1. Davis, Devra. The Secret History of the War on Cancer.
Approx. New York: Basic Books, 2007, p. 413.
Equivalency in
Equivalent Dose 1. Brenner, D. J., & Hall, E. J. (2007). Computed tomogra-
Exam Type Machine Setting Relevant Organ Chest X-rays
to Relevant
.15 - .01 mSv* phy — an increasing source of radiation exposure. N Engl J
Organ (mSv)
Med, 357, 2277-2282. <http://content.nejm.org/cgi/content/
Pediatric Head full/357/22/2277>
Unadjusted a Brain 60 400-6000
CT Scan
2. “Cardinal Health Launches New PET Marketing Tools,”
Pediatric Head (2006). <http://nps.cardinal.com/nps/PETfoundations/current-
Adjusted b Brain 30 200-3000
CT Scan News.asp>
Ped. Abdomi- 3. Amis, E. S., Butler, P. F., & Applegate, K. E., et al. (2007)
Unadjusted Stomach 25 166-2500
nal CT Scan American College of Radiology White Paper on Radiation Dose
Ped. Abdomi- in Medicine. J Am Coll Radiol, 4, 272-284.
nal CT Scan Adjusted Stomach 6 40-600
See all references for The Unrecognized Risks of CT Scans on
Chest X-ray our website www.preventingcancernow.org
(PA/lateral) n/a Lung .01/.15 .01-.15

Screening
n/a Breast 3 20-300
Mammogram

Source: Society for Pediatric Radiology and National Cancer Institute, “Radiation & Pediatric Computed Tomography: A
Guide for Health Care Providers,” Summer 2002, http://www.cancer.gov/cancertopics/causes/radiation-risks-pediatric-CT
Winter 2008
a “Unadjusted” refers to using the same settings as for adults. b “Adjusted” refers to settings adjusted for body weight.
Volume 2 • Number 2
*Chest-x-ray equivalency based on NCI estimates in this table

Center for Environmental Oncology — University of Pittsburgh Cancer Institute 3


www.environmentaloncology.org Helping to make prevention the cure for cancer.

Question:
Children, Playsets
and Wood Decks:
Safety?
Dear Center for Environmental Oncology,

My deck and my children’s playset are made of


pressure treated wood, which I’ve heard could be
dangerous. What are my alternatives?
Pregnancy and Environmental Health
by Judith Balk, MD, MPH, Magee-Womens Hospital of UPMC and Assistant Professor,
University of Pittsburgh and Michele Ondeck, RN, Med, LCCE childbirth educator,
Answer: Magee-Womens Hospital of UPMC
All parents want to have healthy children. In this article, Magee-Womens Hospital of
For many years, more than 90 percent of all In our industrialized world, women and UPMC’s physician Dr. Judy Balk and child-
pressure treated wood contained chromium copper
men of childbearing age need to not only birth educator, Michele Ondeck, answer
arsenic (CCA), an arsenic-laden wood preservative
address issues of how to eat healthy and some frequently asked questions from
to prevent damage from rot, insects and fungi.
maintain fitness but also are confronted pregnant women around environmental
Arsenic, a known human carcinogen, can leach
with environmental and workplace expo- health issues.
to the surface of the wood and into surrounding
sures that may impact their health and the I love to eat fish but the guidelines of what
soil, exposing children to unsafe levels. Tests have
shown that even years after installation, arsenic health of their unborn child. fish are safe to eat during pregnancy con-
continues to leach from pressure treated wood. A woman’s health before her pregnancy fuses me?
In 2002, wood manufacturers agreed with the is the most significant determinant of a Eating a diet high in omega 3 fatty acids,
U.S. Environmental Protection Agency to phase healthy pregnancy and baby. A precon- found in salmon, for instance, is good for
out CCA-treated wood by December 31, 2003. ception visit (a visit to a primary care your cardiovascular health and is impor-
doctor by a woman who could conceive tant for the fetus’ brain growth. Women of
Alternatives to chemically treated wood include
recycled plastic or naturally rot-resistant before her next visit) may include coun- childbearing age should avoid eating fish
domestic woods like aromatic cedar and black seling related to her workplace exposures high in methymercury (organic mercury).
locust. Playground equipment and decking and the need to achieve normal weight Methyl-mercury can permanently damage
materials may be available in these materials and establish an active lifestyle, as well the brain of the developing fetus and can
— check with the manufacturers directly. as a recommendation that she take pre- increase the chance that birth defects will
natal vitamins (this is good advice for all occur. Organic mercury was used as a fun-
Taken from Healthy Child, Healthy World
website: www.healthychild.org women of childbearing age.) Questions gicide in agriculture in the 1960’s, and also
about fathers’ workplace exposures and released into water as a byproduct of the
good and bad habits are also relevant. It metals industry. The larger, older and fat-
is important for a woman who is obese to tier the fish, the more methylmercury and
lose weight before conceiving in order to other contaminants it can contain. Meth-
Winter 2008 reduce pregnancy complications and to ylmercury can especially accumulate in
Volume 2 • Number 2 reduce her body burden of environmental high levels in large or predatory fish, such
toxins that are stored in fat tissues.

