Troubling news about toxics in our food grows daily, with chemicals and metals of concern contaminating popular products from Skittles to Pop Tarts.
That’s why President Joe Biden’s nominee to lead the Food and Drug Administration should prioritize tackling those risks.
Biden last week nominated former FDA Commissioner Robert Califf to return to that position, which he held for the last year of the Obama administration. If confirmed by the Senate, Califf needs to put the “F” back in “FDA” by using its regulatory power to ensure food safety, such as banning the toxic “forever chemicals” known as PFAS from product packaging.
Consumers says toxic chemicals in food is one of their top concerns, especially those in food marketed to children. But the FDA, which is charged with protecting the food supply from toxins, has largely let food and chemical companies decide whether chemicals and contaminants linked to everything from cancer to lower IQ should be in our food.
The need to act is urgent, as shown by the discovery of toxic heavy metals in baby food. Many parents were shocked when congressional investigators revealed trusted baby food brands contain high levels of metals like arsenic and lead that could harm their baby’s developing brains.
Yet FDA officials have long known that baby food could be contaminated with high levels of arsenic or lead – and have largely failed to set limits that baby food companies must meet. It was not until this year that the agency even told producers of their duty to reduce toxics in their food.
Or consider the risks of food laced with PFAS, which are linked to cancer, reproductive harm and immune system harms that weaken the effectiveness of vaccines.
For decades, FDA has allowed PFAS in food packaging, despite knowing these toxic chemicals, which build up in our blood, could migrate into the food we eat. In recent years, seven states have moved the ban PFAS from packaging as the health risks – long hidden from the public – became common knowledge.
But rather than ban PFAS from food packaging, FDA has downplayed these risks.
And some harmful chemicals are even intentionally added to food, including substances like BHA, TBHQ and titanium dioxide. Some of these chemicals were approved by FDA for use in food more than 50 years ago to make processed food taste better or last longer. Many are added to products marketed to kids, including Skittles and Starburst.
Other countries have methodically reviewed – and even banned – some of these additives, but the FDA has largely declined to ask, in light of new science, whether these chemicals remain safe.
Most food chemicals evade FDA review and enter the marketplace through a waiver in federal food safety law known as the Generally Recognized as Safe, or GRAS, loophole, intended for ingredients that were obviously safe to bypass review. Instead, with FDA’s complicity, novel chemicals previously unknown to science are being added to food, thanks to the loophole.
So it’s good news the FDA may soon have a new commissioner with Califf, an experienced regulator with a track record of tackling the risks of toxic substances.
If confirmed to lead the agency again, Califf should immediately ban PFAS from food packaging. A toxic forever chemical has no place in our food. Safer alternatives are available.
He should also accelerate FDA’s timelines to set mandatory standards for toxic metals in baby food. Every day, 10,000 babies will start eating solid food. Parents cannot wait until 2024 or later for FDA to set standards for baby food companies. Califf should immediately require baby food companies to test for metals and post the results.
And he should move quickly to close loopholes that let the chemical companies – not the FDA – decide whether food chemicals are safe. He should also insist that chemicals that have not been subject to meaningful review for decades get a second look for safety concerns.
In his previous term as FDA commissioner, Califf demonstrated he understands that repeat exposure to toxic chemicals in our food and in personal care products like sunscreen pose serious health risks.
Given another chance to serve, he should seize the opportunity to protect consumers – especially babies and children – from needless exposures to dangerous toxics.
Iris Myers is a communications associate with the Environmental Working Group. Scott Faber is a senior vice president of government affairs for EWG. Their views do not necessarily represent those of Environmental Health News, The Daily Climate, or publisher Environmental Health Sciences.
Banner photo: Former Food and Drug Administration Commissioner Robert Califf in 2016. Last week President Joe Biden nominated Califf to again lead the FDA. (Credit: Governor Earl Ray Tomblin/flickr)
NAPA, Calif.—Sonny, a 10-month old, crawls through the tunnel of a playground surrounded by fresh cedar wood chips as the sun sets in October. His 4-year-old sister, Lenny, climbs the rungs of the jungle gym as their parents, Rebecca and Omar Chowaiki, keep watch.
"He is the happiest baby. He is so smiley," Rebecca Chowaiki said of her son. "We named him Sonny because it was a hard pregnancy, and we knew there would be some obstacles he needed to get over, so we wanted him to have a sunny disposition."
Sonny was diagnosed with a condition called bilateral clubfoot. A specialist put casts on his feet, he underwent surgery to cut his achilles tendon, and he wore orthotic shoes connected by a bar. He also received physical therapy for another condition called hypotonia, which meant he slouched when sitting and his head drooped. This amounted to months of medical appointments. "You just take it as it comes," his mother said.
Smoking cigarettes during pregnancy can significantly increase the risk of a baby having clubfoot, but Sonny's mother has never smoked a cigarette. "We've been breathing in buildings burning for the last four years," she told EHN. "We've all been smoking in one way or another."
The sky is blue today, but the grass and shrubs are crisp as kindling. Officials declared red flag warnings in recent weeks, meaning the dry and windy conditions are perfect for wildfires to ignite and rapidly spread. "When that happens, we brace ourselves," Chowaiki said.
Since 2017, wildfires have swept Napa and nearby Sonoma each fall. The summers are hotter and last longer, and rain is less frequent. The fires have cast a thick fog of smoke over the region, lasting for weeks or months. Chowaiki breathed the smoke in 2017, 2018, and 2019 leading up to Sonny's conception.
Omar Chowaiki displays a photo of his son, Sonny, with leg casts after surgery for clubfeet, at his home in Napa, California on October 9, 2021. (Credit: David Ryder)
A hill rises behind the playground. Chowaiki can see it from her kitchen window. It's a source of anxiety for her — fires have reached the other side of the hill in previous years.
"It's really scary. There's a lot of PTSD. You go to sleep thinking: 'OK, if I have to wake up suddenly and I see the hill is on fire behind me, I'll tell my husband, you grab our daughter, I'll grab our son, and we'll just hope that the dogs follow us.' "
Chowaiki doesn't draw a direct link between Sonny's condition and the wildfires — "we don't live in a vacuum," she said — but she recently enrolled in a study at the University of California, Davis, that is examining birth outcomes of people exposed to wildfire smoke. After years of inhaling the stuff, she is curious how it affected her body and child.
Climate change-fueled fires in California are increasing in severity every year, blanketing the western U.S. and Canada in ominous smoke that can be seen from space. Since the 1970s, California's average summer temperatures have increased by 1.4 degrees Celsius, and the state has seen a five-fold increase in acreage burned, according to a Reuters data analysis. Some parts of California now experience double the number of fire weather days per year compared to the 1970s, according to Climate Central. Wildfire smoke is reaching further across the continent, as far as Toronto and New York in summer 2021. As both wildfires and populations grow, more people are exposed to smoke that contains plastics, heavy metals from burned buildings and vehicles, and tiny, dangerous particles that can travel deep into the lungs and enter the bloodstream. Scientists know that wildfire smoke increases the risk of asthma for children, and heart disease, heart attack, stroke and death for adults.
Now scientists believe smoke and stress from wildfires also likely play a role in adverse pregnancy outcomes, such as low birth weight, preterm births — and even miscarriages.
Wildfire smoke and birth outcomes
Tinted orange by wildfire smoke from Oregon and southern Washington, the sun lowers behind a hill in Kalama, Washington on September 9, 2020. Across the state line, in Oregon, officials have given Level 3 "go now" evacuation notices to at least half of Clackamas County due to multiple wildfires. (Credit: David Ryder)
Each year, of the 3.75 million live births in the U.S., about 500,000 babies are born prematurely and 120,000 babies have birth defects, according to the US Centers for Disease Control and Prevention. Nonsmoking pregnant people who are exposed to tobacco smoke have a higher risk of preterm birth, low birthweight, and miscarriage, the CDC says. Air pollution can also contribute to low birthweight or preterm birth, even at levels below the federal Environmental Protection Agency's standards.
About an hour's drive from Napa, scientists are investigating whether to add wildfire smoke to the list of risk factors for adverse birth outcomes. In the city of Davis, California, about 4,000 rhesus macaques, a primate roughly the size of a housecat, live in dozens of outdoor cages as big as gymnasiums. Since the 1960s, the California National Primate Research Center has studied the monkeys because they are biologically close to humans. But recently the primates became the subject of unplanned research released in September.
In November 2018, at the peak of monkey mating season, smoke from the Camp Fire about 100 miles away cloaked the cages. Researchers followed the monkeys' pregnancies, and when it was time to give birth in the spring, they found the primates exposed to smoke had a higher rate of miscarriages.
In the nine previous years, the monkeys breathing clean air had an average live birth rate of 90%. The monkeys exposed to wildfire smoke in 2018 had a live birth rate of 82%— an 8% drop.
Bryn Willson, an OB/GYN resident at UC Davis and lead researcher on the primate paper, told EHN she was surprised the effect wasn't worse. "There were still several primates that got pregnant right at the peak of poor air quality, and they went on to deliver healthy [babies]," she told EHN. Willson said another team of researchers plans to follow the monkeys born after the 2018 wildfires to see how the smoke affects them long-term.
The monkey study is part of an emerging body of research.
A crow is silhouetted by the sun, which is tinted orange from wildfire smoke, on September 11, 2020 in Medford, Oregon. Hundreds of homes in nearby towns have been lost due to wildfire. (Credit: David Ryder)
In 2012, UC Berkeley scientists found that the 2003 southern California wildfires were associated with a slightly reduced birth weight, and in 2019, research by the Colorado School of Public Health linked wildfire smoke to preterm births. Low birth weight is associated with a higher risk of infant mortality, and disease or inhibited cognitive development later in life. Babies born too early can have learning disabilities and visual and hearing conditions, according to the World Health Organization.
