Reporting on the intersection of health and the environment
By Lisa Stiffler
Some of the hottest topics in news these days are at the intersection of health and environmental beats. Drinking water that's fouled by pesticides, dry-cleaning chemicals or factory farm waste. Plasticizing chemicals that cause breast development in boys. Finding fish that's safe to eat and sustainably caught. Reporters can help connect these dots for readers, making the link between their morning grande latte or aspirin, and the caffeine or pharmaceuticals measured in the lake or bay down the street.
The stories have great consumer angles that help empower concerned consumers to select environmentally friendly products that won't harm their families. At the same time, policy makers and regulators are taking notice of these issues and, in some cases, taking action.
- Pollution in your community
- Kids and pollution
- Food, farms and pesticides
- Climate change and human health
- Endocrine disruptors, human health and the environment
In California, air pollution near freeways is suspected of causing brain cancer – the leading cause of death from cancer in people younger than 19. In New Jersey, groundwater and soil contaminated from billions of pounds of explosives produced for more than a century at a DuPont factory are potentially linked to high rates of kidney cancer and non-Hodgkins lymphoma.
Landmark acts to clean America's air and water were approved decades ago, and the environment has gotten cleaner in many respects. Despite that progress, the pollution continues, endangering human lives. In fact, the U.S. Environmental Protection Agency announced that in 2008, 3.86 billion pounds of toxic chemicals were released by industries and government facilities into the air and water and onto land. That's approximately 12 pounds of toxic waste being dumped for every American.
Air pollution is associated with lung disease including cancers, asthma and allergies. But it can harm other organs, too, including the heart and, as mentioned previously, the brain. Also keep in mind that what goes up, often comes down and becomes water pollution. And, of course, there's plenty of pollution going straight into the water from sewage plants, mining operations, manufacturers, storm water runoff from highways and buildings, and farmland. Humans are exposed to water pollution through contaminated drinking water, where toxics enter the food chain, and dirty ocean and lake beaches.
Louisville skyline (Photo by Glorius via Flickr)
Americans don't share the risk from pollution equally. People who are low income, racial or ethnic minorities, or immigrants often are more likely to live and work in areas with higher concentrations of polluting facilities, highways and historically contaminated sites.
Embrace the data! There is a lot of good state and national information on pollution emissions and cleanup sites across the country. What's being dumped in your backyard, and what are the health risks? The EPA is responsible for regulating pollution cleanup and emissions. It delegates certain aspects of these duties to state agencies but still provides a good place to start and can direct reporters elsewhere if needed:
Superfund sites, by state
Toxics Release Inventory provides the amount of pollution annually released into the air, water and land by weight, for each state's largest polluters.
AIRNow is the federal site tracking air quality in real time, plus has an extensive list of state and local links.
Get population information from the U.S. Census Bureau and create maps overlaying income and race with polluters and Superfund cleanups: American FactFinder is the Census Bureau's quick link to data sets.
Oil spill resources
- Mental health impact of the BP spill multiplies
- Resources for reporting on health and the oil spill
- CDC Emergency Response and Preparedness
Kids deserve special attention in the environmental health arena. Because their minds and bodies are still developing, babies and children often are most at risk for the harmful effects of pollutants. The trouble is, there's a lack of research specifically focused on safe exposure levels and the threats posed by dangerous chemicals to our youngest, most vulnerable citizens.
Massive toy recalls beginning during the 2007 holiday shopping season drew attention to the risk posed by products made explicitly for children. That's been followed by concerns about toxic chemicals in baby bottles and other infant items. It's resulted in some stronger safety regulations at the state and federal level, though advocacy groups are pushing to expand the items and chemicals being covered.
Another area of exposure for kids is at school through bus diesel pollution, contamination in drinking water, pesticide use, and even artificial turf fields, thanks to worries about heavy metals in the recycled materials used to make the turf. 
Check your state's regulations for toxic chemicals in kids' products. How are they affecting local manufacturers and stores? How do parents feel about the level of regulation? Which chemicals are not addressed? Potential resources:
The National Children's Study is a long-term examination of the role of environment in children's health that's being led by multiple federal agencies with local participation across the United States.