4 Center for Environmental Oncology — University of Pittsburgh Cancer Institute


CEO-UPCI www.environmentaloncology.org

as tuna, shark, king mackerel, swordfish, age woman uses about 12 products a day.
and tilefish. Children and pregnant wom- That could mean she is applying well over
en should not eat these fish. If a pregnant 100 different chemicals to her skin, hair
woman eats mercury-contaminated fish, and nails in a single day. The Federal Drug
the mercury travels from her bloodstream Administration (FDA) does not regulate or
and across the placenta to the fetus. require personal care product manufac-
turers to test products, so little or no data Protect Your Children
Experts recommend that when a woman is
exists on most of the chemicals of con- from Hidden Pesticides in
preparing for pregnancy she should avoid
cern. In the Unites States, we are guided Your Home
fish high in mercury for 3 to 6 months.
by the principle of “prove harm” before Some pesticides have been shown to cause cancer
When pregnant, a woman should eat up to in humans, especially when people are exposed
12 ounces a week of a variety of fish and regulating chemicals. In contrast, the
at high levels. Children are at increased risk for
shellfish that are lower in mercury (such European Union is guided by the “precau- pesticide poisoning because of their smaller
as salmon, canned light tuna, shrimp, pol- tionary principle” and has banned most of size and because pesticides may be applied to
these chemicals of concern. The best ap- surfaces that are easily accessed by children.
lock and catfish). Consumers also need to
be aware of the source of their fish, as only proach is prevention. Antibacterial Soaps and Disinfectants: May
a small percentage of fish are inspected. Thankfully, now there is an on-line guide contain any number of 275 different active ingredients
classified by the EPA as pesticides. Frequent use of
Check advisories about fish caught locally. with safety ratings of more than 23,000
antibacterial soaps selects for more resistant bacteria.
The safest fish are wild caught or farmed products at www.comesticsdatabase.
Alternative: Teach your children to wash their
in the United States by environmentally com. Skin, hair and nail care products are hands frequently with regular soap.
responsible operations. Next time you are rated for safety, depending on the chemi-
shopping, consider buying a can of salm- cals they contain as well as other criteria. Mothballs: Can cause serious health
problems if ingested or by inhaling the fumes.
on that is not only low in mercury but also All women, pregnant or otherwise, should
1,4 Dichlorobenzene, found in mothballs, may be
inexpensive and a good source of protein learn to always read product labels with reasonably anticipated to be a carcinogen.
and omega 3 fatty acids. the idea that fewer ingredients usually Alternative: Always keep mothballs out
For more information: means a lower risk. It is also a good idea of reach of children. Use cedar balls or
to avoid products with words like “fra- lavender sachets to ward off moths.
www.cfsan.fda.gov/seafood1;
www.epa.gov/ost/fish; www.ewg.org grance,” “parabens,” or “ phthalates” Synthetic Carpets: May contain anti-mildew
on the label and to avoid nail polish with pesticides, as well as toxic adhesives. Many chemicals
A friend told me that I should not use formaldehyde in it. Organic cosmetics and used on carpets are volatile organic compounds (VOCs),
make-up when I am pregnant. But, I look which may cause carcinogens to be released into the air.
personal care products are a safer alter-
so much better in make-up. What can I native, but there are still, as yet, no na- Alternatives: Choose alternative flooring: ceramic
use and still be safe? tiles, untreated hardwood, cotton or hemp rugs (with
tional standards established for using the
non-toxic adhesive and non-plastic backings.)
A teratogen is something that causes words “natural” or “organic” in personal
harm to a fetus, and there is no known care products. Paint: Several brands contain anti-mildew pesticides
way to predict if an individual fetus will and emit VOCs. Test paint chips from walls and windows
Magee-Womens Hospital is hosting a for lead, which is very dangerous to children’s health.
be sensitive or not to a substance. It de- book reading and discussion related to Alternatives: Choose “No-VOC” or natural milk
pends on the substance itself, how much safe cosmetics about the new book by paints. Keep children away from chipping and
exposure the pregnant woman/fetus had Stacy Malkan, entitled Not Just a Pretty peeling paint; clean sills with a damp rag.
to it, and for how long and when, during Face-The Ugly Side of the Beauty Indus-
the pregnancy, a woman is exposed. It is References:
try on Wednesday, February 13, 2008 from
thought that the most vulnerable period National Cancer Institute: www.cancer.gov
6:00-8:00 pm. Dr. Maryann Donovan of the
for the fetus is within the first 57 days of ATSDR: www.atsdr.cdc.gov
Center for Environmental Oncology will
pregnancy. also discuss these issues along with Mia
There are many concerns about personal Davis from the Safe Cosmetics Campaign. Winter 2008
care products and cosmetics. An aver- To register, call the education department Volume 2 • Number 2
Continued on page 12

