The Importance of Place in the Experience of Environmental Contamination Phil Brown, Ph.D Director of Research Translation Core and Co-Director of Community Engagement Core Northeastern Superfund Research Program This project is supported by Grant Award Number P42ES017198 from the National Institute of Environmental Health Sciences. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Environmental Health Sciences or the National Institutes of Health. www.neu.edu/protect 1
Environmental epidemiology begins with historical work on “place”: Snow’s research on cholera www.neu.edu/protect 2
Woburn, Massachusetts - Childhood leukemia cluster from well water contaminated by TCE from W.R. Grace and Beatrice Foods factories - “Popular epidemiology” – major effort on citizen-science alliance -Partial settlement -One of the major post-Love Canal examples of community response to contamination My entry into environmental health, 1984 www.neu.edu/protect 3
Tallevast, Florida 95% African-American historical community of long-time landowners Berrylium plant located in middle of residential neighborhood 1946 Massive TCE contamination Residents’ primary desire – resettle together www.neu.edu/protect 4
Fenceline Communities: Richmond, California -Major oil refinery with hazardous activity -Low income,largely African- American and Latino -Multiple exposures -High asthma rate -Our Household Exposure Study helped residents prevent refinery expansion NIEHS EJ grant www.neu.edu/protect 5
St. Lawrence Island, Alaska Multiple effects of place Military dumping Biomagnification Atmospheric deposition www.neu.edu/protect 6
Dealing with school siting on contaminated land Brown University Superfund Research Program Assist in legal case Work with DEM to push city government on monitoring Get first law in US to prohibit school siting on contaminated land www.neu.edu/protect
Brown University ENACT (Tiverton, RI) Superfund Research Program • Work with Environmental Neighborhood Action Group (ENACT) to obtain adequate clean up of the soil contamination that has been discovered in Tiverton from manufactured gas plant waste • Home values disappear – people can’t sell or move • Work with legislature to get nation’s first program to provide home loans to people in contaminated areas • Work with legislature to get polluter fines bill Local demonstration Gas plant waste found in soil Disrupted lives www.neu.edu/protect
Place may be the fire and the fire house afterward “Give Toxics the Boot” Safer Chemicals/Health Families and IAFF 3/26/14 Large focus on flame retardants, but also more generally on chemical Seattle hazards Burlington VT San Francisco www.neu.edu/protect
“Environmental Amnesia” • Sandra Steingraber’s wonderful article in Orion on how people live in the midst of historical contamination and have no idea • Industry doesn’t have to disclose • State agencies rarely have records • People may want to forget due to property values, jobs, other aspects of local economy, and tax base, commitment to the place www.neu.edu/protect 10
ENVIRONMENTAL BREAST CANCER MOVEMENT – RESPONSE TO HIGH PREVALENCE IN A LOCATION • Since early 1990s, a new subset of the breast cancer movement • Motivated by rising incidence, weak knowledge of breast cancer etiology, and by potential link to environment • Women noticed excess cancer rates in Long Island (NY), San Francisco Bay Area, and Cape Cod, Massachusetts • Goals: – broaden public awareness of potential environmental causes – increase research into environmental causes – increase activist participation in research – create policy to prevent environmental causes Long Island Bay Area Mass. www.neu.edu/protect
Symbolic Persuasion: Barrels to Blood 55-gallon drums icon of environmental advocacy from 1970s- 1990s… Bodies as the place of contamination Bodies as new symbol used for environmental advocacy Embodied experience in a political context www.neu.edu/protect
Transdisciplinary Approach www.neu.edu/protect 13
Preterm Births, United States and Puerto Rico March of Dimes 2013 Premature Birth Report Card Babies born before 37 completed weeks of gestation are considered preterm. Puerto Rico has the highest rate (17.7%) of any U.S. jurisdiction Below only Malawi (18.1%) globally. www.neu.edu/protect
Changes in Risk Factors for Preterm Birth: Puerto Rico and US, 1990 and 2010 Risk Factor Puerto Rico United States 1990 2010 2010 Early prenatal care 71.3% 75.8% 73.1% Maternal education 66.6% 80.9% 80.1% Multiple gestations 1.7% 1.9% 3.5% Trends in factors do not seem to explain the high preterm birth rate of Puerto Rico www.neu.edu/protect 15
Potential Contribution of Environmental Contamination Several studies 1 have related Contaminant Exposure to Adverse Reproductive Outcomes • • Phthalates Reproductive damage • • Chlorinated solvents (e.g. TCE) Preterm birth • • Pesticides Prenatal mortality • • Heavy Metals Spontaneous abortions All have been found in groundwater in Puerto Rico k j k j j k k j k j j k k j k j 1 ATSDR, 2007; CERHR, 2006; Latini et k j al., 2003; Ha and Cho 2002; Khattak, 1999; Lipscomb and Fenster, 19991 j k k j www.neu.edu/protect
Contamination in Puerto Rico Study Site Superfund Sites in Puerto Rico: 3 sites were listed on NPL early 1980’s (1983, 1984, 1984) and 3 sites listed recently (1999, 2003, 2006) Contaminants include VOC’s (Tetrachloride, Trichloroethylene), pesticides, heavy metals www.neu.edu/protect (lead, copper, chromium), phthalates.