The Association of Occupational and Environmental Clinics offers experts in children's environmental health.
What are local schools doing to make sure they're providing a safe environment for students? Have they tested the drinking water quality? What are their rules associated with pesticide use?
EPA monitoring for air pollution near schools nationwide.
Beyond Pesticides is a national effort to reduce pesticide use at schools.
A question many mothers struggle with at some point during their pregnancy: What kind and how much fish can I safely eat to get the brain-developing benefits of omega-3 fatty acids without mercury harming my fetus? It's tragic that super foods such as salmon now carry with it risks from pollution. Fish – particularly big fish including Chinook or king salmon, marlin and swordfish – build up, or bioaccumulate, dangerous chemicals. And they aren't the only contaminated foods. The U.S. Food and Drug Administration tests a wide range of foods for pollutants.
Vegetables and grains, unfortunately, are not immune from contaminants either. A study of children eating conventionally grown versus organic produce found pesticides at levels six-times higher in the kids eating conventionally produced veggies. That's not to mention the levels of pesticide exposure experienced by farm workers and their children.
Conventional, large-scale farming has other environmental health concerns. Runoff from agricultural land carries fertilizers that can create oxygen-depleted dead zones in bays and canals. Waste from concentrated animal feeding operations or CAFOs with potentially thousands of heads of cattle can create aggravating odors and create pollution from bacteria-laden, manure-tainted runoff.
The debate continues over whether organic and free-range packaging labels can be trusted. One angle to consider is the option of getting local foods from the booming farmers markets, and if that's better for the environment and human health than mass-produced organic foods.
FDA's Total Diet Study measures numerous contaminants in a wide range of food items. Go to the "Analytical results" link, then scroll down to the chart with individual years listed to get results for specific items.
Fish issues are nuanced – not all fish are equally contaminated with mercury. Farmed versus wild fish have different levels and so do different kinds of fish. Also keep in mind that other foods can be polluted too, and that there are great health benefits of fish that should not be overlooked.
The National Lake Fish Tissue Study from the EPA measures the amount of pollution in freshwater fish.
Consumer Reports has great information on environmental food safety issues. See the food safety link near bottom of page.
We're all familiar with the reporting on the effects of climate change. Snow packs are shrinking and sea levels are rising. But what will a warmer world mean to human health? It's a question that's gotten much less attention than the changes to the physical world that scientists are forecasting – but it's certainly no less important.
In 2007, the Intergovernmental Panel on Climate Change – the go-to source for the scientific lowdown on global warming – released its latest report summing up how climate change is affecting the world and projections for the future. The IPCC concluded that the warming of the planet is "unequivocal" and that it is "very likely" that the observed temperature increases are due to increasing levels of heat-trapping greenhouse gases.
Climate change's potential to seriously threaten human health affects every region of the country and includes some surprises. Scientists and doctors are, as you'd expect, predicting there will be more cases of heatstroke and heat-related deaths as the days and nights get hotter. But they also predict more asthma attacks, worse allergies, and more lung cancer and heart disease. That's because of the ripple effects that come from a warmer planet with higher levels of carbon dioxide.
Higher temperatures cause the formation of more ground-level ozone, a pollutant that's unfamiliar to many folks, but that causes lung irritation, asthma attacks and increased lung disease. The heat is also expected to trigger more forest fires, which release massive volumes of small particulate matter that can lead to heart attacks and lung disease.
In a clever series of experiments, scientists grew ragweed both in a rural setting and in an urban setting that was identical in terms of soil and water – except the latter was warmer and had higher carbon dioxide levels, simulating the expected changes in the climate. In the urban setting, the weed produced more allergy-causing pollen than its "pre-climate change" rural counterpart. In a different study, poison ivy was grown in conditions with higher CO2 and the noxious plants grew faster and produced a more virulent form of the oil that causes the allergic reaction. In general, plants are flowering earlier in the spring, resulting in a lengthening of the allergy season for some irritants.