Center for Environmental Oncology — University of Pittsburgh Cancer Institute 5


www.environmentaloncology.org Helping to make prevention the cure for cancer.

Pesticides and Breast Cancer: A Wake Up Call


by Meriel Watts, PhD, a scientist with Pesticide Action Network (PAN) Asia and the
Pacific, www.panap.net, and co-ordinator of PAN Aotearoa New Zealand, author of
Ethical Pesticide Policy: Beyond Risk Assessment
Incidence of breast cancer continues to we find in household fly sprays, the herbi-
Pesticide Action Network rise in most countries. Even those coun- cide atrazine which contaminates ground
(PAN) Asia and the Pacific, tries that traditionally have been regarded and drinking water in the US, New Zealand
Penang Malaysia as having relatively low rates, compared and other countries, the aerially applied
www.panap.net panpa@panap.net with countries like the USA and New herbicide 2, 4-D renowned for its ability
Zealand—notably the developing coun- to drift off-target over long distances, and
Pesticide Action Network (PAN) is a global network
working to eliminate the human and environmental tries of Asia—are beginning to catch up. organophosphate insecticides. Some pes-
harm caused by pesticides and to promote Why? There is no easy answer. The fac- ticides—such as chlorpyrifos and diazi-
biodiversity based ecological agriculture. PAN Asia tors involved in breast cancer genesis non—are found in the meconium, or first
and the Pacific is committed to the empowerment
are many and complex, and still not fully feces, of newborn children indicating ex-
of people especially women, agricultural
workers, peasant and indigenous farmers. understood. One potential factor, however, posure while still in the womb. Others are
is frequently overlooked, and this is expo- contaminating breast milk. This does not
sure to pesticides, which has escalated mean breastfeeding should be replaced
dramatically in developing countries over by bottle-feeding. Despite the residues,
the last 20 years. breastfeeding confers overwhelming ben-
Pesticides and Breast Cancer: A Wake-Up efits on both mother and child.
Call examines available experimental and The evidence considered in A Wake Up
epidemiological evidence suggesting that Call includes epidemiological studies ex-
pesticides may contribute to the puzzling amining possible links between exposures
growth of breast cancer. While this new to various pesticides and incidence of
book focuses on pesticides used in the breast cancer; or body burdens of organo-
Asia Pacific region, the information it con- chlorine insecticides and incidence. It also
tains applies to any country where they considers mammary tumors produced in
are employed. It identifies 98 pesticide laboratory trials. These are the commonly
active ingredients, one adjuvant and two acknowledged indicators of breast cancer
contaminants of pesticide formulations risk. In fact, this is as far as most reviews
that potentially affect the risk of breast go, and other indicators of a pesticide’s
cancer. The pesticides identified include potential to cause breast cancer are gen-
insecticides, herbicides, fungicides and erally overlooked.
fumigants. The capacity of pesticides to disrupt hor-
It would be nice to think of these sub- mones has been well documented. The
stances as largely obsolete pesticides role of estrogen in breast cancer is now
such as DDT, although the resurgence in well established and the potential role of
use of this one in Africa is a real concern. estrogen-mimicking chemicals widely
But, in fact, the vast majority of pesticides accepted. But what of the effects of pes-
covered in the book are still currently in ticides on other hormones – androgens,
use, particularly in developing countries. progesterone, prolactin, melatonin and
Some are also still widely used in the USA, prostaglandins? These hormones also
Europe and New Zealand. These include have a role to play in the development of
Winter 2008 organochlorines like lindane used for head breast cancer. And so may the pesticides
Volume 2 • Number 2 lice control, the synthetic pyrethroids that that affect them.

