Pittsburgh 2005:
Health and the Environment Conference
Abstracts

Thursday, April 7, 7:30 - 9:00 p.m. - Opening Plenary
"Confirming the Evidence: Health and Environmental Toxicants"

Dr. Bernard D. Goldstein
"The Unity of Health and the Environment"
Recognition of the network of linked pathways by which human activities impact on broad planetary, geological, chemical, and biological systems has led to a welcome increase in multidisciplinary approaches to understanding, preventing, and investigating these effects. Lagging behind has been incorporation of information about the human health impact of these changes. The artificial division between effects on humans and effects on global and local ecosystems and sustainability has been abetted by academic and political organizational structures that have been difficult to bridge. The place of human health within the interconnected global web of effectors and receptors extends well beyond the traditional human environmental health issues of the toxicity of chemical and physical agents. The human species is not known for its ability to plan wisely beyond the short term. A better understanding of health impacts may be the best way to spur the individual and collective will to address global and local environmental changes.

Dr. Kenneth Olden
"The Need for Innovative Technologies in Environmental Health"
The discipline of environmental health sciences is on the threshold of undergoing a profound transformation because of recent efforts at consolidation of genomic and toxicologic sciences. Environmental health research is an example of an area of science that has evolved beyond the boundaries of a single discipline. Unraveling the complex nature of the interactions between genes, gene products, and environmental factors will require the development of new technologies and models of inquiry that bridge boundaries of multiple disciplines. If the interdisciplinary approach is not applied, advancement in understanding of the role that genes and environmental factors plays in human health and disease will continue to be incremental; whereas, opportunity exists for transformative change in the field. In fact, the whole movement toward interdisciplinary research is being driven by both the inherent complexity of nature and societal problems. Also, the availability of generative technologies have the capacity to transform both genomic and environmental sciences to create a new and more productive hybrid discipline.

Dr. Devra Lee Davis
"When Smoke Ran Like Water -- What Past Pollution Episodes Teach Us About the Future"
Major episodes of lethal pollution in the middle of the twentieth century in Donora, Pennsylvania, and London, England, provided turning points for the creation of environmental policy and public health research in the industrial world. Documentary film excerpts from these episodes will be shown that make clear that everything people do leaves trails of numbers. Births, deaths, the sex of our children, smoking, even the size and shape of our private parts can all be measured and counted. Some of these measurements will mean nothing, but others tell who we are, how long and well we are living, where we have been and whether we will ever get to where we think we're going. Epidemiology works well when conducting carefully controlled, randomized trials of pharmaceuticals. But the world outside of drug trials, the world of what is called environmental epidemiology, is not such an easy or elegant place to study. Efforts to develop molecular epidemiology analyses of cellular and genetic events that signal ties to environmental factors are underway at the University of Pittsburgh Cancer Institute's Center for Environmental Oncology. These hold the promise of revolutionizing our ability to understand the ways that the environment shapes life, death and sex.

Dr. Philip J. Landrigan
"Environmental Threats to the Health of Children: New Epidemiologic Approaches"
Patterns of disease among children in the industrially developed nations have changed dramatically in the past 100 years. Despite the emergence of Acquired Immune Deficiency Syndrome (AIDS) and severe acute respiratory syndrome (SARS), vaccines, antibiotics, and improved hygiene have controlled the classic infectious diseases. Infant mortality has decreased by 90%. Life expectancy has nearly doubled. Yet amid this success a new challenge has arisen. Chronic diseases have increased sharply in incidence and have become the leading causes of childhood illness in the developed world.To overcome these difficulties, the U.S. Congress has authorized the National Institute of Child Health and Human Development "to conduct a national longitudinal study of environmental influences on children's health and development". The specific objectives of the study, now termed the National Children's Study (NCS) are to elucidate the factors in the environment that contribute to the causation of asthma, learning disabilities, mental health problems, birth defects and obesity.

Friday, April 8, 8:15 a.m. -- 10:15 a.m.- Plenary
Emerging Themes Research Agenda

Dr. Ted Schettler
"Overview of Existing and Emerging Science"
Human health status is determined by complex interactions among genetic, environmental, and social factors. This presentation will address environmental factors that impact health status and give examples of interactions with other determinants. Although environmental factors can influence health throughout the lifespan, developing fetuses and children are sometimes uniquely vulnerable to environmental agents at exposure levels that have no discernable impacts in adults. Moreover, accumulating data suggest that early life exposures may have a significant impact on health status throughout the lifespan. Examples will illustrate these points.