Warmer temperatures and increased flooding due to changes in rain patterns and less precipitation falling as snow are expected to increase some insect and rodent populations. Tick-borne lyme disease is predicted to spread farther north and into Canada. Places where it's already found could see an increase in the density of ticks. More flooding means more mosquitoes and a potential increase in cases of West Nile Virus. And hantavirus, which is carried by deer mice, could also explode as droughts kill off many of the predators of the mice, allowing the rodents to thrive. 
Editors want a hook that gives a story urgency and timeliness. For climate and health stories, new research could be that hook. Or take advantage of extreme weather events – hurricanes, heat waves and the like. But be careful not to say that the weather event is climate change in action (scientists will never point to a single event and say "this is climate change"), but rather explain that this is the sort of weather that experts predict will become more frequent.
At Health Journalism 2008, officials from the American Public Health Association and its partners unveiled a public health blueprint for tackling climate change in advance of National Public Health Week (April 7-13). This one-of-a-kind consensus document, compiled by a group of leading climate change and public health professionals, outlines strategies to mitigate and prepare for the effects of climate change. Bloomberg story about the announcement: Climate-Change Bill Should Address Health Effects, Group Say.
Ten Comments on the Health Risks of and Public Health Responses to Climate Change, from Kristie Ebi, M.P.H., Ph.D., consultant, on the "Intersection of global climate change and health" panel at Health Journalism 2008.
Presentations from the "Effects of global climate change on health panel" at Health Journalism 2009.
- "Climate change, air quality, and health: A study and some other comments" from Catherine Karr, M.D., Ph.D., M.S., University of Washington School of Medicine and School of Public Health
- "Heat-Related Mortality in Washington State: Past and Future," Elizabeth Jackson, doctoral candidate, University of Washington
- "Climate Change, CO2 and Public Health: the Botanical Perspective," Lewis Ziska, Ph.D., plant physiologist, Agricultural Research Service, U.S. Department of Agriculture | Study
In "Hot or Not?: Recognizing and Managing the Health Impacts of Climate Change," Robert Wood Johnson Health & Society Scholar Sabrina McCormick examines three illnesses recently recognized as exacerbated by climate change: West Nile Virus in the Northeast United States, increasing toxicological exposures in coastal Alaska Native communities, and heat-induced illnesses in Philadelphia, Penn.
Intergovernmental Panel on Climate Change (PDF) released its 2007 assessment on climate changes, causes and effects. It's working on its fifth assessment, which will be released in 2014.
These stories are most powerful when localized. Contact universities and government agencies that are increasingly trying to predict the local impacts of climate change (degrees of warming, changes in rain patterns, etc.). Call local and state public health officials. What sorts of health challenges are they expecting? How are they preparing to respond?
Trust for America's Health is a nonprofit group that did a nationwide analysis in October 2009 to determine America's readiness to respond to the health threat posed by climate change, including a state-by-state analysis.
American Academy of Pediatrics' Committee on Environmental Health's policy paper on the effects of climate change on children's health.
Autism numbers are skyrocketing. Obesity has hit epidemic levels. Girls are experiencing puberty at ever younger ages. These trends are alarming and to varying degrees inexplicable. Some wonder: Could industrial chemicals in our environment be playing a role?
There's increasing awareness that the chemicals in household items – from our couch cushions to our hand lotion, our eyeglasses to our printed sales receipts – include ingredients that mimic human hormones, potentially causing a suite of health problems. These so-called endocrine disruptors may play important roles in countless products, but the trouble is that they don't stay put. They escape from everyday items into our house dust, the air and out into the environment where they wind up in our food and water.
When they get into our bodies, endocrine disruptors interfere with our hormone systems, preventing the right signals from being sent, or sending wrong ones. They're blamed for problems in brain development, puberty and infertility, metabolism and some cancers. In the Endocrine Society's first ever "Scientific Statement" released in June 2009, the organization called this class of chemicals a "significant concern to public health."