6 Center for Environmental Oncology — University of Pittsburgh Cancer Institute


CEO-UPCI www.environmentaloncology.org

Examples of Pesticides:
Insecticides:
organochlorines – endosulfan, lindane
synthetic pyrethroids – permethrin, deltamethrin
organophosphates – malathion, dichlorvos
Herbicides:
triazines – atrazine, simazine
others – 2,4-D, paraquat
Fungicides:
mancozeb, captan
In addition, there are a number of other We cannot rely solely on epidemiology Fumigants:
DBCP, ethylene dibromide
mechanisms by which pesticides might to unravel the relationship between pes-
influence the onset and progression of ticides and breast cancer—not least be- Adjuvants:
nonylphenol
breast cancer: through their influence on cause breast cancer can have such a long
the immune systems’ Natural Killer T-cells, latency period, it may be virtually impos- Contaminants:
dioxin, 1,4-dioxane
through interfering with cellular communi- sible to establish exposures in a meaning-
cation, or the function of enzymes on cell ful way. The relevant exposures may have
repair, or impeding the cell’s natural ability occurred very early in life or even at the
to cause tumor cells to die off. And there is fetal stage. The fetus is exquisitely sensi-
For More Resources about
evidence that a number of pesticides can tive to carcinogens and hormonally active
Pesticide Safety
adversly affect these mechanisms, raising substances. Recent studies covered in our
Pesticides
the risk of breast cancer. report indicate that when pregnant rats Environmental Protection Agency (EPA):
While the available evidence does not are exposed to the fungicide vinclozolin, Home Page
breast cancer incidence is elevated in www.epa.gov/pesticides/
prove that pesticides are causing breast
cancer in humans today, it does provide each of the four succeeding generations Pesticides Health and Safety (EPA)
(at least). Human Health Issues
proof that they have the potential to influ- www.epa.gov/pesticides/health/index.htm
ence its onset and development, and thus Table 2 (see page 8), adapted from the Si-
Information on Pesticides Health Issues
to raise the risk. lent Spring Institute, condenses informa- Center for Disease Control and Prevention (CDC)
So what do we do, while we wait for tion on 216 different chemicals proven to Health Studies
www.cdc.gov/nceh/hsb/pesticides/links.htm
evidence to accumulate? Continue using cause mammary tumors in animals. Some
these pesticides despite the warnings? of these are found in pesticides, and none
Hope for the best while we wait for ir- has ever been regulated for its potential to
refutable proof? Or take a precautionary induce breast cancer.
approach and drastically reduce the expo- Our report calls for a systemic change in To purchase Pesticides and Breast Cancer:
sure of girls and women – especially preg- our thinking about pesticides in order to re- A Wake Up Call, order at Pesticide Action
Network (PAN) Asia and the Pacific at
nant women—because of the heightened duce the risk of breast cancer. Regulatory
panap@panap.net
vulnerability of the neonate to carcinogens processes have to come to grips with the
and hormonally active chemicals? many different mechanisms that underlie
breast cancer and how pesticides may Winter 2008
influence these. The current paradigm in Volume 2 • Number 2
Continued on page 8

Center for Environmental Oncology — University of Pittsburgh Cancer Institute 7


www.environmentaloncology.org Helping to make prevention the cure for cancer.