Dr. Herbert Needleman
"Lead and Crime: A Little-known Effect"
Most studies of lead have focused on psychometric IQ. Yet there are many suggestions that the regulation of impulse may be a more important and sensitive target. Most studies of criminal behavior focus on social or rearing factors, slighting or ignoring the role of the brain. While some neurotoxins, e.g., alcohol and amphetamines, are acknowledged as elicitors of aggressive behavior, lead has been largely overlooked. I shall briefly review the history of lead toxicity and focus on recent studies indicating that lead exposure may be associated with delinquent or criminal behavior.

Dr. John Peterson Myers
"Environmental Exposures Altering Gene Expression: New Opportunities for Disease Prevention"
New scientific research examining the effects of contamination on how genes behave is challenging today's public health standards. These new findings emphasize that (1) low doses of some biologically-active molecules can alter signaling processes controlling gene expression at extremely low levels; (2) chemical mixtures are ubiquitous and they affect outcome; (3) exposures interact with other factors such as stress; (4) exposures during sensitive periods in development can lead to effects much later in life; and (5) people vary in sensitivity because of genetic and developmental differences. Together, these findings indicate that the health burden of chemical exposures may significantly exceed current estimates, and they point toward important new opportunities for disease prevention.

Friday, April 8, 10:30 a.m. - 12:15 p.m. - Plenary
"Filling in the Gap: An Environmental Health Research Agenda"

Dr. Adolfo Correa
"Environmental Birth Defects Tracking"
The Metropolitan Atlanta Congenital Defects Program (MACDP) was created in 1967 in the aftermath of the thalidomide tragedy to provide early warning of changes in the prevalence of defects at birth that might be due to modifiable factors. Since then, the program has been collecting, analyzing, and interpreting birth defects surveillance data for five central counties of metropolitan Atlanta, with an emphasis on the evaluation of temporal trends, descriptive epidemiology, and etiologic studies. A growing need for population-based data on the possible impact of environmental factors on prevalence, as well as development of new databases, has prompted efforts to conduct various data linkages. These data linkages, in turn, are broadening the scope of analysis of MACDP data, including a better characterization of the temporal and spatial variation in prevalence. This presentation will provide examples of data linkages conducted with MACDP data that may allow for environmental tracking of birth defects and of some of the methodological challenges raised by such linkages.

Dr. Robbie Ali
"Towards an Inventory of Pittsburgh's Environmental Health"
Highlights from the report from the Center for Healthy Environments and Communities describing the pertinence, availability, general strengths and weaknesses of several types of environmental health data. Dr. Ali will emphasize the Pittsburgh region while covering the following: source monitoring/ emissions, environmental monitoring, human exposure, health outcomes, built environment factors, and consumption/ supply/demand. He will also discuss political/systemic and environmental justice considerations, and a few examples of existing local endeavors to compile, creatively link and report information. Finally, he will outline possible next steps in building the available base of regional environmental health information.

Dr. Shelley A. Hearne
"Chronic Disease Tracking Systems and Policy Implications"
Three decades of environmental laws, regulatory action and focus and the nation has made considerable progress cleaning its water, air and land. But without similar attention to our health, many environmentally related diseases are at unacceptably high rates or actually increasing, such as asthma and obesity. The Centers for Disease Control and Prevention (CDC) reports that approximately 2/3 of U.S. deaths and disabilities are associated with chronic diseases, with 70% preventable. Pennsylvania and the U.S. must strengthen its environmental health research, health agencies and health tracking tools in order to better protect its citizens from preventable diseases. Unfortunately, Pennsylvania lags behind the nation in environmental health protections and an action plan will be presented for positioning the state as a future leader.

Workshops

Friday, April 8, 1:45 p.m.--3:30 p.m., Conference Room A
"Learning Disabilities"

Dr. Carol Utay
"Identification and Treatment of Learning Disabilities"
A learning disability is a neurobiological disorder in which a person's brain works or is structured differently affecting a person's ability to speak, listen, read, write, spell, reason, recall, organize information, and/or do mathematics. Recognizing a learning disability is difficult because the severity and characteristics vary. A learning disability can't be cured or fixed; it is a lifelong issue. With the right support and intervention, however, children with learning disabilities can succeed in school and go on to successful, often distinguished careers. Parents can help by encouraging their strengths, knowing their weaknesses, understanding the educational system, working with professionals and learning about strategies for dealing with specific difficulties. The purpose of this discussion is to highlight typical signs of learning disabilities.