PCBs, or polychlorinated biphenyls, are a family of some of the most infamous endocrine disruptors. These industrial chemicals were banned in the U.S. in the 1970s, but persist in the environment, turning up in mud, water, fish and other marine life. Yet the next generation of endocrine disruptors are being manufactured and released to the environment in vastly greater volumes than PCBs ever were. They include flame retardants known as PBDEs, or polybrominated diphenyl ethers; bisphenol A, or BPA that's used to make hard, clear, glass-like plastics; and phthalates, a family of chemicals with myriad uses that include making plastics soft and pliable and fragrances longer lasting.
PBDEs are sometimes called a cousin to PCBs because of the similarity in their chemical structure. These flame retardants are added to electronics including TVs, computers and household appliances, foam cushions, beds, and cars and airplanes. Scientists are trying to solve the mystery of how PBDEs move from consumer items into living organisms, and have pinpointed house dust as a prime exposure route for humans. Additionally, babies can be exposed to PBDEs through breast milk and adults through contaminated foods including fish and dairy products. , A key problem with PBDEs is that, like PCBs, they're slow to breakdown and instead build up over time or "bioaccumulate" in people in the environment.
There are three forms of PBDEs that have most often been used in consumer items: penta-BDE, octa-BDE and deca-BDE. U.S. manufacturers of the penta and octa forms voluntarily stopped making them when environmental concerns arose. Deca is still in wide use, though some states have banned some of its applications. Based on animal studies, Deca can cause problems with thyroid function, liver toxicity and cancer. It is also believed to have the potential to break down into the more toxic penta and octa forms.
BPA is getting a lot of media and consumer attention in recent years. That's particularly due to new research showing that the chemical can leach out of containers and into the food and drinks that we consume, providing a direct route of exposure. Particularly troubling is BPAs use in baby bottles, as well as a liner to soda cans, tin cans, microwavable plastics, dental sealants, sports bottles, CDs and eyeglasses.
At even low levels of exposure, BPA is linked to hyperactivity, diabetes and genital deformities. But there's been a hot debate between government regulators with the U.S. Food and Drug Administration and academic experts as to the degree of threat posed by BPA. Canada, in the meantime, has ruled BPA to be "toxic" to humans and banned its use in baby bottles and other products. U.S. states are increasingly pursuing their own BPA rules.
Phthalates pose a tricky challenge for consumers trying to limit exposure because they pop up in unexpected places. The plasticizer is used in fragrances, nail polish and lotions. It turns up in toys, plastic shower curtains, air fresheners, vinyl flooring and drier sheets. It's used in medical devices such as IV bags and feeding tubes.
As with PBDEs, there are different kinds of phthalates in use in different products, with different potential health effects. Human health problems include mutations in male genitals and sperm damage. Routes of exposure include house dust, indoor air and certain foods. For children, exposure can occur by chewing on toys containing phthalates, and even through baby lotions and other personal care products.
The issue of toxic chemicals in common items is the gift that keeps giving. There's always new research about health effects or discussions about state and federal regulations. Check your local universities to see what's new and find out what action if any your state or members of Congress are taking to keep consumers safe.
Environmental Health Perspectives offers links to some of the latest research on endocrine-disrupting chemicals.
There's no reason to be alarmist when telling these stories, no need for headlines screaming: "Your water bottle will kill you!" It's enough to say that research continues to raise concerns and to let people know how these chemicals are – and are not – being regulated by the government. It's also appropriate to point out that consumers who are concerned about these chemicals – perhaps they err on the side of caution or are worried about particularly vulnerable populations (such as pregnant women, infants and children) – will have a difficult time avoiding some of these ingredients. That's because labeling laws are incredibly lax.
Milwaukee Journal Sentinel did an exceptional series called "Chemical Fallout" on toxic chemicals in consumer items and the failure of safety regulations.
Chemical-industry groups will field questions and critique research and regulations:
Because these chemicals literally are in countless products, it's no trouble finding "real people" to insert into your stories. That can include women shopping for beauty and personal-care items; parents concerned about what's in their kids' bottles, teethers and toys; or workers in fields including nail salons (phthalates), or computer recycling, and airline attendants and pilots (flame retardants).
Environmental Working Group is one of the most active nonprofit groups in tracking hazardous consumer chemicals.
 Steinberg, Jim. "Tests link cancer to snarled freeway air." Inland Valley Daily Bulletin, Dec. 8, 2009.