Pesticides and Breast Cancer: A Wake Up Call


How Safe is Continued From Page 7
the Water many nations allows use of suspect pes- tect women from breast cancer when we
We Drink? ticides to continue until proof of human reject this approach, applying the precau-
harm, sufficient to persuade the regula- tionary principle and requiring substitution
The Blue
tors and the courts of law, can be collect- of less harmful methods of pest, weed and
Death
ed. This places the onus on scientists who disease management in place of the sus-
Disease, work in the public interest to try to achieve pect pesticides.
Disaster and the impossible. We can only begin to pro-
the Water We
Drink Table 2 Chemicals Shown to Cause Mammary Gland Tumors in Animal
by Dr. Robert Morris
Studies and Produced at More than 1 Million Pounds Annually
“With the keen eyes of a scientist and the sensibilities In Female
of a seasoned writer, Dr. Robert Morris chronicles Air Food
Chemical Name Consumer Occup.
the fascinating and at times frightening story of our Pollutant Additive
Products Exposed
drinking water. His gripping narrative vividly recounts
the epidemics that have shaken cities and nations, the 1,2-Dibromomethane x
scientists who reached into the invisible and emerged
1,2-Propylene oxide x x x
with controversial truths that would save millions of
1,3-Butadiene x x
lives, and the economic and political forces that opposed
1,4-Dioxane x x
these researchers in a ferocious war of ideas.”
2,2-Bis(bromomethyl)-1,3-propanediol x
www.TheBlueDeath.com
4,4’-Methylene-bis (2-choloraniline) x
Acrylamide x x
Acrylonitrile x x
Benzene x x x x
Chloropene x
Ethylene oxide x x x x
Hydrazine x x
Nitrobenzene x x
Nitromethane x x x
ortho-Nitrotoluene x
ortho-Toluidine x x x
Reference for Table 2: Styrene x x x x
Toluene diisocyanate mixtures x
Davis, Devra. The Secret History of the War on Cancer.
vinyl chloride x x
New York: Basic Books, 2007, p. 288.
vinyl fluoride x
Ruthann A. Rudel, Kathleen R. Attfield, Jessica N. Schifano, and
vinylidene choloride x x
Julia Green Brody, “Chemicals Causing Mammary Gland Tumors
1,2-dichloroethane x x x x
in Animals Signal New Directions for Epidemiology, Chemicals
1,2,3-Trichloropropane
Testing, and Risk Assessment for Breast Cancer Prevention,”
Cancer 109, S12 (2007): 2635-2666 1,2-dichloropropane x
Carbon tetrachloride x x x
Methylene chloride x x x x
Isoprene x x
Winter 2008 3,3’-Dichlorobenzidene x
Volume 2 • Number 2 Amsonic acid x

8 Center for Environmental Oncology — University of Pittsburgh Cancer Institute


CEO-UPCI www.environmentaloncology.org

Create Better Breathing Space for Asthmatics


Checklist from Healthy Child, Healthy World: www.healthychild.org
Minimize pet dander.
“Cat dander is everywhere, even if you
wash the cat,” Centers for Disease Control
Dr. Ruth Etzel says. “The only real solution
is not to have the cat.” Or, wash the animal Create Better Breathing Space
every two to three weeks, Los Angeles pe-
for Asthmatics Continued
diatrician Harvey Karp advises. Try air cleaning and purifying machines.
No cigarette smoking in the home or car, Consumer Reports says a good air cleaner can
or anywhere in asthmatics’ presence. help those allergic to dust and mold spores,
Ventilation is crucial. citing the fan/filter models as most effective in
Furnace and heating duct filters should
“The building of tightly-sealed houses over removing airborne dust. The machine will help
be replaced periodically as they collect
the last two decades has made it much most in the asthmatic’s bedroom; but keep it
dust and molds. Some businesses provide
easier for moisture and dust to collect in at least six feet from the bed (it creates draft),
duct-cleaning services.
homes,” Harvard professor Dr. Douglas and don’t place on carpet (it can kick up dust).
Keep asthmatics away from gas stoves. But, “They can only help if you’ve gotten rid of
Dockery notes. Many vapors trapped in-
doors, from perfumes and air fresheners “Open the oven door and you get a blast the risk factors first, like dust mites, mold and
to formaldehyde from particleboard, ir- of NO2,” says University of British Colum- danders,” Harvard School of Public Health
ritate asthmatics. When it’s fresh or even bia professor emeritus Dr. David Bates. associate professor Dr. Harriet Burge warns.
cold outside, keep windows open a crack “The asthmatic child should not sit in the Asthma Resources
to circulate air. On hot days, close win- kitchen doing homework if the oven is be-
dows and use air conditioners to ventilate ing used.” Make sure that stoves are well-
and filter out smog. ventilated, too.