Potential Exposure to Contaminants in the study area CVOCs PHTHALATES Potential Contamination Sources Superfunds (Active and inactive) Human Subject Study Area Groundwater Study Area www.neu.edu/protect 18
Data and Sample Collection Delivery & Third Visit First Visit Second Visit Postpartum Screening & (Clinic) (In-home) (Clinic) Recruitment (Clinic) 16-20 weeks 20-24 weeks 24-28 weeks V3 Interview & V1 Interview V2 Interview Interview Food Frequency Home Medical Record Medical Record Medical Record Geographical Abstraction Abstraction Abstraction Coordinates Study Subject Environmental Cord Blood Biological Biological and Biological Samples, Samples Samples Samples Placental tissue Product Use Product Use Product Use Screening and Recruitment Sample & Data Questionnaire & Collection Urine Collection Instructions www.neu.edu/protect
Community Engagement Core Leaders: Carmen Velez Vega, UPR Phil Brown, Northeastern Univ. Other members: Liza Anzalota del Toro, Colleen Murphy PROTECT Wins the 2015 People’s • Choice Award at the EPA Community Involvement Training Conference Major collaboration with March of • Dimes in San Juan The CEC has brought a number of • community partners together to form a Community Advisory Board that include Ciudadanos en Defensa del Ambiente (CEDDA; Citizens for Environmental Defense), Ciudadanos del Karso (Citizens of the Karst), and COTICAM (Steering Committee for Environmental Quality). www.neu.edu/protect 20
Community Engagement Core Report personal exposure data to • participants, collaborating with Silent Spring Institute Develop and distribute brochures to • participants and general public on avoiding exposures in household and personal care products, and food Develop and distribute education • material to health professionals on environmental factors in reproductive health Presentations at Health Fairs • Documentary “36 Semanas ” • ß (“36 Weeks”) • www.neu.edu/protect 21
Tap Water Brochure www.neu.edu/protect 22
Retention strategies • Project identity = “PROTECT” – Increases bond with participants, community and study site • Establishment of a Call Center – Continuous and updated contact with study participants Frequent meetings at the Prenatal Clinics – Engage personnel and community in the project www.neu.edu/protect 23
Acknowledgements Research Funding NIEHS – Superfund Research Program • 1P42ES017198-01A1 – Research Support G12RR03051 (RCMI Program, UPR Medical Sciences) – RedCap • U54 RR 026139-01A1 NCRR, NIH • 8U54 MD 007587-03 NIMHHD, NIH- Laboratory Backup & • Transportation Logistics Community in Puerto Rico PROTECT participants • Federally Qualified Health Centers • Morovis, Camuy, Ciales, Quebradillas, Lares • Physicians • Dr. González Camacho • Dr. Rodríguez Cacho • Dr. Capre Febus • Dr. José Ortiz • www.neu.edu/protect 24
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