 Murray, Brian T., "Higher rates of cancer in Pompton Lakes may be from DuPont water contamination." The Star-Ledger, Dec. 10, 2009.
 Environmental Protection Agency, Clean Air Act
 "Pollution in People: Cord Blood Contaminants in Minority Babies," Environmental Working Group, Dec. 2, 2009.
 Freking, Keith. "EPA unveils new policies on water at schools." Houston Chronicle, Dec. 8, 2009.
 Curl, Cynthia, et al. "Organophosphorus pesticide exposure of urban and suburban preschool children with organic and conventional diets." Environmental Health Perspectives, 2003 March; 111(3): 377-382.
 Garber, Kent. "Dead Zones Grow in the Gulf of Mexico." U.S. News and World Report, June 6, 2008.
 "Climate Change 2007: Synthesis Report Summary for Policymakers." Nov. 12-17, 2007.
 Jackson, J. Elizabeth et al. "Public Health Impacts of Climate Change in Washington State: Projected Mortality Risks Due to Heat Events and Air Pollution."
 Sohn, Emily. "Ozone Linked to Deadly Lung Disease." Discovery Channel, March 16, 2009.
 "Particulate Matter (PM) Basics." U.S. Environmental Protection Agency.
 Ziska, Lewis H. et al. "Cities as harbingers of climate change: Common ragweed, urbanization, and public health." The Journal of Allergy and Clinical Immunology, February 2003, Vol. 111, Issue 2, Pages 290-295, www.jacionline.org/article/S0091-6749(03)00959-X/abstract
 Mohan, Jacqueline E. et al. "Biomass and toxicity responses of poison ivy (Toxicodendron radicans) to elevated atmospheric CO2." PNAS, June 5, 2006, 103:9086-9089.
 "Climate Change Futures: Health, Ecological and Economic Dimensions." The Center for Health and the Global Environment at Harvard Medical School. November 2005.
 Diamanti-Kandarakis E et al. "Endocrine-Disrupting Chemicals: An Endocrine Society Scientific Statement." Endocrine Reviews 30(4):293-342, 2009.
 Agency for Toxic Substances and Disease Registry Toxicological Profile, Centers for Disease Control and Prevention
 Stiffler, Lisa. "PBDEs: They are everywhere, they accumulate and they spread," Seattle Post-Intelligencer, March 29, 2007.
 Betts, Kellyn S. "Unwelcome Guest: PBDEs in Indoor Dust," Environmental Health Perspectives, Volume 116, Number 5, May 2008.
 "Toxic Fire Retardants (PBDEs) in Human Breast Milk." Environmental Working Group, September 2003.
 Schecter, Arnold, et al. "Polybrominated Diphenyl Ether (PBDE) Levels in an Expanded Market Basket Survey of U.S. Food and Estimated PBDE Dietary Intake by Age and Sex." Environmental Health Perspectives, Volume 114, Number 10, October 2006.
 "Washington State Polybrominated Diphenyl Ether (PBDE) Chemical Action Plan: Final Plan," January 2006.
 Rust, Susanne, et al. "Bisphenol A is in you." Milwaukee Journal Sentinel, Dec. 2, 2007.
 "States hope to join Minnesota in banning BPA." Safer States, May 8, 2009.
 U.S. National Library of Medicine
 Sathyanarayana, Sheela, et al. "Baby Care Products: Possible Sources of Infant Phthalate Exposure.", Pediatrics, Vol. 121 No. 2, February 2008, pp. e260-e268.
Lisa Stiffler is co-editor for Sightline Daily, a collection of environmental, economic and social news stories affecting the Northwest. Sightline Daily is a project of Sightline Institute, a Northwest sustainability think tank. Before joining Sightline in 2009, she was a reporter at the Seattle Post-Intelligencer for 10 years, most of them spent covering environmental issues. She did investigations on the health of Puget Sound, the national failure to protect endangered species, and the multi-billion dollar Hanford cleanup. At Sightline, she helps tie together the day's news with research and insight for sustainability stories. Her e-mail address is firstname.lastname@example.org.