New research suggests wildfire smoke may increase the risk of miscarriages for humans, too.
In an unpublished paper currently under peer review, Stanford researchers looked at data to see if the apocalyptic 2020 wildfire smoke that turned day to night on the west coast correlated with the number of people experiencing miscarriages at the Stanford ER near San Jose, California. Compared to years with no smoke, they found that the likelihood of a lost pregnancy during the 2020 wildfire smoke event increased by 29%.
"They're big numbers," Marshall Burke, who co-authored the paper with lead researcher Bibek Paudel, told EHN. Burke also contributed to a previous paper that found that one day of medium- to high-intensity wildfire smoke exposure increased the likelihood of preterm birth by 1%, meaning that two weeks of exposure led to a 14% increase in likelihood of preterm birth. "It's consistent with our other paper," he said of the ER data. "In-utero exposure to wildfire smoke can dramatically worsen birth outcomes."
Burke said it's "absolutely possible" that smoke contributed to Sonny's condition, and Chowaiki is right to be curious. "I don't think we have the smoking gun study on birth defects in particular, but everything we've found about the effects of wildfire smoke on pregnancy outcomes suggests that it could have a range of negative outcomes."
While policy changes over the last 30 years have decreased dangerous air pollution from vehicles and industry in California, Burke said megafires are now contributing a larger proportion of that poor air quality — about half the air pollution in the state. "The state overall has seen pretty impressive declines in exposures to these pollutants, [but] wildfires are pushing in the other direction," Burke said. "They are increasing exposures again."
What does wildfire smoke do to our bodies?
Rebecca Schmidt, associate professor at the UC Davis School of Medicine, is in the midst of a study following people who were pregnant during the megafires in 2017, 2018, 2019, and 2020. Chowaiki enrolled in her study.
"Our hope is to be able to follow the kids from these pregnancies as they get older and look at various outcomes, because there has been very little done [on respiratory outcomes later in life]," Schmidt told EHN.
Schmidt is sampling participants' hair for heavy metals that could be from the wildfires. She is also collecting placentas for testing.
An Australian doctor found that placentas of people who were pregnant during wildfires looked similar to those of people who had smoked a pack a day of cigarettes, but Schmidt hasn't seen anything like that in California placentas. "It hasn't been replicated yet, and it was a small study, but it does give pause on, is this something we should be concerned about?" she said.
Scientists don't know how wildfire smoke might affect fetuses in the womb, but they have some theories.
Similar to cars and industrial plants, wildfires emit tiny particles like PM 2.5 and PM 0.1 that are so small they can cross from the lungs into the bloodstream and travel all over the body. "They tend to give rides to other contaminants," Schmidt said. "Things like heavy metals piggyback on those small particles and also get deep into the lungs and other places. And that causes inflammation. In general it's not good to have inflammation for health."
Schmidt said inflammation from infection can disrupt the placenta and lead to issues like preterm delivery, low birth weight, and stillbirth.
Willson has a theory, too. The Camp Fire that blanketed the monkey cages in smoke was the most destructive fire in California history, incinerating more than 18,000 buildings. Sampling from the Camp Fire smoke showed it contained oxidized organic material from burnt trees and also phthalates, which are known to disrupt endocrine pathways in the body, affecting metabolism and damaging DNA, from burnt furniture and buildings. Phthalates have been linked to abnormal fetal development and adverse outcomes after birth.
"When buildings are burned and furniture is burned, you release into the atmosphere other toxic compounds that include things like phthalates, which we know are not good for humans to breathe in," Willson said.
Willson said pollutants like PM 2.5, PM 0.1, and phthalates may cross the placenta, but more research is needed to confirm this.
Stress from wildfires
Rebecca Chowaiki holds her son, Sonny, at a park near their home in Napa, California on October 9, 2021. (Credit: David Ryder)
Schmidt surveyed parents about their symptoms from the wildfires. Short-term effects included coughing, irritated eyes, and sore throat. But one of the most common symptoms was long-term stress and anxiety from proximity to wildfires. "Even up to a year later, they were still experiencing a high level of stress and anxiety," she said.
Stress can ramp up inflammation in a similar way to smoke, she explained, meaning pregnant people could face double exposure from smoke and mental health impacts. She pointed to a study showing that stress is a risk factor for outcomes like preterm delivery.
Chowaiki said her pregnancy with Sonny was "extremely stressful" due to the pandemic and in-utero diagnosis of his bilateral clubfoot.
She also feels climate anxiety. Her daughter Lenny was born prematurely during the fall 2017 wildfires. While she was in the ICU, the hospital briefly lost power. Since then, whole towns in California have burned to the ground. "I know so many people at this point who have lost their homes," she said. She knows her home may not be here next year.
Protecting pregnant people from wildfire smoke
Rebecca Chowaiki and Omar Chowaiki pose for a portrait with their son, Sonny, and daughter, Lenny, at their home in Napa, California on October 9, 2021. (Credit: David Ryder)
Burke recommended that people stay inside when it's smokey, close windows and doors, and invest in indoor air filtration. If they can't filter the entire house, they should filter one room and stay in there as much as possible. He extended this advice to people living far away from fires; in summer 2021, smoke from wildfires drifted across the continent into cities like Toronto, Boston, and New York.
Burke acknowledged that not everyone can afford to filter indoor air, and some people work outside, like construction and agricultural employees. In that case, he said N-95 masks can help reduce exposure to smoke, but employers and regulators must take responsibility for protecting workers, whether it's from heat waves or wildfires.
"It's our broader responsibility to limit their exposures — that means reducing the amount of wildfire smoke in the air. That's the fundamental thing we need to do," he said.
In wildfire season, Chowaiki checks the air quality from different sources so she knows when to stay inside. If she has to go outside in the smoke, she wears an N-95 mask.
"If you put a frog into boiling water, it's going to jump out, but if you put a frog into water and you heat it up slowly, it will stay there until it dies," Chowaiki said. "I feel like that's what we're doing. We're allowing this to become our normal, and it never should have been normal."
Banner photo: Sonny Chowaiki sits in the arms of his mother, Rebecca, at a park near their home in Napa, California on October 9, 2021. (Credit: David Ryder)
A plastic additive used to make IV bags and tubing pliable interferes with breast cancer treatment, increasing mortality and the likelihood the cancer will return.
Resistance to chemotherapy and hormonal therapy is a major clinical problem in breast cancer medicine, especially for cancer metastasis and recurrence, according to scientists writing in the journal Biomedicine & Pharmacotherapy.
The additive DEHP is a member of the family of chemicals known as phthalates. Phthalates have a host of handy industrial uses, from softening plastic and binding makeup to making ink stick to plastic bags. Scientists have recorded nearly as many adverse health impacts, from cancer and diabetes to infertility. The additives became part of the national conversation earlier this year with the publication of Dr. Shanna Swan's Count Down, linking phthalates to global declines in male fertility.
In a study published earlier this month, researchers found DEHP also increases drug resistance, interfering with breast cancer treatment and increasing the likelihood of relapse.
"Regulators have long turned a blind eye toward the serious and harmful effect that phthalates have on our health," said Pete Myers, chief scientist at Environmental Health Sciences, publisher of EHN.org. "This paper shows yet again what researchers worldwide are finding: We need safer chemistry in our products."
Dangerous mining conditions plague Congo, home to the world’s largest supply of cobalt, a key ingredient in electric cars. A leadership battle threatens reforms.
SAN FRANCISCO—Aliyah Dunn-Salahuddin still remembers riding the bus home from elementary school and smelling fresh-baked pastries and bread from the Parisian Bread Factory near Evans Street. She also remembers how quickly that scent would turn to one of sewage and smoke as the bus pulled closer to her home. Dunn-Salahuddin grew up two decades ago […]
Tens of millions of people will be forced to flee their homes over the next few decades as a result of worsening environmental effects of climate change, experts have warned.
A public art exhibition inspired by a nine-year-old girl who died from chronic asthma brought on by London's polluted air will form part of a culture festival in the capital next year.
E-cigarette maker Juul will pay $14.5 million to Arizona, and will no longer market or sell its products to young people in the state, as part of a settlement for a consumer fraud lawsuit.
In her new book, the sociologists talks about how nourishing children has become "an anxiety-provoking and high-stakes endeavor" and positions food access as part of a larger constellation of hardship.
Cases in children in the United States have risen by 32 percent from about two weeks ago, amid a rush to inoculate children ahead of the winter holiday season.
Last month, the White House outlined new and ongoing federal efforts to combat nationwide per- and polyfluoroalkyl substances (PFAS) pollution, especially agency actions to address the legacy of PFAS pollution in our water, air, food, and communities.
We commend the Biden-Harris Administration for taking these important steps to clean up the mess that has resulted from decades of failures in how the federal government evaluates and regulates PFAS risks. However, there is still much to be done on legacy PFAS pollution, and it needs to be done fast.
Addressing legacy PFAS pollution is not enough; it is crucial to prevent additional PFAS from entering commerce and further exposing us and our environment. To effectively do so, the federal government must move away from its current piecemeal, agency-by-agency approach to regulating PFAS, which too often leads to incomplete information and long-term environmental health consequences.
Here, we offer the Biden-Harris Administration seven recommendations to deal with PFAS in commerce using a whole-of-government approach, and finally start to turn off the PFAS tap.
The nation’s growing PFAS problem
PFAS are a broad category of widely used synthetic chemicals. Given their ability to effectively repel water, resist stains, lubricate surfaces and more, PFAS are often intentionally added to clothing, furniture, cosmetics, and food packaging, leading to human exposures. Additionally, decades of manufacturing, use, and disposal of PFAS and PFAS-containing products has significantly contaminated the environment, leading to further exposures via polluted air, water, and food. Unfortunately, because PFAS are so persistent, once in the environment, the chemicals don't go away.