Don’t harbor dust mites. Ask your pediatrician about allergenic


foods.
Microscopic dust mites and their drop-
pings are a potent allergen and asthma If there is a family tendency to allergy, Dr.
trigger. One way to limit the amount of Ruth Etzel from the Centers for Disease
dust mites in your homes is to encase mat- Control says, parents might limit foods
tresses with impermeable covers. associated with allergies, such as cow’s
milk, from the child’s diet in the first two
Eradicate cockroaches and keep clutter
years. She and other pediatricians recom- Resources for Childhood Asthma
to a minimum.
mend that mothers try to breastfeed their
The Asthma Center
Piles of dirty clothes make a growth en- infants for at least the first year. Children’s Hospital of Pittsburgh
vironment for mildews and mites; piles of www.chp.edu/clinical/03a_asthma
Check your local air quality index daily.
paper attract cockroaches. Remember, Asthma Resources
you can eliminate household pests with- Asthmatic children should not exert them- US Environmental Protection Agency (EPA)
out using toxic pesticides. selves outside in hot, smoggy weather, or www.epa.gov/asthma/index.html(Asthma)
when a dusty wind blows; smog counts www.epa.gov/iaq/index.html (Indoor Air Quality)
Maintain humidity below 50 percent.
tend to be highest between 3pm and 6pm. For more resources about childhood asthma, visit our
“Dehumidifying is enormously important, Air Now, a site provided by the U.S. Envi- website at www.preventingcancernow.org
as many asthmatics are highly allergic to ronmental Protection Agency, allows you
mildews and molds,” says Harriet Burge, to check your local air quality, get ozone Winter 2008
Ph.D., associate professor at Harvard maps and more. Volume 2 • Number 2
School of Public Health.
Continued on sidebar

Center for Environmental Oncology — University of Pittsburgh Cancer Institute 9


www.environmentaloncology.org Helping to make prevention the cure for cancer.

The Allegheny River Stewardship Project:


A Call For Volunteers
by Conrad Daniel Volz, DrPH, MPH
Project Background, Results Twenty-three percent of samples from
of Previous Research Kittanning had mercury levels above the
What can you do to EPA human health standard of .3ppm.
The fish in our waterways are like canar-
help make The Allegheny There are numerous coal burning power
ies in the coal mines. Just as canaries are
Stewardship project a plants located on our rivers both above
sensors for air quality, fish are sensors for
success? and below Kittanning, PA, and power plant
water quality. Our river fish can anticipate
Volunteer to catch fish during the sampling season.
the consequences of human exposure to emissions are a major source of mercury,
It will be fun! All gear and bait will be provided selenium and arsenic that are found in our
by Venture Outdoors. Just purchase a fishing environmental carcinogens, endocrine-
active substances and metal, metalloid waterways.
license, which you can do online through the PA
Fish and Boat Commission. You can also take a and elemental toxins. An initial study, the What is the Allegheny River
ride on or tour the RiverQuest Research vessel.
Pittsburgh Fish Consumption Study of Stewardship Project?
Volunteer to give hair, toenail, and/or urine 2005-07, showed results that indicate that
samples to researchers so we can gauge actual The Allegheny River Stewardship Proj-
extracts from the flesh and fat of catfish ect is an effort by leading researchers at
biomarkers of exposure to river contaminants.
and white bass from the more contami- CEO-UPCI and the Graduate School of
Contact Dr. Dan Volz, the project’s Principal
Investigator at cdv5@pitt.edu.
nated Pittsburgh Pool surrounding the City Public Health working with concerned
of Pittsburgh proliferated the growth of citizens of the Alle-Kiski Valley river com-
estrogen-receptor positive breast cancer munities, to determine the specific sourc-
cells (MCF-7). These breast cancer cells es and types of river pollutants. This is
multiply when exposed to human estrogen accomplished by monitoring the levels of
or to compounds that mimic estrogens pharmaceutical estrogens, xenoestrogens
(xenoestrogens.) When these same fish and heavy metals in the fish living in the
extracts were added to BT-20 breast river and are also present in wastewater,
cancer cells, which are estrogen recep- river water and river sediment.
tor negative, no cell multiplication was
What are the goals of the Allegheny
observed. This led the research team to
River Stewardship Project?
conclude that xenoestrogens produced
by pharmaceutical wastes or chemicals The goals of the Allegheny River Steward-
found in our detergents and personal care ship Project are to:
products were bioaccumulating in the fish • Engage river community members
because of liquid wastes (effluents) from to become involved in the
wastewater treat plants and sewer over- stewardship of the Allegheny River;
flows.
• Understand the concentrations of
Also surprisingly, significantly higher lev- contaminants in river fish species,
els of the toxic elements—mercury, arse- especially those that people eat;
nic, and selenium—were found in channel
• Associate contaminants in fish
catfish caught upstream on the Allegheny
with potential pollution sources;
River at Kittanning than in those caught
in the Pittsburgh Pool near former steel • Identify human exposures
factories. The Environmental Protection to these contaminants;
Winter 2008 Agency’s Clean Water Act human health • Understand the risks to human health
Ambient Water Quality Criterion for meth-
Volume 2 • Number 2 and the environment from these
ylmercury is based on levels in fish tissue. contaminants and pollution sources;