Michele Gagnon
"Pollution, Toxic Chemicals and Developmental Disability"
Mental Retardation and other developmental disabilities (DD) affect approximately 1.5 million children under the age of 18 and appear to be increasing. Mental retardation is the most common DD affecting approximately 2% of the total US population. Given that we know exposures to many neurotoxicants contribute to mental retardation and other developmental disabilities, the American Association on Mental Retardation (AAMR) has launched a national program to reduce toxic exposures that may contribute to or exacerbate cognitive problems and related disabilities. The main goals of the Initiative are to engage the developmental disabilities sector in the growing national movement to eliminate toxics that may contribute to and worsen neurological problems and disabilities, and to promote better health by reducing toxic exposures on those living with disabilities.

Dr. Ted Schettler, panelist on Friday's first plenary, will also present on this panel.

Friday, April 8, 1:45 p.m.--3:30 p.m., Conference Room B
"Breast Cancer"

Dr. Julia Brody
"Breast Cancer and the Environment -- Realistic Hope for Prevention"
US women's lifetime risk of breast cancer has doubled from 1 in 14 in the 1960s to 1 in 7 today, or 1 in 6 including in situ disease; and incidence is rising most rapidly among immigrants from low-risk nations. Changing patterns in risk cannot be due to genes. Environmental pollutants that mimic estrogen (a known breast cancer risk factor) may play a role. Exposure is common from sources such as detergents, pesticides, cosmetics, plastics, and air and water pollution. Pollutants, such as PAHs, that cause mammary tumors in animals are priorities, too, in the search for breast cancer prevention.

Nancy Evans
"State of the Evidence: What Is the Connection Between Environment and Breast Cancer"
This presentation will summarize the scientific evidence linking environmental exposures to the breast cancer epidemic, and strategies for changes in public policy to protect public health. It will also spotlight major gaps in current knowledge about environmental links to breast cancer and the need for research that will provide information for shaping public policies that can help reverse this epidemic. This presentation will help prepare participants to: Collaborate with scientists in planning and implementing community-based participatory research. Act as teachers and change agents, educating their communities to advocate for changes in public policy that will protect public health.

Friday, April 8, 1:45 p.m.--3:30 p.m., Conference Room C
"Air Pollution"

Dr. Roger C. Westman
"The Roles, the Rules and Implementation for US Air Quality"
This presentation will briefly explain the roles of local, state, and federal air pollution control agencies, the federal air quality standards, and the current status of the air quality. Air quality data are among the most plentiful environmental measurements. Data availability and accessibility will be discussed. The presentation will include how air pollution regulations are developed and how they work, and what are typical control measures and equipment.

Dr. Neil Donahue
"Sources of Fine Particulate Matter in Pittsburgh: Emissions, Transport, and Chemistry"
One form of air pollution causing special concern is particulate matter of less than 2.5 micrometers in diameter (PM2.5). These particles are respired into the deep lung, where they can be trapped. Strong epidemiological evidence indicates that 20,000 to 40,000 excess deaths per year in the United States are caused by acute effects related to PM2.5 exposure. The most significant link is between the total PM2.5 mass and hospital deaths, so it is necessary to understand the total budget of PM2.5 mass in order to understand the implications for health. PM2.5 in Pittsburgh comes from a variety of sources, which we will describe; these are either very local (a diesel at the curb) or very regional (power plants in the Ohio River Valley).

Dr. Evelyn O. Talbott (with Jeanne V. Zborowski, PhD, Vincent Arena, PhD Priscah Mujuru, MPH)
"Air Pollution and Daily Cardiopulmonary Hospital Admissions: An Analysis of Data from Pittsburgh, PA"
This study will present the trends over time for PM10 from 1995 to 2000 in Allegheny County. An earlier report by Sussman and Mazumdar had shown a relationship of Total Suspended Particulate (TSP) with mortality in Allegheny County, PA. (l983). The human health effects of air pollution have been extensively discussed in the literature. Many studies are based on time series analyses of daily mortality or hospital admissions. There has been a particular focus on particulate matter of aerodynamic diameter 10 µm or less (PM10). The results from these studies are important in revising the National Ambient Air Quality Standard. Data consist of daily cardiopulmonary hospital admissions (1995- 2000) among the elderly and young, and PM10 measures in Allegheny County. Trends of air pollution levels will be presented and several approaches to the analysis that take into account temperature, seasonality, and meteorological effects, Statistical issues are addressed and discussed for the interpretation of results. A binary logistic regression (0,1) of those individuals admitted multiple times over the six year period versus those admitted only once will be considered along with age, seasonality, temperature, humidity and PM10.