PFAS are also in the bloodstream of virtually all Americans. Even more alarming, PFAS have been detected in umbilical cord blood and breast milk, indicating that exposures begin in the womb and continue through one's lifetime.
Some PFAS bioaccumulate in the body, making even the lowest exposures problematic. This poses a major public health concern, as epidemiological evidence suggests that PFAS exposure may lead to health problems such as cardiovascular disease, cancer, low birth weights, and impaired immune responses.
PFAS pollution is also an environmental justice problem, as communities of color and low-income populations are more likely to live near facilities that manufacture or use PFAS, making these groups especially vulnerable to the health risks.
PFAS are not simply a legacy issue. While the country has moved away from the use of some PFAS – for example, through corporate phase-outs or regulatory restrictions on PFOA and PFOS, where the evidence of their harm is overwhelming – the fluorochemical industry continues to develop new chemicals in that family in the name of innovation and economic profit. These newer iterations – often promoted as safer alternatives or pushed through regulatory loopholes – not only persist like those they attempted to replace, but they pose many of the same public health risks.
PFAS new and old have been approved or authorized for use by two key regulatory agencies in charge of allowing chemicals into commerce – the Environmental Protection Agency (EPA) and the Food and Drug Administration (FDA). Because these chemicals were not adequately evaluated before they entered U.S. commerce, unsafe PFAS continue to circulate in the marketplace, posing a threat to the environment and human health.
This vicious cycle must end.
Recommendations for the White House
Given that the Biden-Harris Administration is committed to making science-based decisions, we offer seven forward-looking actions the White House should take to address PFAS still being used, and to avoid putting more unsafe PFAS into commerce.
1. Adopt a comprehensive PFAS definition and regulate PFAS accordingly
Require all federal agencies to use OECD's PFAS definitionto ensure a clear and consistent definition that accounts for all relevant fluorinated substances in federal initiatives.
Adopt a government-wide approach to regulate all PFAS as a class given their persistence and potential for similar impacts.
2. Demand adequate data for assessing risks from PFAS, new and old
Develop a national PFAS testing strategy to require companies to fund and conduct studies on new and existing individual PFAS and PFAS mixtures. EPA's testing strategy is a first step, but a broader and more integrated testing plan is needed across the entire federal government.
Require companies to submit sufficient data for PFAS risk assessment, which should include data on accumulation in plants, animals, and humans; testing on relevant complex health endpoints like cancer; developmental and reproductive toxicity; immune, endocrine, and neurobehavioral toxic effects; and information on exposures from all sources, especially during pregnancy.
3. Enhance reporting of PFAS uses and exposure
Build upon EPA's proposed PFAS reporting rule – which will require PFAS manufacturers and importers to report to EPA on their production, uses, and disposal of PFAS – by mandating that agencies require companies to report the same information on PFAS, regardless of regulatory jurisdiction or production volume.
Eliminate reporting loopholes for PFAS mixtures by requiring that all discharges of PFAS mixtures, regardless of their concentration, be reported by industry to EPA's Toxics Release Inventory.
Require PFAS manufacturers to submit analytical standards to fingerprint their chemicals. Analytical standards are crucial to the federal government's efforts to improve its testing methods, identify contaminants, and initiate enforcement actions.
4. Pause authorization of new PFAS and PFAS uses
Issue a moratorium on the production of new PFAS and expanded use of PFAS already on the market,unless and until adequate data are available to make a proper safety determination.
Eliminate safety review exemptions for new PFAS and new uses of existing PFAS regardless of production volume or type of use.
5. Reassess previous decisions that allowed PFAS to come to market
Use a cumulative risk assessment framework that considers co-exposures to other environmental chemicals, including other PFAS, and non-chemical environmental stressors.
Incorporate environmental justice considerations such as the disproportionately high exposures faced by populations living near facilities that manufacture or use PFAS, and workers involved in the production and use of PFAS or PFAS-containing products.
6. Monitor and restrict domestically produced and imported PFAS
Establish a national program to monitor PFAS using broad screening tools such as total organic fluorine methods, which will allow regulators to move beyond looking at one PFAS at a time and improve their understanding of the presence of these chemicals in the environment.
Conduct inspections and take enforcement actions when companies that manufacture PFAS or PFAS-containing products do not comply with regulations.
Establish controls on imported products, as it is well known that PFAS-containing products, including some that contain chemicals banned or no longer manufactured in the U.S., such as PFOA, are manufactured abroad.
7. Apply the concept of essentiality in PFAS regulation
Define criteria for essential and non-essential PFAS usesacross the federal government.
Develop a path to eliminate non-essential uses of PFAS and substitute all uses with available non-PFAS alternatives.
Use the administration's procurement power to purchase products free of non-essential PFAS.
The story around chemicals coming into the market and presenting an environmental and public health risk is not unique to PFAS. We have gone through similar experiences with other persistent, bioaccumulative and toxic chemicals, including PCBs/dioxins and organohalogen flame retardants.
It is time that we learn the lessons from the past and proactively regulate persistent chemicals like PFAS as a class using a whole-of-government approach. We urge the administration to consider these recommendations to protect the environment and public health from continued PFAS pollution.
Lauren Ellis is an Environmental Health Research Analyst at the Environmental Defense Fund. Maricel V. Maffini is a consultant to the Environmental Defense Fund.
Their views do not necessarily represent those of Environmental Health News, The Daily Climate, or publisher Environmental Health Sciences.
Banner photo: President Joe Biden visits East End Elementary School in North Plainfield, New Jersey, on Monday, October 25, 2021. (Credit: Phil Murphy/flickr)
The toxic pollution-induced lockdown in India's national capital will go on for at least another week after authorities extended restrictions till 26 November, as the city of 20 million continued its struggle to breathe clean air.
An investigation into the mental health impacts of air and water pollution in western Pennsylvania found alarming evidence that residents throughout the region are likely suffering changes to their brains due to pollution in the surrounding environment.
Reporting also uncovered the growing gap in mental health care as more people are traumatized by worsening climate change.
The collaboration between Environmental Health News and The Allegheny Front revealed:
Harmful PM2.5 air pollution, which is linked to more ER mental health visits for children, is consistently higher in western Pennsylvania.
Evidence that Clairton, Pa., which has some of the most polluted air in the country, is in the worst 25 percent of U.S. cities for adults experiencing 14 or more days of poor mental health each month.
Air pollution is worse in environmental justice communities experiencing high poverty and crime, which exacerbate the local mental health toll. Black and Hispanic residents report more days of mental health struggles.
Consistently high lead levels—which impact kids' mental health—in regional water, contributing to the percentage of Pennsylvania children with elevated blood lead levels being more than twice as high as the national rate.
There is profound concern, especially among many young people, about climate change, and research shows it is creating climate anxiety. Mental health experts say the profession has not yet prepared for the onslaught of this community trauma.
There are efforts, including in Pittsburgh, to shift the current model of mental health care toward community-based care, training more people to help those with psychological needs, and creating new spaces for people to work together to discuss their feelings and experiences.
More therapists are encouraging people to act, whether by writing to their Congressional representatives, joining climate activism, or just recycling at home, as a way to alleviate climate anxiety.
What we heard
What needs to happen
This series uncovered a disturbing link between common air and water pollution, climate change, and people's mental health—but it also revealed that we need to do more so people don't suffer this way.
We outline major studies in the U.S. and beyond examining environmental exposures and mental health, but the field is nascent and data are sparse. State and federal agencies responsible for regulating toxics in our air and water do not consider how this pollution influences our brain. This needs to change.
This investigation should prompt more regional and national scientific research on the intersection of the environment and our mental health.
Regulatory agencies should pay attention to this growing field and consider children's and adults' brains when taking action against polluters.
No one should suffer from mental illness because of where they live or from anxiety and stress from the climate crisis. This series shines a light on an under-appreciated impact of environmental insults and we hope it fosters conversations and action on mental health.
Environmental Health News is an award-winning nonpartisan organization dedicated to driving science into public discussion and policy. The Allegheny Front is an award-winning public media outlet focused on environmental news relevant to western Pennsylvania. The series was made possible with funds from the Pittsburgh Media Partnership.
Follow the fallout from this investigation on Twitter at the hashtag: #EHNmentalhealth
Emerging research finds polluted air linked to mental health problems, leaving western Pennsylvania children and environmental justice communities at high risk.
New research indicates that childhood lead exposure impacts adult mental health. The toxic heavy metal is found across western Pennsylvania drinking water systems, leaving thousands of kids at risk.
Research shows more people are feeling anxious about the climate crisis and their numbers will only increase in the coming years. Experts are concerned it's taking a toll on mental health.
As climate change worsens, the need will grow for mental health services. Some therapists are recommending climate action to ease worry. Others are advocating for community-based therapies to fill the gap.
PITTSBURGH—Melanie Meade has become the face of clean air advocacy in her community, which sits in the shadow of one of the most heavily polluting industrial sites in western Pennsylvania.
For eight years she's been at community meetings, rallies, and press conferences, and featured in
local news stories about her community's childhood asthma epidemic and high cancer rates. Her message to policymakers and U.S. Steel, which operates the industrial site, Clairton Coke Works, is simple: We deserve access to clean, healthy air.
It's a labor of love—but it has taken an emotional toll.
"When I first learned that Clairton—a town that's only three square miles big—had childhood asthma at more than double the national rate, I thought as soon as other people knew that they'd scream and get Oprah on the phone and things would have to change," Meade told EHN. "It hasn't been like that."
Instead, Meade said, it's often felt like her impassioned pleas are met with a shrug, which has contributed to her anxiety and depression.