10 Center for Environmental Oncology — University of Pittsburgh Cancer Institute


CEO-UPCI www.environmentaloncology.org

• Obtain and share data with policy- human or ecological health from
makers so that an action plan these levels of contaminants in fish;
may be made to solve the • To obtain data, evidence, and
identified problems, and; other information that can inform
• Form strategic partnerships policymakers in preparing for a regional
with stakeholder groups along approach to water management;
the Allegheny River to help ensure • To form strategic partnerships with
ongoing stewardship activities. the CEO-UPCI, GSPH, RiverQuest,
What are the expected outcomes of the Venture Outdoors, The Rachel Carson
Allegheny River Stewardship Project? Homestead, the Alle-Kiski Health
• To engage river community members, Foundation, and the Heinz
anglers, recreational boaters and the Endowments, in order to
general public (who generally galvanize the river communities,
obtain their drinking water from our groups, schools, and individuals
rivers) in the planning, execution and to become stewards of the river;
data analysis portions of the projects. • To raise awareness in this area of
Specifically, this project will teach the importance of the river to the
both interested adult and teenage public’s health and well being, not only
community members the procedures in the sense of drinking water or fish
associated with the catch consumption but for aesthetic, cultural,
and measurement, geographic historical and recreational values;
positioning, gender identification, Lessons learned from the project will be
dissection, analysis and interpretation transformed into long-term community
of results of the fish study; environmental and specific water quality
• To understand the different goals, so that the footprint of the project
concentrations of contaminants, which widens and deepens with the passage of
are of significance to public health, and time.
which are carcinogenic (able to cause What is the duration of the
cancer), estrogenic or toxic and have Allegheny Stewardship Project? PERSONAL POLLUTION
accumulated in the fish species along PROBLEM STATEMENT
Community meetings, focus groups, and
major sections of the Allegheny River;
surveys to determine priority locations Describe, name. and/or draw a current or past
• To correlate the concentrations of for actual river sampling are now being
environmental pollution problem that you are aware
contaminants in fish with proximity of that may be affecting your community or the
held and planned. Actual river fishing and Allegheny River Watershed in general. Please be as
to the liquid wastes (effluents) from water-and-sediment-sampling will occur specific as possible and try to tell us exactly where
industrial facilities, power plants at numerous locations on the Allegheny the problem(s) are occurring or has occurred. This
fallout or fly ash pile leeching into the River on weekends from May through ear-
may be an air, water, land, or mixed source pollution
waters, municipal sewer overflows, problem. This can also be mailed to Dr. Dan Volz at
ly June of 2008.Analysis of samples and re- Bridgeside Point, 100 Technology Drive, Suite 564,
former industrial waste sites and/ port preparation will continue through the BRIDG, Pittsburgh, PA 15219-3130. cdv5@pitt.edu
or areas of environmental degradation late fall of 2008. The project is expected to
• To identify human exposures to the last until Spring 2009, when researchers
contaminants found in fish will hold a series of community meetings
either through drinking water on outcomes of the sampling results. At
and/or eating the fish; that time, strategy for community action Winter 2008
• To understand the risk posed to to solve identified priority problems will be Volume 2 • Number 2
determined.