Claire L. Barnett
"Preventing Harm at School"
With 54 million children in 120,000 schools nationwide, and estimates of the costs to restore America's school facilities ranging from $127 - $254 billion, US GAO, NEA, and US EPA have suggested that half of all students are compelled to be in buildings that daily erode their health and learning. Data will also be available on Pennsylvania schools. Asthma is the single largest cause of absenteeism and an occupational disease among teachers. Just as children are not biologically little adults, schools are not little offices. Attendees will learn what the differences are between adults' and children's workplaces; what the peer-reviewed sciences reveal about school environments and children's health; and what steps can be taken nationally, in the states, and at the local level. Time permitting, attendees will be asked to engage in a discussion about how to develop a policy agenda that promotes a healthy built environment and that prevents harm to children and others.

Friday, April 8, 1:45 p.m.--3:30 p.m., West Wing Meeting Room C
"Pesticides"

Monica Moore
"A Tale of Two Neurotoxins"
Pesticides can affect human health in many ways. This presentation will provide an overview of acute and chronic pesticide health effects, and why children are more vulnerable to pesticide harm than adults. It will then tell "A Tale of Two Neurotoxins" to highlight a particular type of pesticide damage, and illustrate how parents, environmental health advocates and others are challenging long-standing assumptions and practices that result in children's continued exposure to these harmful pesticides, despite the availability of effective non-chemical and least-toxic alternatives. The session also will introduce several important information resources in this field, and invite participants to explore how they can be useful to their particular situations.

William (Bill) U. Couzens
"The Power to Choose, The Power to Change and The Power to be Heard: The History and Mission of Next Generations Choices Foundation - Presenting Models for Advocacy"
Next Generation Choices Foundation is a national environmental health organization that has developed models for positive change. The founding philosophy of the organization is to give people information and models that, in turn, allow them as individuals make better choices. Next Generation Choices Foundation has been deeply involved in agricultural issues that include limiting off-target pesticide drift, creating buffer zones for schools, developing best practices for agricultural spraying, as well as advocating for the health of farmers and their communities. The organization is concerned about pesticide drift especially as it effects children, i.e.: cancer, asthma, neurological and development disorders.

Dr. Glenn F. Smartschan
"Implementation of IPM in a School Setting"
The Mt. Lebanon School District is a typical suburban school district of about 5,500 students located just south of Pittsburgh. In 1998, a discussion began related to the use of herbicides and pesticides in buildings and on fields. A vociferous debate commenced which called into question long accepted practices of pest management and the potential threat to human health related to the use of certain chemicals. The result of the discussion was the adoption of an Integrated Pest Management Policy by the district which provides the necessary pest control while limiting the use of toxic pesticides to approved and emergency situations only. The district IPM procedures incorporate safe, low risk methods of controlling pest problems while protecting people, the environment and property.

Friday, April 8, 1:45 p.m.--3:30 p.m., Main Conference Room
"Endocrine Disruptors"

Dr. Tom Zoeller
"Thyroid Hormone in Brain Development"
Thyroid hormone is essential for normal brain development both before and after birth. Yet important aspects of thyroid function and of thyroid hormone action remains unclear. At the same time, it is becoming clear that environmental chemicals can interfere with both thyroid function and thyroid hormone action. This presentation will discuss basic information about the role of thyroid hormone in brain development and the mechanisms by which environmental chemicals can interfere with thyroid hormone signaling during brain development.

Drs. Pete Myers and Adolfo Correa, who speak on earlier plenaries, will also present in this workshop.

Friday, April 8, 1:45 p.m.--3:30 p.m, West Wing Auditorium
"Methods of Community Engagement"

Amy Stiffey
"Family-based Community Service for Indoor Environmental Health Hazards"
Healthy Home Resources is a non-profit environmental health organization that uses a proactive, family-centered approach to addressing the rise in illnesses caused or complicated by the presence of indoor environmental hazards. From its origins as a lead poisoning prevention organization, Healthy Home Resources has expanded its mission to address other critical in-home threats to human health including asthma triggers, indoor air quality, household chemicals, radon, asbestos, and take home from work hazards. Utilizing Americorps volunteers, families are offered education and abatement services to reduce the lead hazards that children are exposed to from lead based paint. HHR also offers group education to interested parties and is a leader in the Lead Safe Pittsburgh Coalition.