"It makes you feel defeated," she said. "You wonder, should I have given more time to my own family and children rather than fighting to try and deal with these issues?"
Meade isn't the first activist to feel disheartened over slow progress. But recent scientific discoveries point to another risk factor: Exposure to air pollution causes changes in the brain that increase risk for mental illness.
And despite big gains over the past few decades, this leaves millions in the U.S. at risk, as roughly four out of 10 U.S. residents live in counties with unhealthy air pollution, according to the American Lung Association's
2021 State of the Air report. The report looked at ozone, and short- and long-term particle pollution—and people of color were 61% more likely to live in a county with a failing grade in one of the pollution categories.
Western Pennsylvania has some of the worst air quality in the nation:
Allegheny County (which encompasses Clairton and Pittsburgh) has only achieved full compliance with federal air quality standards once in its entire history—in 2020, when COVID-19 related shut-downs reduced emissions;
Despite that reduction in emissions, residents still experienced an average of one day a week of unhealthy air in 2020;
Allegheny County is in the top 2% of all U.S. counties for cancer risk from air pollution;
Local elementary schools near polluting facilities experience childhood asthma rates as high as 30%—more than triple the national average of 8% and the state average of 10%;
Climate change is driving extreme weather events in the region that will heighten the risk of air pollution exposure.
Air pollution isn't just an urban problem; many rural parts of western Pennsylvania also experience air pollution from the oil and gas industry.
In addition to its air pollution problems, the region also bears a substantial burden of mental illness. New research indicates that childhood exposure to air pollution can impact our mental health as adults, and links spikes in air pollution with more emergency room visits for mental illness among children. Meanwhile, western Pennsylvania communities with the highest level of air pollution often face other hardships that negatively impact mental health—like poverty, crime, and racism—while lacking access to mental health resources.
"Scientists used to assume that air pollution primarily impacted the lungs," Aaron Reuben, a researcher and PhD candidate in clinical psychology at Duke University, told EHN. "Eventually we learned it impacts the heart, too. Now we've realized that air pollution impacts every organ system we've looked at, including the brain."
The mental health burden of air pollution
View of U.S. Steel Edgar Thompson Works from Eighth Street and Halket Street in Braddock, PA. (Credit: Njaimeh Njie)
In April, Reuben published a groundbreaking study on air pollution and mental health that was more than two decades in the making.
It found that the more air pollution people were exposed to as children, the more likely they were to experience mental illness when they turned 18—the age when initial symptoms often appear.
Rather than focus on a specific diagnosis like most previous studies, the researchers looked at study participants' responses to detailed survey questions about many symptoms including dependence on alcohol, cannabis, and tobacco; antisocial behavior; eating disorders; depression; anxiety; post-traumatic stress; and delusions and hallucinations.
"Assessing symptoms gives us more information about how many different symptoms people are having and at what level of severity," Reuben said.
"The idea that there's a specific disorder people get with an on or off switch is really outdated," he added. "Mental illness is not binary. We're not simply either depressed or not depressed. We all walk around with symptoms of mental distress that we find more or less burdensome depending on what's going on in our lives and our ability to regulate that distress."
Reuben's study used data on two air pollutants linked to altered brain health in previous studies: PM2.5 (microscopic pollutant particles generated during industrial processes and combustion of fossil fuels and wood) and nitrogen oxides (pollutants associated with fossil fuel burning from power plants, vehicle emissions, and some industrial sites). Only nitrogen oxide exposure showed clear evidence of worsening mental health, but Reuben said it's likely that other chemicals in air pollution have similar effects.
"The more we study additional air pollutants, the less confident I am that there's any class that doesn't harm the brain," he said.
While his research doesn't prove that air pollution causes mental illness, Reuben said, it does indicate that exposure to air pollution may moderately increase the severity of mental illness, and substantially increase the social and financial burden of mental illness on communities.
These findings have major implications for western Pennsylvania.
From 2018-2020, 40% of adults in Allegheny County reported having one or more days where their mental health was "not good," according to state data. That figure was even higher—53%—among 18-44 year olds. These figures were higher in Allegheny County than in half of other Pennsylvania counties, and slightly higher than state averages.
An estimated 13% of adults in Allegheny County said their mental health was not good for 14 or more days in the last month. That figure was slightly higher in the city of Pittsburgh at 15%, and even higher in Clairton at 18%. This puts Clairton in the worst 25% of U.S. cities for the percentage of adults experiencing 14 or more days of poor mental health each month.
Pennsylvania is among the top 10 U.S. states for mental health spending. Allegheny County officials have said they hope to secure $25 million in federal COVID-19 relief funds to allocate toward mental health, drug, and alcohol services, which would bring the total amount budgeted toward those services for 2021 to $500 million.
A study published earlier this month uncovered a genetic marker for depression that makes people more susceptible to depression triggered by air pollution, marking the first time scientists have shown a direct link between air pollution exposure and the brain's functioning at a neurological level.
A massive 2019 study looked at mental health data from 151 million people in the United States and 1.4 million people in Denmark and found that long periods of increased air pollution in urban areas were linked to a 16% increase in cases of bipolar disorder and a 6% increase in depression diagnoses.
View of the Clairton Coke Works in Clairton, PA. (Credit: Njaimeh Njie)
"We saw significant associations between air quality and mental illness, even after controlling for other factors that could cause mental illness" Andrey Rzhetsky, a co-author of the study and professor of medicine at the University of Chicago, told EHN. "I was personally surprised by how strong the signal was."
The researchers had more detailed data for the Denmark group, Rzhetsky said, and the link between air pollution and mental illness for that group was even stronger: Air pollution exposure was linked to a 31% increase in bipolar disorder, a 104% increase in schizophrenia, a 210% increase in personality disorder, and a 68% increase in major depression.
In addition to being much larger, Rzhetsky's study differed from Reuben's in that it looked at official mental illness diagnoses rather than symptoms and considered the effects of 87 different air pollutants. That makes it difficult to compare the two studies, Rzhetsky said, but he thought Reuben's study was "very well designed." Both studies have similar limitations, including relying on data modelling to estimate people's exposure to air pollutants.
Scientists are still trying to figure out exactly what happens in brains exposed to air pollution that affects mental health and cognition, but many think it's related to the inflammation that air pollution causes. Chronic inflammation in the brain can damage neurons that are involved in the brain and nervous system's regulatory responses, which in turn can impact mental health.
"Studies in animal models have shown there are three different pathways by which air pollutants can get into the brain and cause inflammation," Rzhetsky said. "One is through the lungs by entering the blood-brain barrier. Another is through olfactory neurons connecting the nose to the brain, and the third is through the stomach and the digestive system."
When pollutants enter the brain through these pathways, he explained, "it creates persistent inflammation in the brain which can cause symptoms in animals that mimic things like depression or bipolar disease."
Short spikes in air pollution send more kids to the ER for mental illness
Children playing at an annual "Trunk or Treat" event on Braddock Avenue and Library Street, in Braddock, PA. (Credit: Njaimeh Njie)
Research suggests that exposure to even brief spikes in air pollution increases emergency room (ER) visits for mental health crises in children.
Cole Brokamp, an assistant professor of pediatrics at Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, was the lead author on the first study to look at short-term exposure to air pollution and mental health effects in children. That 2019 study found that children exposed to high amounts of air pollution were more likely to end up in the ER for a mental health problem a few days later than children with lower exposures.
Brokamp looked at five years of emergency room data for more than 6,800 children under the age of 18 who visited Cincinnati Children's Hospital Medical Center for psychiatric distress including anxiety, depression, bipolar disorder, suicidality, personality disorders, and schizophrenia.
The researchers estimated the kids' exposure to PM2.5 from the three days prior to their visit to the emergency room, and determined that every increase in PM2.5 exposure of 10 micrograms per cubic meter was linked to a large jump in emergency room visits—even though all the daily exposures remained below U.S. Environmental Protection Agency (EPA) standards.
Brokamp noted that few other studies have investigated the link between children's mental health and air pollution exposure, but their findings likely represent the tip of the iceberg.
"Our study only captured children with mental illness severe enough to prompt an emergency room visit," Brokamp told EHN. "We also have to think about how it may or may not affect people who have milder depression or anxiety. They may never go to the emergency room, but it doesn't make their mental health problems any less important."
No one has yet studied whether there's a link between air pollution and ER visits for mental illness in western Pennsylvania. EHN reached out to the Pennsylvania Department of Health, the Allegheny County Health Department, and the two biggest hospital systems in western Pennsylvania (University of Pittsburgh Medical Center and Allegheny Health Network) to request data on children's emergency room visits for mental illness, and none were able to provide that data. But substantial spikes in air pollution are a frequent occurrence in the region.
The median level of estimated daily PM2.5 exposure in Brokamp's study that led to increased mental health ER visits for children was 10.5 micrograms per cubic meter of air. According to an EHN analysis of EPA data, one or more of the air monitors in Allegheny County recorded daily averages of PM2.5 higher than 10.5 μg/m3 for about four months in 2020 (129 days)—and 2020 was one of the best years in recent history for air quality in the region.
"We're concerned about the results of this study and this analysis of Pittsburgh's air," Patrick Campbell, executive director of the Pittsburgh-based clean air advocacy organization Group Against Smog and Pollution (GASP), told EHN. "We hope our public health officials will take it seriously."
Brokamp's study is part of a growing body of research indicating that air pollution exposure is harmful to human health at levels well below current legal limits.
The federal 24-hour standard for PM2.5 is 35 micrograms per cubic meter of air. The Allegheny County Health Department, which oversees air quality in the region, hasn't yet published its annual air quality report for 2020, but in 2019 one of the county's air monitors (the one closest to Clairton) recorded 24-hour PM2.5 levels that exceeded that standard on nine days. The highest level recorded was 66.4 micrograms of PM2.5 per cubic meter of air—nearly twice as high as the level currently permitted by law in the U.S. The EPA is expected to tighten standards for PM2.5 in 2022.