Center for Environmental Oncology — University of Pittsburgh Cancer Institute 11


Printed on chlorine-free 100% PCW Recycled Paper, with soy-inks. www.environmentaloncology.org

Pregnancy and Environmental Health Continued From Page 5


at 412-802-8299 or register at www.ma- baby. What should I do?
gee.upmc.coml. Do not microwave in plastic, as this can
I was so happy that I stopped smoking be- release toxic contaminants from the plas-
fore I was pregnant. I asked my family to tic into foods. It is also important to pay
stop smoking, too, but they say it doesn’t attention to how you prepare and store
matter. Is that true? your food. When food is stored in plastic Winter 2008
containers, some of the chemicals in the Volume 2 • Number 2
First of all, congratulations that you have
stopped smoking! You have decreased plastic may leach into the food. Some of
those chemicals are hormone-mimicking Additional
the chances that your baby will be born
chemicals called endocrine disruptors Internet Resources
prematurely or with a low birth weight.
which can have negative impacts on a Beyond Pesticides
Your family is mistaken. Second-hand www.beyondpesticides.org
fetus’ reproductive organs. For safety,
smoke does matter! Second-hand smoke Breast Cancer Fund
it is recommended to store food in glass
or environmental tobacco smoke is a www.breastcancerfund.org
or ceramic containers, and only in plastic
combination of smoke exhaled from the containers after foods have cooled. Never Environmental Working Group
smoker and smoke from the burning ciga- www.ewg.org
microwave in plastic containers or wrap, www.comesticsdatabase.com
rette. Cigarette smoke contains some 4000 even those marked “microwave safe.”
chemicals, including carbon monoxide, Health Care Without Harm
Again, a glass or ceramic bowl is recom- www.hcwh.org
ammonia, lead, and nicotine, which are mended for use in the microwave. Discard Healthy Child, Healthy World
known reproductive toxins that cross the
any plastic containers that have started to www.healthychild.org
placenta. If you and your unborn child are break down. Perfectly Natural
regularly exposed to second-hand smoke,
If you look on the bottom of plastic cups, www.perfectlynatural.com
you increase yours and your child’s
bottles and containers, there is a triangle The CDC
chances of eventually developing lung www.cdc.gov
cancer, heart disease, emphysema, al- with a number in it. Plastics marked 1, 2
4 and 5 are “safer” plastics. Avoid plas- The Green Guide
lergies and asthma. Also, babies exposed www.thegreenguide.com
to tobacco smoke have an increased risk tics marked 3, 6 and 7 as they can leach
harmful chemicals into your food or drink. The National Cancer Institute
of Sudden Infant Death Syndrome (SIDS) www.nci.nih.gov/cancertopics
and are hospitalized more frequently with Check children’s plastic sippy cups and
Susan G. Komen for the Cure
other health problems. their plastic baby bottles for unsafe num-
cms.komen.org/komen/index.htm
bers on them. This is also applicable to
So, keep your home and car smoke-free. Venture Outdoors
baby’s plastic toys. For instance, the bath-
At Magee-Womens Hospital, women are www.ventureoutdoors.org
tub rubber ducky toy can be made from an
tested at the prenatal clinics for carbon unsafe plastic called PVC.
monoxide. Carbon monoxide levels are
higher in women who live with smokers Magee-Womens Hospital’s intensive care
compared to those who live in a smoke- unit for babies has eliminated the use of
Stop smoking Resources
free environment. Share this information one of these plastics in medical equip-
ment called DEHP. They have replaced PA Free Quitline
and encourage smokers in your family to 1-800-QUIT NOW
consider a smoking cessation program. intravenous tubes bringing baby’s blood,
UPMC Health Plan Ready to Quit Line
Knowing that this will protect your health medicine or nutrition with a safer plastic.
1-800-807-0751
and the health of your unborn child may In addition, Magee’s nurses have been
Pittsburgh STOP (Stop Tobacco in Pregnancy) Program
be just the motivation they need to quit. trained to be knowledgeable about some
412-551-8694
of these issues, and all new parents are
I am working hard to eat a healthy diet For more information: www.cdc.gov/tobacco
given information about environmental
now that I am pregnant. At work, I was health before they are discharged from
heating my lunch in a plastic container,
the hospital.
and someone said I was poisoning my
Please share this newsletter and be
sure it is recycled.
12

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