Two Steps Forward, One Step Back

Congress Compromises On Children’s Health

Somewhere between court hearings and Congressional testimony, preserving the innocence of childhood became a priority of the Clinton Administration (which had previously shown a tolerance for toxins in toys, chemicals in baby food and arsenic in water). "Each federal agency shall identify environmental risks that may disproportionately affect children," proclaimed former President Bill Clinton in the 1997 Executive Order that first put the government on notice. Furthermore, he said, each agency "shall ensure that its policies, programs, activities and standards address [these] risks."

Until that time, a child’s unique biological sensitivities and continual exposure to toxins were not acknowledged; instead, standards were set using an adult body as a measuring stick. The few attempts at regulation were not based on health but were balanced against economic factors.

"In the past 50 years in this country, we have made great strides in making the environment safer for adults," testified Dr. Richard Jackson, director of the National Center for Environmental Health, before the House Appropriations Committee in May of 2000. "But unfortunately, we haven’t done nearly as good a job of making the world a safe place for children to live, learn and play."

The National Academy of Sciences (NAS) came to the same conclusion in 1993 when it released Pesticides in the Diets of Infants and Young Children. This scientific study motivated Clinton’s executive order as well as a Presidential task force to help implement it, ultimately resulting in a National Asthma Prevention and Control Plan, a federal strategy to eliminate lead poisoning, a national network to research and register childhood cancers, and a public database of research on children’s environmental health and safety.

The work of individual agencies also shifted to reflect the new focus. The Agency for Toxic Substances and Disease Registry puts special emphasis on impact to the health of children when addressing hazardous waste sites. The National Institute of Environmental Health Sciences developed a children’s health research agenda to explore the relationship between timing of exposure, stage of development and health outcome. It established, with the Centers for Disease Control and Prevention (CDC), an assessment project to define endocrine disrupting compounds in the U.S. population and a center to assess the potential of specific compounds to cause birth defects. The CDC’s Environmental Health Laboratory, able to measure specific chemicals in a child’s blood or urine, will be invaluable in guiding the direction of future public health efforts.

Agents of Change

Former Environmental Protection Agency (EPA) Administrator Carol Browner actually predated Clinton by two years with a seven-step national agenda announced in 1995. Browner called for considering the unique vulnerability of children and infants in all assessments of environmental risk. To formally implement this agenda and the President’s executive order, the Office of Children’s Health Protection (OCHP) was created to raise awareness and guide federal agencies in their decision-making process.

This, of course, is easier said than done. "The difficulty is that children’s health is a cross-cutting issue," says Dr. Michael Firestone, science policy director for the OCHP. "No one program has sole responsibility for it."

The Food Quality Protection Act (FQPA), unanimously passed by Congress in 1996, is a classic example of just how difficult adjusting regulation to account for children’s health has been. The FQPA calls for pesticide safety margins 10-fold stronger, a 10-year term for review of all registered pesticides and a re-review of the 9,721 pesticide tolerances already established. It also requires that the EPA consider all possible health risks, non-dietary sources of exposure and exposure to other chemicals with the same toxic mechanism.

The first chemicals sacrificed under this stringent new system were the pesticides methyl parathion (banned from use on all fruits and many vegetables) and azinphos methyl (reduced on peaches and pears) in 1999. These were followed by sharp restrictions on use of the organophosphate chlorpyrifos—the most commonly used pesticide in homes, buildings and schools—in June of 2000. The organophosphate diazinon—the most widely used pesticide on residential lawns—was banned for all indoor uses by 2001 and for all lawn, garden and turf uses by 2003; phase-out for 20 food crop uses has also begun.

Both child health and environmental advocacy groups have questioned the practice of selling off stocks of restricted toxic chemicals. Though home and school uses of Dursban were banned in 2000, existing inventories of the chemical can still be sold for years. The FQPA also permits "negligible" levels of carcinogenic pesticides, advocates complain. Residues of pesticides banned in foods years ago, such as dieldrin, continue to show up regularly, and potent toxins are still legally applied to food crops.

Although the agency did review the first third of pesticide tolerances by August 1999 as required by law, it did not live up to its full promise, says the NRDC. Included in that first group under the federal microscope should have been those chemicals that pose the greatest risk to children—namely all organophosphates, compounds derived from World War II nerve gases.