Chris Togneri, the public health information officer for the Allegheny County Health Department, said the agency has taken meaningful steps toward improving air quality in the region in recent years.
"The Health Department believes that everyone deserves healthy air," Togneri told EHN, noting that the agency's Air Quality Program, which includes around 50 employees, "operates one of the densest air monitoring networks in the nation," consisting of 16 EPA-approved air monitoring sites that are regularly analyzed to determine if monitors should be added or relocated.
He also pointed to recent improvements to the agency's air quality alert system and air quality dashboard aimed at making information on air quality more accessible to the general public.
"Overall," he said, "efforts by the Health Department have resulted in some of the largest improvements in air quality in the United States."
Environmental injustice and mental health
Air pollution doesn't respect geopolitical boundaries, so air pollution's impacts on mental health are relevant to everyone in western Pennsylvania. But many of the communities that experience the highest levels and most frequent spikes of air pollution also experience other community stressors like poverty, crime, and racism.
In Brokamp's study, children from neighborhoods experiencing high levels of poverty were the most likely to experience a mental illness crisis following spikes in air pollution. He said this could be because poverty and crime cause stress, which results in inflammation that can harm brains and immune systems, which could worsen similar impacts from air pollution exposure.
Examples of what some researchers call "toxic zip codes"—regions where a combination of environmental injustice, racism, and poverty create substantial negative health impacts—abound in western Pennsylvania.
For example, the Monongahela Valley (commonly referred to as the "Mon Valley"), a former steel corridor of municipalities from the southern tip of Pittsburgh to the West Virginia border including Braddock, Duquesne, Clairton, McKeesport, Charleroi, Monessen and Uniontown, regularly sees extreme spikes in air pollution leading to some of the dirtiest air in the country.
The municipalities in the Mon Valley have poverty rates ranging from 16%-40%—significantly higher than Allegheny County's poverty rate of 11% and the state poverty rate of 12%. A number of these communities also have substantially higher percentages of Black residents compared to the state or region as a whole: Allegheny County is 13% Black and Pennsylvania is 12% Black, compared to Duquesne, which is 57% Black; Braddock, which is 67% Black; and Clairton, which is 38% Black.
Johnstown, a former steel town about 65 miles east of Pittsburgh, which has a slightly higher percentage of Black residents than the state average (15%) and a poverty rate of 38%, had the same number of unhealthy air days as Pittsburgh in 2020 despite having a population that's fifteen times smaller (19,569 and 300,286, respectively).
And air pollution exposure in these communities is likely worsening mental health effects in ways that aren't fully recognized by researchers and public health officials.
Maggi Barton, a spokesperson for the Pennsylvania Department of Health, told EHN, "The Division of Environmental Health Epidemiology in DOH has not investigated the link between air pollution and mental health."
Togneri told EHN that Allegheny County's mental health programs are managed by the Department of Human Services, which is a separate agency, and that while that agency assesses some underlying causes of mental illness, they don't have access to data from people with private insurance, which limits what they can research.
He also noted that the Health Department has enacted new legislation specifically aimed at improving air quality in the Mon Valley, which was signed into law in September. It requires 18 local industrial polluters that impact air quality in the Mon Valley (including the Clairton Coke Works) to lower their emissions when forecasted weather conditions are expected to trap pollutants close to the ground.
Campbell, with GASP, said of the legislation, "It's not a perfect regulation, but we are seeing modest improvements in terms of both air quality and how health officials are communicating poor air days… and any improvement is good news, even if it's not moving as quickly as we'd like it to be."
Access to mental health care
"People are reluctant to ask for help just once, let alone having to ask for help getting there, too," said Clairton clean air advocate, Melanie Meade. ((Credit: Njaimeh Njie)
Impoverished communities often lack mental health resources. Pennsylvania has approximately 220 mental health providers for every 100,000 people—putting it in the bottom half of U.S. states for access to mental health care. Allegheny County has a better rate, with 349 providers per every 100,000 people—but those resources aren't evenly distributed or equally accessible.
In Clairton, where 23% of residents live below the poverty line, the nearest hospital is about four miles away, but many residents don't own cars and public transit is notoriously slow and unreliable.
"Clairton doesn't have any immediate [mental health] support here, so you have to have transportation out of here to get the help you need," Meade, the Clairton clean air advocate, said. "People are reluctant to ask for help just once, let alone having to ask for help getting there, too."
No one has studied potential links between air pollution and mental illness in Clairton, but studies have shown a near doubling in asthma exacerbations in the area following acute air pollution events, revealing a clear link between local air pollution and residents' health. It's likely that these fluctuations in air pollution are also impacting long- and short-term mental health in Clairton.
Meade grew up in Clairton, but was living in North Carolina when her father died from complications related to chronic obstructive pulmonary disease (COPD) in 2013. She came back to Clairton to plan his funeral and ended up staying. Within six months, her mother died, too. Her brother had died a few years before, and the weight of those losses hit her all at once.
She felt like she was drowning in grief. She was depressed and anxious. She traveled across town to seek help at a behavioral health clinic, but she didn't feel that she found culturally competent care.
"I didn't feel like the people I was speaking to cared about me," she said. "I felt like they were just trying to give me a quick band-aid instead of really trying to understand my perspective...and I felt I got labeled an 'angry Black woman' when I questioned them."
Meade found other ways to care for her mental health, including sharing her feelings with other community advocates and spiritual leaders. But she still wishes mental health care was more easily accessible in her community.
"With a multibillion-dollar industry here causing all this pollution, we should have mental health facilities available for everyone," she said. "We shouldn't have to wait for transit or ask for a ride or money for bus tickets."
Banner photo: Melanie Meade outside of her home in Clairton, PA. (Credit: Njaimeh Njie)
PITTSBURGH—In an average week, NaTisha Washington hears from seniors forced to choose between keeping their water running or paying medical bills, moms afraid to make their baby's formula with tap water over fear of contamination, and local politicians frustrated by barriers to improving water quality.
"Many of these communities have been struggling to deal with COVID-19 and job loss and all the recent civil rights actions and discrimination issues while also not having access to safe drinking water at home," Washington, an environmental justice organizer with One PA, a nonprofit community advocacy group, told EHN.
Much of Washington's work relates to clean water access in low-income western Pennsylvania communities. The problems she sees primarily fall into two categories: Drinking water that's contaminated with lead and
other toxic chemicals, and the threat of shut-offs due to nonpayment of water bills.
Both of those issues, she said, create mental health impacts like stress and anxiety.
It's not hard to imagine how fearing that your water is unsafe to drink or will be shut off could contribute to stress, anxiety, or depression. But emerging scientific research also suggests that a common drinking water pollutant—lead—impacts mental health.
Kids are exposed to lead through lead paint, contaminated soil, and contaminated drinking water, which remains
a primary source of lead exposure. No level of lead exposure is safe for children, and blood lead levels lower than those that officially qualify as "poisoning" are still harmful to developing brains.
"We've known for a long time that early life lead exposure causes problems related to learning performance and cognitive deficits in children, but now that many lead-exposed [groups of children] have been followed into adulthood, we're also seeing that later in life they're more likely to have major depression, schizophrenia, and other psychiatric disorders,"
Tomás R. Guilarte, professor, researcher, and director of the Brain Behavior & the Environment program at the Robert Stempel College of Public Health & Social Work at Florida International University, told EHN.
"There's no question that even at low levels of exposure there are associations with neurodevelopmental and psychiatric disorders," he added.
These findings have major implications in the U.S. and abroad. While bans on lead in paint and gasoline have had a positive impact, roughly one in three children around the world are still exposed to harmful levels of lead. "This is not a trivial problem," Guilarte said.
In a survey of more than one million kids in the U.S., researchers earlier this year reported that more than half of children have detectable levels of lead in their blood. The exposure was worse for children of color: About 58% of kids from majority Black zip codes and 56% of kids from majority Hispanic zip codes had detectable levels of lead compared to 49% of kids from majority white zip codes.
In addition, about 186 million people in the U.S.—about 56% of the population—drank water from drinking water systems with lead levels above 1 part per billion (the level set by the American Academy of Pediatrics to protect children from lead in school water fountains) from 2018 to 2020, according to a report from the Natural Resources Defense Council.
Western Pennsylvania is particularly at risk:
The percentage of Pennsylvania children with elevated blood lead levels is more than twice as high as the national rate;
Blood lead levels in Allegheny County are declining overall, but not equitably: The percentage of children of color with confirmed elevated blood levels is six times greater than the percentage of white children with elevated blood lead levels;
Among school districts in 10 Western Pennsylvania counties that tested drinking water for lead in 2019, 71% reported lead contamination, but less than half took action to remove it.
The percentage of Pennsylvania children with elevated blood lead levels is more than twice as high as the national rate. (Credit: Nenad Stojkovic/flickr)
In October, the Centers for Disease Control and Prevention (CDC) lowered the threshold for blood lead levels considered "higher than average" from 5 micrograms per deciliter to 3.5 micrograms per deciliter.
This shift will mean that many more children in Allegheny County and across the country will be considered to have blood lead levels requiring intervention. Currently, when a child is found to have a blood lead level higher than the CDC's previous threshold of 5 micrograms per deciliter in Allegheny County, the Allegheny County Health Department offers a free home investigation to test water, dust, and soil samples for lead.
Chris Togneri, the health department's public health information officer, told EHN the agency is still reviewing the CDC's revised threshold to consider updating that policy.
In addition to its lead exposure and drinking water issues, western Pennsylvania also bears a substantial burden of mental illness.