Fred Brown
"Working with At-risk Populations Using the Environmental Justice Institute Triangulation Model"
The Environmental Justice Institute (EJI) is a nonprofit organization dedicated to educating, organizing informing low-income and minority persons in Pittsburgh and Southwestern Pennsylvania regarding environmental issues that impact health, mobility and quality of life. EJI assists in the development of projects, research, studies and advocacy in cooperation with local government, education, charitable and civic bodies and provides supportive services to low income and minority persons. This presentation will focus on the EJI Triangulation Model that has helped the organization to have success in motivating at-risk populations to become involved in the struggles to save public transportation and to work for a more just and clean community environment.

Myron Arnowitt
"Organizing at the Fenceline: Empowering Community Residents through Environmental Monitoring"
Clean Water Action and Clean Water Fund have been working with residents in the Pittsburgh area who live in "fenceline" communities, i.e. those neighborhoods immediately adjacent to major sources of hazardous pollution. CWA and CWF work to empower residents most affected by environmental problems, as a part of ensuring environmental justice, and to draw on community based knowledge. A number of different methods are employed to engage these communities in solving environmental problems, including community education, community organization, and community based monitoring programs. CWF established the first community based air pollution monitoring program in Pennsylvania in 2001, known as "bucket brigades" for their use of simple low-tech sampling equipment built in 5 gallon buckets. CWF currently operates three "bucket brigades" in industrial communities in Pennsylvania, two outside of Pittsburgh in the Neville Island area and in the Mon Valley, and one in south Philadelphia. Sampling by residents of local air pollution problems has lead to increased monitoring and research of problem areas by government agencies and universities, and has improved environmental compliance.

Jan Jarrett
"Building Citizen Networks and Participation"
Citizen support for environmental protection is central to PennFuture's mission. Jan Jarrett heads up programs that engage PennFuture members, the larger environmental/ conservation community, and interested Pennsylvania citizens in environmental health protection and restoration activities. These programs provide organizing and media assistance to local environmental organizations, networking and coordination services for statewide environmental groups, and information about current environmental issues to PennFuture members and the general public.

Friday, April 8, 3:45 p.m.--5:30 p.m., Main Conference Room 
"Building New Partnerships for Environmental Health Advocacy"

Dr. Richard Wiles
"Engaging the Public"
Engaging the public through the media is essential to achieving policy changes that protect children from environmental contaminants. To make news, advocates, policy experts, scientists, and public health professionals need to collaborate more closely and support each other's work more effectively.

Diane Heminway
"Re-engaging Workers: Beyond Occupational Health"
What is the cost of a job? Too often, it is compromised health, unsafe work conditions, depleted resources, fouled air and tainted water. Rather than remaining sad, silent and defeated, many in the labor movement are joining forces with allies in the environmental health community to build strong blue-green coalitions. Collectively, we are a potent force that understands that economic sustainability and human rights go hand in hand with environmental protection. This talk will discuss how such alliances have repeatedly shown powerful corporations that workplace health and safety concerns do not punch a clock, nor do they stop at the company's gate.

Jane Browning
"The Learning Disabilities Association of America Model for Environmental Health Advocacy"
The Learning Disabilities Association of America built upon a long-standing interest in research into the nature and causes of learning and other developmental disabilities by partnering in key collaborations to reduce human exposure to environmental neurotoxicants. Merging advocacy for people with neurological disorders with environmental advocates and scientists, a powerful new collective policy voice is emerging on a national scale and at the grassroots. The LDA Healthy Children Project promotes and coordinates grassroots prevention activities in 14 states, while LDA works with national partners to move the policy agenda and within the Collaborative on Health and the Environment to promote public education.

Dr. Ellen Dorsey
"Calling for Prevention & Precaution"
Public opinion sways policy-makers and any call for prevention and precaution must take into account what environmental health means to the public and why bringing health to the center of the environmental movement resonates. This presentation will present what it means to build a movement. It will look at what the strategies are for bringing in key constituencies, and will describe what the environmental health movement looks like, from the local picture to the national. We are witnessing a nascent movement and it started in California, in Seattle, in Portland, in Boston, and it's starting here. The precautionary principle, and how it is being operationalized is a point of convergence in this movement.