What’s more, federal agencies do not routinely require full-scale testing for neurotoxic effects, and most tests are performed only in adult animals, which previous studies have shown fail to predict toxic effects on the developing brain. They also do not follow animals exposed in infancy over their lifetime, and so they do not address degenerative diseases, like Alzheimer’s or Parkinson"s, which may manifest only after years of cumulative damage. The ability of a pesticide to disrupt the human immune and endocrine systems is also overlooked, and the EPA has yet to develop guidelines to assess the interaction of multiple pesticides.

"The agency continues to regulate chemicals one at a time, collect data one at a time, test toxic effects one at a time, when exposures come in mixtures," says Dr. John Wargo, director of the Center for Children’s Environmental Health at Yale University. "It is hamstrung by the approach that it has taken."

And the EPA has not yet reached its 1997 deadline for reregistering nearly 200 older pesticides. Reregistration has so far resulted in the elimination of home lawn use of chlorothalonil, which poses a cancer risk to toddlers who play on treated lawns, and the improved labeling of DEET, a pesticide in insect sprays that has been implicated in, but not proven to cause, seizures in young children.

The NRDC, joined by United Farm Workers, the Breast Cancer Fund and Physicians for Social Responsibility, among others, took their complaints to court in a lawsuit that lasted well over a year. In the last days of the Clinton Administration, the EPA settled out of court, setting new timetables to review all 39 organophosphate insecticides, and agreeing to decide how to restrict 11 particularly hazardous pesticides, determine the cumulative risk of four chemical families, protect farm workers from three of the most noxious insecticides used on crops and initiate a pro

gram to screen chemical effects on the endocrine system.

Less than a month later, the pesticide industry sent a letter demanding the EPA withdraw from the agreement. The new EPA administrator, Christine Todd Whitman, eventually signed an amended version with language ensuring additional public comment and external review. Environmental groups consider the EPA’s position to be a compromise at best and a foreshadowing of the administration’s lack of resolve.

Another fear is that "efforts gathering steam two years ago to completely wreak havoc with this law will resurface," says Andy Igrejas, children’s health campaign director for the National Environmental Trust, referring to the Regulatory Openness and Fairness Act of 1999, introduced by Richard Pombo (R-CA). "It basically undid the FQPA," says Igrejas. "It undid the additional safety factor, the calculation of cumulative exposure and common mechanisms of toxicity."

Environmentalists claim the bill is drafted nearly word-for-word by the pesticide and agribusiness industries. In the 2000 election cycle, Pombo received $36,709 in campaign contributions from the American Crop Protection Association, State and National Farm Bureaus and the Implementation Working Group. Though the bill ultimately stalled in committee last session, Pombo intends to reintroduce it with few changes.

For the Record

Even with such a precious commodity at stake, agency efforts for children’s health have met with ardent resistance. Five years after the EPA set a more restrictive guideline for mercury exposure, opposed by electric utilities and the fishing industry, the NAS finally announced it "scientifically justifiable." Congress had asked the academy to intervene, banning the EPA from imposing mercury-reducing regulations on power plants until the review was complete.

The EPA also finally received the go-ahead for new, more stringent air-quality standards for ground-level ozone and fine particulates first announced in 1997. The revisions will protect 125 million Americans, including 35 million children, estimates the EPA, and prevent 15,000 premature deaths, 350,000 cases of asthma and one million cases of decreased lung function in kids.

The EPA’s final push under Browner saw through standards for several contaminants posing pediatric hazards. In the case of lead, the agency defined a dangerous level for paint, dust and soil, offering a uniform benchmark for government action to protect the public from lead hazards, and for homeowners, schools and childcare providers to make decisions regarding remediation and safety.

This rule was one of the only measures to escape unscathed during the early days of the Bush Administration. Held up temporarily were new diesel rules cutting pollution from heavy-duty trucks and buses by 95 percent and sulfur content in highway diesel fuel by 97 percent. These regulations will annually prevent an estimated 8,300 premature deaths, 5,500 cases of chronic bronchitis and 17,600 cases of acute bronchitis in children, predicts the EPA, and they will help asthmatic children avoid more than 360,000 asthma attacks and 386,000 cases of respiratory symptoms. Held up indefinitely were steps to curb sources of haze in national parks, which create the same pollutants that concentrate more intensely in cities and become trapped in children’s smaller airways.