From 2018-2020, 40% of adults in Allegheny County reported having one or more days where their mental health was "not good," according to state data, a figure that's higher in Allegheny County than in half of other Pennsylvania counties, and slightly higher than state averages. An estimated 13% of adults in Allegheny County said their mental health was not good for 14 or more days a month.
A survey conducted by the Allegheny County Health Department from 2015-2016 indicates the issue is even more serious among non-white residents: 48% of Black and 47% of Hispanic residents said their mental health was "not good" for one or more days a month, compared to 42% of white residents.
Togneri said the Allegheny County Health Department works to address disparities in lead exposure through an index which ranks census tracts where children are more vulnerable to lead exposures based on factors like race, poverty level, and the age of housing.
"We do increased outreach in the areas that are identified as being at higher risk levels," he said. "As is the case in all departments, more resources would allow for greater outreach."
In Pittsburgh, the number of pediatric patients seeking mental health treatment has increased by 30% since the spring of 2020. Meanwhile, Pennsylvania is experiencing a statewide shortage of mental health care workers, and in Pittsburgh therapists are quitting their jobs in droves because of burnout.
This is your brain on lead
View overlooking Braddock, PA and the Monongahela River, from the Rankin Bridge. The Mon Valley is visible in the background, including Kennywood Park, stretching towards Duquesne and Clairton, PA. (Credit: Njaimeh Njie)
Guilarte has been studying lead exposure since the 1980s, when lead poisoning among children was rampant.
He was the lead author on a 2021 literature review that looked at dozens of human and animal studies and found increasing evidence that childhood lead exposure is a risk factor for psychiatric disorders like anxiety, depression, and obsessive compulsive disorders, and neurodevelopmental disorders like ADHD, autism, and Tourette syndrome.
The largest of these studies looked at more than 1.5 million people in the U.S. and Europe and found that people who had higher lead exposure as children were more likely to have negative personality traits like lower conscientiousness, lower agreeableness, and higher neuroticism in adulthood (all of which contribute to mental illness).
"Lead exposure impacts a protein receptor in the brain known as the NMDA receptor, which is critically important for brain development, learning, and cognitive function," Guilarte said, adding that improper functioning of the NMDA receptor is also seen in the brains of people with certain mental illnesses (like schizophrenia). The NMDA receptor influences the development of inhibitory neurons that help keep the brain balanced. When it's damaged by lead exposure, it creates too few of those neurons.
"In a healthy brain you have excitatory and inhibitory neurons operating in exquisite balance," Guilarte explained, "but if that's interrupted and you have too many of one or the other, the brain goes haywire."
For decades, scientists only considered the impacts these changes had on children's brains while they were still children, but emerging research suggests some symptoms of the damage done by lead don't emerge until adulthood or even middle age.
The poisoning of a generation
A woman walks up Grant Avenue, at the intersection of Fifth Street in Duquesne, PA. (Credit: Njaimeh Njie)
Aaron Reuben, a researcher at Duke University, led the longest study ever conducted on early life lead exposures and mental health outcomes in adulthood. It followed 579 people in New Zealand from the time they were 3 years old until they were 38 years old, and found that people who were exposed to higher levels of lead as children were more likely to experience symptoms of mental illness as adults, including antisocial behavior, eating disorders, depression, anxiety, post-traumatic stress, substance abuse, delusions, and hallucinations.
"Because we've been following these kids for so long we can also look at where they are as adults compared to where their parents were when the study started," Reuben told EHN. "We've found that kids with low levels of lead exposure tend to do a little better than their parents on the whole in terms of socioeconomic standing, but for kids at the higher end of lead exposure, they appear to have slipped down the ladder compared to their parents and have lower social mobility."
The mean blood lead level for children in the study was 11 micrograms per deciliter. That level is higher than most kids experience today, but it still happens—in Allegheny County at least 582 tests showed blood lead levels higher than 10 micrograms per deciliter in children younger than six between 2016 and 2020, and across the U.S. as many as 243,749 children currently have blood lead levels higher than 10 micrograms per deciliter.
More significantly, that level of lead exposure is representative of the exposures experienced by an entire generation.
"The levels of exposure we looked at are typical for kids born in the 70s in most places in the world when lead was still being widely added to paint and gasoline," Reuben said. "I've estimated that there are about a hundred million people in their forties and early fifties living in America who had high lead exposures as kids."
Western Pennsylvania has a large population of residents in that age bracket.
In Allegheny, Butler, Washington, and Westmoreland Counties—the four most populated counties in Western Pennsylvania—there are around 371,656 people between the ages of 40 and 54 who likely experienced high levels of lead exposure as children.
In 2016, 18 Pennsylvania cities including Pittsburgh, Altoona, Johnstown, and Erie had higher levels of lead exposure among children than those seen in Flint, Michigan, at the height of its lead crisis.
Additionally, recent reporting on Pittsburgh's lead crisis revealed that lead levels in the Pittsburgh Water and Sewer Authority's [PWSA's] water rose steadily from 1999 to 2016, and that because of inconsistent testing, the region's water could have had dangerously high levels of lead contamination for years before it was caught during the city's "lead crisis." The county didn't mandate universal blood lead screening for kids until 2018, so it's difficult to assess just how widespread lead exposure was during that time period.
Even today, despite the county's universal lead screening program, about 35% of kids in the region aren't getting tested for lead exposure. In many parts of the country, the percentage of kids getting screened for lead declined sharply last year, likely due to the COVID-19 pandemic.
"We don't have a good understanding of where those children are or why that's happening," Michelle Naccrati-Chapkis, executive director of the health advocacy nonprofit Women for a Healthy Environment, told EHN.
The legal federal limit for lead in public water systems is 15 parts per billion (ppb), and PWSA's lead levels were higher than that from at least 2013-2016. Across the country, about seven million people were served by drinking water systems that exceeded the 15 ppb threshold from 2018 to 2020, according to the NRDC report.
The U.S. Environmental Protection Agency (EPA) has set a non-enforceable health goal for lead in public drinking water of zero. In 2019 the agency proposed revisions to the Lead and Copper Rule that would lower the action level from 15 ppb to 10 ppb and create stricter requirements for replacing lead service lines, but those revisions haven't yet been passed.
Overlapping impacts
Across the country, the COVID-19 pandemic has taken a huge toll on mental health. In October, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the national Children's Hospital Association declared a national emergency in children's mental health.
"We need more mental health resources and capacity, especially for those in extreme mental health crises," Marita Garrett, the mayor of Wilkinsburg, a small borough about eight miles from downtown Pittsburgh, told EHN.
In October, the city of Pittsburgh announced a new lead ordinance that will require testing for lead paint and dust in rental housing built before 1978 (when lead paint was banned), implementing lead safety plans for repairs and demolitions of buildings that could contain lead paint, and installing drinking water filters at city-owned water facilities.
But Allegheny County is home to 130 self-governing municipalities—more than any other county in the state—and the Pittsburgh ordinance won't apply to them. Many, including Wilkinsburg, have government agencies that are under-funded and under-staffed. Garrett said old lead water lines in Wilkinsburg need to be replaced, but it's expensive.
Naccrati-Chapkis said Lead Safe Allegheny, a local coalition of government agencies and nonprofits, hopes to help other municipalities in the county use the Pittsburgh lead ordinance as a model to pass their own.
Meanwhile, communities with childhood lead exposures are also likely to experience other issues that can disproportionately impact people's mental health, including poverty, racism, violence, and other harmful environmental exposures, including air pollution.
Wilkinsburg, for example, is a majority non-white community that experiences high levels of air pollution from U.S. Steel's Edgar Thomson Mill and has a poverty rate of more than 24%.
In these types of communities, Guilarte said, "It's almost like the perfect storm for these children to have developmental problems." He noted that lead poisoning is linked to higher rates of crime and violence, and that mental illness likely plays a role.
Communities with high levels of poverty are more likely to have lead in their water, but research has also shown that regardless of income level, Black children in the U.S. are two to three times as likely as white and Hispanic children to experience lead poisoning—a lingering effect of racist practices like redlining and a clear result of environmental injustice.
"This is a pure consequence of our history of systemic racism and a racialized caste system in America that has still not been adequately addressed today," Reuben said.
Examples of "toxic zip codes"—regions where a combination of environmental injustice, poverty, and violence create substantial negative health impacts—abound in western Pennsylvania
For example, the Monongahela Valley (commonly referred to as the "Mon Valley"), a former steel corridor of municipalities from the southern tip of Pittsburgh to the West Virginia border, is home to a large number of environmental justice communities (census tracts with a poverty rate of at least 20% and/or a non-white population of at least 30%) and also faces disproportionate risk of lead exposure.
Duquesne is a Mon Valley town about 10 miles southeast of Pittsburgh that's about 70% non-white (compared to Allegheny County as a whole, which is 80% white). In June, during one of 10 virtual discussions about the Lead and Copper Rule between representatives from the EPA and cities across the country, Duquesne Mayor Nickole Nesby told the agency that on average, children tested in Duquesne for blood lead levels have an average of 7 micrograms per deciliter.
"Those children are going to need medical services," Nesby told EHN, pointing to the city's high poverty rate and noting that 33% of the city's school children have learning disabilities. At the state level, about 17% of children have learning disabilities. "We don't even have a medical facility in Duquesne. We need medical care and we need medical research."
In addition to lead problems, Duquesne's drinking water contains levels of unregulated contaminants linked to cancer at rates up to 400 times higher than recommended health limits.
Duquesne buys its water from the Municipal Authority of Westmoreland County, but Nesby said contaminants enter the water once it flows through Duquesne's aging infrastructure, which would cost millions of dollars to repair that the city doesn't have. Nesby is hoping to use some COVID-relief funds toward that end. She recently traveled to Washington, D.C. to talk about her city's infrastructure needs before the U.S. Chamber of Commerce.
"Our water department is just run amok," she said. "We need help."
A 2018 report by the Allegheny County Health Department identified the census tracts in the county with the highest levels of lead exposure risk based on factors like what percentage of homes were built before 1950 (when lead paint and lead water pipes were more common) and what percentage of the population is under 5 years old. Many of those census tracts fall within the Mon Valley.
These overlapping impacts can also have physical effects that impact mental health.
"There's evidence that one harmful exposure changes the brain in a way that can magnify the effects of another harmful exposure later on," said Reuben, who has also studied the impacts of air pollution on mental illness. "So it's not an additive effect—one plus one equals two—but a synergistic effect, where if you're getting one hit from lead exposure and one from air pollution, they combine to create three or four hits."
Banner photo: NaTisha Wasington in conversation with Melanie Meade in Clairton, PA. (Credit: Njaimeh Njie)
Mathitha Ramachandran, a junior at Fox Chapel Area High School, is only 16 years old but she's already spent years worrying about climate change.
In September, she was on her way to a student climate strike in Pittsburgh, along with about 150 other young people chanting and carrying signs. Hers read, "Fight for our Future."
Sometimes it feels to her like there's a natural disaster, like a storm or wildfire, nearly every day. "You're constantly being, like, berated with this kind of news that it just feels so urgent and so necessary to learn about it and to know what's going on," she said.
Ramachandran remembers when she first started looking online about climate change in middle school. She felt panic but didn't know how to talk about it.
Climate anxiety increasing in the U.S.
Dr. Claire Cohen, in front of their Highland Park home, with three of her late sister's six children who she raised. (Credit: Njaimeh Njie)
A recent
survey published of 10,000 young people, age 16-25, worldwide found that 59-percent are very or extremely worried about climate change.
They reported feeling sad, afraid, anxious, and angry.
"As a young person, you're thinking about all these things and you're trying to grapple with - how are these adults not thinking about these things?" she said. "Yeah, definitely. There's anger there."
Dr. Claire Cohen often hears these kinds of concerns from young people. She's a psychiatrist at Southwood Psychiatric Hospital for children and adolescents in suburban Pittsburgh and raised six kids herself. She hears from young people in her office and at home.
"Their biggest concern is, is the world going to be worth living in by the time they're ready to be on their own? And should they have children because is the world going to be unlivable by the time they have children?" Cohen said. "Some of them even feel like it may be the end of the world."
Cohen has been a psychiatrist for more than 40 years, but she didn't understand that climate change could impact mental health until after Hurricane Katrina, in 2005, when a boy came into her office with his mother. They had relocated to Pittsburgh after surviving the disastrous storm in Louisiana.
"They had lost everything and they almost lost their lives and they were temporarily separated because of that whole big flood," she remembered.
Profound
traumatic events like this can impact how a child's brain develops. It can give kids more trouble with learning and memory, and make it more difficult to modulate emotions.
"You see a lot of these kids, like my little patient with Katrina, will develop
ADHD symptoms. They'll have problems with emotional outbursts," she said. "So I began to realize it's not just interpersonal violence that can cause those kinds of traumas. It's the climate, too. And if we don't address this, we're going to have more kids with trauma."
Adults are increasingly worried about climate change too, according to Susan Clayton, the Whitmore-Williams Professor of Psychology at the College of Wooster in Ohio. "Particularly in the last couple of years, we just hear more and more people who are worried, who are worried at this very profound level," she said.
Clayton is the lead author of a
new report for the American Psychological Association and ecoAmerica on climate change and mental health.
She's been researching whether climate anxiety is clinically significant, as a threat to mental health.
In her work, surveys of nearly 400 adults asked about how climate change was affecting them. It asked whether thinking about climate change made it difficult for respondents to concentrate, sleep, work or socialize.
"Fifteen... 20... 25% of the people we surveyed said that at least some of the time they had trouble concentrating because they were thinking about climate change or they had nightmares or they were crying or other impacts that I think suggest that climate anxiety is beginning to have an impact on our lives," Clayton said.
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poll last year by the American Psychiatric Association found that more than two-thirds of Americans are somewhat or extremely anxious about the impact of climate change on the planet, and more than half are anxious about its impact on their own mental health.
Dr. Elizabeth Haase is the Medical Director of Psychiatry for Carson Tahoe Hospital and Behavioral Health Services in Nevada and chair of the association's
climate change committee. "What I'm seeing most is grief," she said, "like the people that actually talk to me about climate change, it's because of the losses that they are seeing around them."
Haase hears grief about the loss of animals, and about the destruction of the natural environment. Some adults get triggered at the mention of apocalyptic change. While others display symptoms of
continuous traumatic stress.
"Which is the model that we use to understand children who are in chronically abusive or neglectful situations," Haase explained. "It puts a kind of low-grade strain on their stress system to know that people are not going to respond to them, that people are going to mistreat them and there's nothing they can do about it. I think a lot of people are essentially feeling that as we watch our leadership fail us so completely."
A call to action for mental health experts
Dr. Gary Belkin in New York City as part of the ThriveNYC mental health initiative on November 29, 2018. (Credit: Dr. Gary Belkin)
Mental health research has been slow to study the psychological effects of climate change, Haase said.
Still, there's plenty of research on how the impacts of climate change affect people. For example, air pollution and heat. "As temperatures go up, or in the wake of an acute heatwave, there are increases in violence, depression and suicide, which are completely independent of social class," Haase said.
She and other mental health professionals say the problems that will come with climate change will be so widespread that the current system won't be able to handle it. Dr. Gary Belkin, a psychiatrist based in New York, is pushing for immediate action.
"We've got to get communities and people ready for the social and emotional effects of environmental collapse," he said.
Belkin is a former deputy health commissioner of New York City and founder of the Billion Minds Institute, which is focused on the social aspects of climate change.
After seeing how people have treated each other during the covid pandemic, Belkin is not confident in society's ability to pull together, but that's what he thinks is needed. "Because success in dealing with that and enduring that is going to fall on us and our social ties and our ability to take action and our connectedness," he said.
"Our profession and the basic setup of clinical mental health services is a very poor match for the challenges that we have now and are just going to be increasing," he said.
Belkin wants to flip the current model, where individuals seek one on one treatment in an office, on its head and move to a more community-based approach to help people deal with their climate anxiety.
Banner photo: Mahitha Ramachandran at the climate strike on September 24, 2021, in Pittsburgh. (Credit: Julie Grant/The Allegheny Front)
A small group of high school students from around Pittsburgh set up chairs in a circle on the patio outside of Phipps Conservatory and Botanical Gardens for a monthly climate action meeting, organized by Communitopia.
Each student expressed their own reasons for getting involved, like Claire Bertolet, a 9th grader at Pittsburgh Allderdice High School, "I'm afraid life is not going to be like it is today, and we're not going to be living as comfortably," she said. "In the future it's going to be too late and we're not going to have time to act on it."
Some expressed concern for social and environmental justice, others for the impact of large corporations on the climate.
Allderdice junior Malcolm Kurtz is an avid hiker and bird watcher. "I am really concerned with how species are affected by climate change," he said. Kurtz finds meaning in climate work, while Ava DiGiacomo, a sophomore at North Allegheny High School, said the state of the world sometimes makes her feel helpless.
"This summer I started spending a lot more time outside, and there were moments when I would just sit and think, 'This world is so beautiful, and it's slowly getting ruined,'" she said. "And sometimes it feels like, personally, I can't do anything that's really going to make a big change. And that's not that's not an easy feeling to deal with."
But they are creating community around climate action, so they don't have to do it alone. On the evening they gathered in early October, some had just attended a climate march, and the group had organized a bicycling event called Pedal-Topia.
Rebecca Carter, a junior at Pittsburgh CAPA 6-12, appreciates the community they are creating. "Things like Pedal-Topia, where we can get together and do something in nature as a group of activists can be really helpful and cathartic," she said.
A need for climate-aware therapists
Dr. Elizabeth Haase, chair of the American Psychiatric Association's climate change committee, thinks students like this are on the right track. Feelings of anxiety, grief and longing for what's been lost in the environment, and worry about what will happen in the future with climate change, are all becoming more pervasive, according to Haase.
She's among a growing group of mental health professionals pushing for more climate awareness among counselors. Haase is also on the steering committee of the Climate Psychiatry Alliance, which is growing. "I think in five years we've gone from being a band of seven to eight people to 240 members," she said. The group has a directory of climate-aware mental health professionals.
Treating climate anxiety is not the same as clinical anxiety disorders, according to Haase. "It's a different animal, a different response when you're facing a real world problem," she said.
She compares it with treating someone with claustrophobia. She would encourage that person to face their fear, and spend time in enclosed spaces, like a subway car.
"That is not an appropriate response when the subway car is on fire, right?" Haase asked. "The subway is on fire. You don't want to sit there and let your fear wash over you. You want to start doing stuff."
When her patients express concerns about natural disasters, climate change and ecological collapse, she advises them to find ways to talk with their family and friends about it and also to take action - join a climate group, write to their local congressperson, or pack up photographs and important belongings in an emergency backpack.
"Even just doing something like that gives you a greater sense of control, and it creates a safer space for you to be in when something bad is happening," Haase said.
A call for therapists to train others to serve the growing needs
Rebecca Carter, talking with Julie Grant of The Allegheny Front about her concerns about climate change. (Credit: Njaimeh Njie)
Dr. Gary Belkin, a former deputy health commissioner of New York City, and founder of the Billion Minds Institute, which is focused on the social aspects of climate change, wants the mental health community to start taking action quickly.