All 54,000 community water systems, serving 254 million people, would be subject to a new arsenic standard unveiled in January, as would, for the first time, 20,000 water systems that serve people only part of the year, such as those at schools, churches and factories. Arsenic, released into the environment through such unnatural means as mining, smelting, agriculture and pressure-treated wood, has been implicated in various cancers, and in cardiovascular, pulmonary, immunological, neurological and endocrine damage. The current national standard is based on one set in 1942, and it is five times the amount recommended by the World Health Organization.

The American Wood Preservers Institute filed a challenge in federal court to overturn the new standard, and Senator Pete Domenici (R-NM) filed a bill to do the same. On March 20, Whitman opted to defer the revision (prompted by a 1999 NAS study) nine months pending further scientific review. The NRDC announced in May it will sue to challenge the rule’s suspension, and the suspension of the right-to-know measures requiring water utilities to keep their customers informed.

Calling the Shots

Whitman has also stood by the President’s post-election decision not to pursue tightening power plant emissions of carbon dioxide, the largest contributing greenhouse gas, and to withdraw from the Kyoto Protocol, a treaty that would bind industrialized nations to cut emissions of six greenhouse gases. Children are more susceptible to increases in pollution-related respiratory illness and illness resulting from thermal extremes. Both phenomena are associated with global warming, concludes an April 2000 Redefining Progress report.

An even more disconcerting player in the new administration may be John Graham, appointed by Bush as an administrator in the Office of Management and Budget (OMB). Graham is founder and past director of the industry-funded Harvard Center for Risk Analysis, where he has long argued that the economic cost of many environmental rules far exceeds the benefit of life years saved. Every regulation drawn up by some 50 government agencies must first pass through the OMB for analysis. No matter who the President is, says Daniel Swartz, director of the Children’s Environmental Health Network, "the OMB tends to slow down and sometimes stop EPA regulation."

If regulation does get through, the EPA may no longer have the wherewithal to enforce it. Twenty-five million dollars—and the environmental enforcement buck—was redirected from the FY 2002 EPA budget to individual states. But it’s not in the bailiwick of states to resolve issues in which kids have different sensitivities than adults, says Swartz. A second fiscal insult would result from the consequent loss of fine money no longer flowing in from enforcement actions once taken by the agency itself. "Children’s health and the environment should not be controversial," says 20/20 Vision’s Jim Wyreman. "But so far, more conservative elements are calling the shots."

Most of the shots, perhaps, but not necessarily all of them. The Leave No Child Behind Act, poised for introduction as E goes to print, is a comprehensive bill addressing health- and child care access, gun safety, education and welfare. It also calls for applying child-sensitive safety provisions to all chemicals already tested for safe exposure levels, reducing the use of toxic chemicals in schools and daycare centers, and expanding parental right-to-know.

The bipartisan Clean Power Act of 2001 is worded to slash emissions of four major pollutants including carbon dioxide, to which President Bush recently turned a blind eye. Look to Congresswoman Nancy Pelosi (D-CA) for upcoming legislation that would provide funding for a nationwide health tracking system, linking current biomonitoring efforts to adverse health outcomes from environmental exposures. Senator Barbara Boxer (D-CA) reintroduced in May the Children’s Environmental Health Protection Act.

The introduction of legislation, t

hough, represents only half the battle. Acts that would have better prevented and managed asthma, identified and abated lead poisoning and forced disclosure of environmental risks to children’s health were all stalled in committees of the 106th Congress. The children of the men and women in the 107th Congress can already thank their parents for at least one victory: As a provision in the education bill, the Senate passed the School Environmental Protection Act of 2001, requiring implementation of safer pest management strategies in schools and advance notification of school pesticide use.

The challenge of the new administration, says pediatrician Dr. Philip Landrigan, will be to maintain the momentum. "The people working in this field," he says, "are really trying hard to make children’s environmental health a bipartisan issue. It’s an issue that ought not to be held hostage by either political party."

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