He already sees more mental health needs than there are available therapists, and climate change - the heat, droughts and wildfires, and general background stress it causes - is going to make that worse.
"We really have to get good at rethinking how we can reach a ton of people across that spectrum, And the only way we're going to do that is by enlisting communities to be part of doing that," Belkin said.
Belkin spearheaded a program in New York where mental health professionals trained employees at child care centers, churches and programs for at-risk youth, places that he calls the front lines for mental health.
"We skilled those staff in screening for distress and illness, for basic counseling skills," he said. "We have to engineer things so you don't have to look for care or support. You trip over it. And that's really what we have to aim for."
Beginning efforts to expand climate care in Pittsburgh
Walter Lewis, CEO of the Homewood Children's Village in Pittsburgh, says a few years ago he wouldn't have connected climate change with the mental health of his organization's clients. That's starting to change. (Credit: Njaimeh Njie)
One group on the front lines in Pittsburgh is starting to look into climate change and mental health: the Homewood Children's Village. It has six advocates that stay in touch with 300 members, including more than 100 families, according to the nonprofit's CEO, Walter Lewis. They regularly check in about education, economics, food, and health, including mental health.
"Probably three or four years ago, it would have never dawned on me to think about some of the types of trauma and mental health impacts of climate change," he said.
Disadvantaged communities like Homewood are expected to experience worse climate impacts than their wealthier neighbors. Lewis now sees the neighborhood's high rates of basement flooding, and childhood asthma, as potentially climate-related. So even though his advocates are not mental health professionals, Lewis says he can raise their awareness about how traumatic these types of incidents can be for their clients.
"People are now more empathetic to knowing that, 'Hey, we just had a heat wave, these are some things you might want to think about when you're talking to your families or the children that you work with,'" he said.
A new approach: Community-based therapy
Dr. Kenneth Thompson and his daughter Alice Thompson (pictured in Shadyside) (Credit: Njaimeh Njie)
Dr. Ken Thompson, a community psychiatrist, based at the Squirrel Hill Medical Center in Pittsburgh, and his daughter Alice Thompson, a fourth year medical student, have been working to bring
Integrated Community Therapy to the U.S. through their Visible Hands Collaborative.
Currently their free sessions are held twice a week online.
A trained facilitator welcomed more than a dozen people to a recent Tuesday evening online session, using a technique practiced in Brazil for 27 years, where in-person groups as large as 200 people gather to share their experiences, learn from each other and gradually deal with problems in their families and neighborhoods.
"The goals of this method are to help people learn how to express themselves and sort of have emotional literacy, how to talk about their feelings, and how to help people develop a sense of empathy with each other," Ken Thompson explained.
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Facilitators are trained over months, it doesn't take years like mental health professionals. There are now around 40,000 facilitators in Brazil, as well as other countries, and the Thompsons are starting to train facilitators in the U.S.
"Having a safe space that's sustained over time is going to be really helpful, especially as climate change progresses," Alice Thompson said. "It will allow people to connect not only over their trauma, but also externally so they can support each other in other ways."
Her father continued, "It becomes a real powerful glue, and I feel like we need a lot of glue in this society...to keep us hanging together," he said.
In our polarized society, efforts like this are starting to help more people re-learn how to talk with others, and see their shared humanity, and hopefully reweave some of the community fabric that's been pulled apart. Because as the climate worsens, people are going to need each other.
Banner photo: The student climate strike on September 24, 2021 in Pittsburgh brought out more than 150 young people. Experts say this kind of action can help people who are anxious about the climate crisis. (Credit: Julie Grant/The Allegheny Front)
Climate Psychiatry Alliance has resources to cope with mental health and climate change, and a search function to find a climate-aware therapist.
The Good Grief Network is a 10-step program inspired by the structure of Alcoholics Anonymous whose meetings help "individuals and communities build resilience by creating spaces where people can lean into their painful feelings about the state of the world and reorient their lives toward meaningful action."
Visible Hands Collaborative is a father-daughter psychiatry team from Pittsburgh that's working to build community therapy groups, called Integrative Community Therapy. They are currently online, but planning to start in person (free) sessions at the Squirrel Hill Health Center.
Radical Support Collective is focused on "social change leaders"—people who are working on climate change and other issues, and looking for coaching and training to avoid burnout and continue to work with purpose and joy.
Take action for clean air
If you're interested in advocating for cleaner air for the sake of better physical and mental health, there are many ways to get involved:
Report local air pollution to the Allegheny County Health Department online or via phone (412-687-ACHD).
Download the Smell Pittsburgh app to submit and map air pollution concerns in the region.
Connect with local groups advocating for cleaner air:
Delhi is engulfed in its seasonal thick brown smog – air so toxic that schools and offices have closed. But where does all this air pollution come from, and what is India doing about it?
Schools and factories close. India’s Supreme Court blasts the government’s do-nothing response. But Delhi residents continue to suffer from the bad air.
India's capital New Delhi, one of the world's most polluted cities, is once again choking under a thick cloud of toxic smog and doctors say the poor air quality is leading to an alarming rise in respiratory illness among children.
"Safe" limits on human exposure to phthalates set by national and international regulatory authorities may not adequately protect public health, according to a new analysis published in the journal Environmental Health on Monday.
The study, synthesizing dozens of human studies, drew significant associations between phthalate exposure and human reproductive, neurodevelopmental, behavioral, hormonal, and metabolic health problems. It also underpins the need for reassessing regulatory standards with up-to-date science.
A group of chemicals widely used in the plastic industry to soften plastic products, phthalates are omnipresent in modern life. From rubber duckies to garden hoses to fast food burgers, phthalates can easily sneak into our bodies and disrupt our endocrine system by heisting hormone receptors—such as the estrogen receptors or the retinoic acid X receptors—and messing with gene expression switches. Human and animal studies have linked phthalates to a wide range of health impacts, including birth and reproduction problems, impaired brain development, diabetes, and cancer.
"We know that the exposure [to phthalates] is quite broad," Maricel Maffini, an independent public health consultant based in the U.S. and the lead author of the paper, told EHN. "We were trying to figure out whether the doses that regulators considered safe for people to be exposed to are still protective." The study was funded by Swiss conservation nonprofit, MAVA Foundation, and Food Packaging Forum, a Zurich-based science communication nonprofit focused on food packaging materials and their impacts on health.
Worst-offender phthalates
This paper focused on five what Maffini called "worst-offender" phthalates: benzyl butyl phthalate (BBP), diisobutyl phthalate (DIBP), dibutyl phthalate (DBP), dicyclohexyl phthalate (DCHP), and bis(2-ethylhexyl) phthalate (DEHP).
To investigate the health impacts, the authors extracted data from 38 previously published papers where any of the five chemicals or their metabolites were shown to have a statistically significant association with a health outcome. They then extrapolated the level for each phthalate linked to the adverse health effects and compared them with phthalates' safe limits set by the European Chemicals Agency, which proposes phthalate regulations to the European Commission, and the U.S. Consumer Protection Safety Commission, whose phthalate ban in the U.S. has only been limited to children's toy or child care articles.
The researchers found for DBP, DIBP, and BBP, their estimated dose ranges significantly associated with any adverse health outcomes were all below the safe limits decided by the regulatory agencies. While the lowest estimated intakes linked to a significant health outcome for DEHP, DBP, BBP, and DIBP were 0.03, 0.19, 0.06, and 0.08 microgram per kilogram of body weight per day (μg/kg-bw/d), their limits were 35, 6.7, 500, and 8.3 (μg/kg-bw/d) respectively, representing up to an 8,000 times discord between empirical data and what regulatory bodies considered safe.
Phthalates regulation
Currently, safe limits for phthalates are established by national or international regulatory agencies based on their effects shown through male reproductive health studies in animal models, according to this paper. However, the authors of this study say that these regulatory decisions may not protect consumers from other human health effects, which may not be accounted for during decision-making and can occur below the safe limits.
"We should go back and take another look at whether the safety levels from a regulatory purpose are still safe," Maffini added.
"I think it's a really great study and very timely," Lariah Edwards, an environmental health scientist who studies phthalates at the George Washington University but was not involved in this study, told EHN, alluding to the fact that the U.S. Environmental Protection Agency (EPA) is currently reviewing the health risk for phthalates before setting regulations. All phthalates investigated in this study, except for DCHP, are also included in EPA's phthalates current management plan.
The U.S. has yet to have comprehensive phthalate regulations on the national level. In 2017, the U.S. Consumer Product Safety Commission banned the use of eight phthalates in children's toys and child care products. However, these banned chemicals are not outlawed by the U.S. Food and Drug Administration in food packaging materials, allowing these harmful chemicals to make their way back to the consumers.
"It doesn't really make sense," Edwards said of the patchwork of the phthalates regulations in the U.S. "It is my hope that when phthalates are reevaluated by EPA, they will consider this wide body of rich human data when they're trying to make these regulatory limits."
Spark the conversation on phthalates
This study is not a systematic review of previous phthalate literature, which requires stricter protocols and methods. Another limitation is that although researchers tried to include as many publications as possible, the study could still have missed relevant papers, skewing the analysis.
Instead, "this paper is supposed to spark the conversation," said Maffini. "There is human data of chemical exposures on phthalates that should be considered when it's appropriate for regulatory purposes."
Banner photo: Researchers have found phthalates present in common fast foods. (Credit: Eric Parker/flickr)
Choked in toxic smog, New Delhi has shut down schools and workplaces. Though nations pledged to move away from coal at the UN climate summit, India is reluctant to replace the polluting fuel source.
Johnson & Johnson on Friday said it would split into two companies, hiving off its consumer health division that sells Band-Aids and Baby Powder from its pharmaceuticals and medical devices business. Legal liability for talk was offloaded to a new subsidiary, which immediately filed for bankruptcy.
