Advancing Environmental Public Health through Community Exposure Research and the New Science of Biomonitoring
Madame Marie Curie was the first woman to win a Nobel Prize in physics in 1903. In 1911 She became the first scientist to win the Nobel Prize twice with her discovery of the radioactive elements radium and polonium. Madame Curie championed the use of portable x-ray machines during World War I. She died on July 4, 1934 from aplastic anemia due to prolonged exposure to radiation.
85 years have passed since Madame Marie Curie died of a rare blood disorder linked to radiation exposure -in which her bone marrow stopped producing new blood cells. She was known to carry test tubes of radium- the radioactive element she discovered in 1898 -in the pocket of her lab coat. “My beautiful radium”, she wrote, enthralled by it “with ever new emotion and enchantment.”
The element Radium is a million times more radioactive than uranium. Madame Curie’s lab books are so highly contaminated they cannot be safely handled today. According to the Agency for Toxic Substances & Disease Registry, radium can be detected in the human body using a simple urine test.
Radium’s tissue destroying properties were enlisted in the battle against cancer and in 1902 American scientist William Hammer obtained samples of radium for medical experimentation.
Radium was used to make luminous paint for watches, aircraft instrumentation dials and deck markers for ships. According to Kate Moore, author of The Radium Girls, when the coffin of Amelia Maggia, an employee of the United States Radium Corporation was exhumed five years after her death at age 24, “Mollie’s corpse was seen to be aglow with a soft luminescence.”
“Biomonitoring is the next logical, critical step for us to take in addressing threats to public health.” Senator Deborah Ortiz, D-Sacramento.
Modern scientists can detect toxic chemicals in human tissue and body fluids using the new science of biomonitoring. In 2002, a study called “The Body Burden” found dangerously high levels of toxic chemicals in body of fluids of participants who volunteered to be tested. Biomonitoring is research that measures the levels of chemicals in our bodies by analyzing samples of blood, urine, breast milk, umbilical cord, hair samples and even baby teeth!
In 2003, a network of public health, faith, labor and environmental scientists - known as the California Body Burden campaign -championed legislation to make California establish a biomonitoring program. That year state Senator Deborah Ortiz introduced legislation to create The Healthy California Biomonitoring Program. In 2008 meetings were conducted in Oakland, California on the implementation of the California Biomonitoring program. That meeting was attended by scientists and activists of the Bayview Hunters Point Community First Coalition.
The Chicken…or the Egg?
A conundrum is a riddle, or a puzzle whose answer is often a pun. One of the most often quoted scientific conundrums is “which came first..the chicken or the egg?”
In environmental public health this conundrum is evident in epidemiological studies raising question as to whether an apparent increase in incidence of asthma, cancer, heart attacks or infant mortality is the result of it occurring more…or is it simply being detected more due to increased surveillance and documentation?
In the Bayview Hunters Point community epidemiological conundrums are evident in breast cancer clusters and increasing infant mortality rates along with diseases clearly linked to toxic exposures including cardiopulmonary, neurological and autoimmune disorders and cancers of radiosensitive organs.
The answer to this public health conundrum can be approached by longitudinal studies that follow the rates of occurrence of a disease over time. Community exposure research draws upon environmental monitoring of air, soil and water along with demographic mapping of toxic sources. All of these epidemiological research models are amplified by the science of biomonitoring in establishing direct cause and effect relationships between toxins in the environment and their disease expression among members of the exposed community.
In 2004, the Environmental Health Section of the San Francisco Department of Public Health documented an increase in hospitalization rates for adult and pediatric asthma, emphysema and congestive heart failure in Bayview Hunters Point ranging from 500 to 2317 cases per 100,000. Additionally, the California Office of Statewide Health Planning and Development analyzed hospital discharge rates in 2000 for adult and pediatric asthma finding an incidence of 851 per 100,000 — the highest rate in San Francisco.
According to the Bay Area Air Quality Management District air pollution in Bayview Hunters Point ranks in the 80th percentile for particulates, carbon monoxide, nitrogen oxides and volatile organic compounds and in the 90th percentile for sulfur dioxide.
The US EPA Office of Air and Radiation’s, “Particle Pollution and Your Health”, identifies particulate matter as a mixture of microscopic solids and liquid droplets suspended in air. Particulate matter is made of a variety of compounds including acids, organic chemicals, metals, soil, dust and allergens. The BAAQMD’s air quality report identifies particle pollution from grading and construction projects as a mix of very tiny solid and liquid particles called fine particulates.
Short term exposure to particle pollution can, within hours, aggravate lung disease, trigger asthma attacks and acute bronchitis and increase susceptibility to respiratory and ENT infections. In people with heart disease, short term exposure to particulates is linked to heart attacks and arrhythmias. Particulate exposure has been linked to pre-term labor and increased infant mortality rates. All of these conditions are evident as health disparities in Bayview Hunters Point.
The National Academy of Sciences Environmental Health Matters Initiative defines environmental health as the science and public health practice focused on the relationships between the environment and public health.
“Every day, in every endeavor, people interact with their environments. Healthy environments are crucial both to the quality of life and to the years of healthy life that people enjoy. Environmental factors that affect human health are many and diverse, including exposure to pollutants, climate change, occupational hazards and the built environment.” National Academy of Sciences Environmental Health Matters Initiative
In July of 2018 Biomonitoring California was asked to implement a state sponsored program in San Francisco to measure chemical exposures in residents living within a one mile radius of the Federal Superfund site at the Hunters Point Naval Shipyard. Biomonitoring California engaged with environmental health and justice representatives working with communities disproportionately impacted by environmental hazards at its November 2017 Scientific Guidance Panel Meeting.
Duyen Kauffman, Health Program Specialist with the Biomonitoring Section of the Office of Environmental Health Hazard Assessment responded in October of 2018: “Biomonitoring is a valuable tool that can directly measure exposures to metals and other chemicals, and biomonitoring results can be one part of evaluating potential health impacts of those chemical exposures. Unfortunately, the capacity of Biomonitoring California to respond to requests such as yours is extremely limited. Our major focus is on statewide surveillance, gathering a representative sample to measure chemical exposures in the California population…as a comparison to results from community based studies.”
Biomonitoring California sponsors a program in the San Francisco Bay Area called the East Bay Diesel Exposure Project that measures markers of diesel exhaust in 50 families. There are no programs, however, that measure human exposure to toxic chemicals among residents living adjacent to a federal Superfund site in the nation. Thus, the Hunters Point Community Biomonitoring Program was born to advance environmental public health research and access to care in one of the nation’s high risk communities.
Biomonitoring research, authored by UCSF researcher Tracey Woodruff, PhD, screened blood samples from pregnant women in San Francisco and found, on average, 56 suspect chemicals in the women’s blood. Most were environmental organic acids (EOA’s) found in pesticides and consumer products detected by high-resolution mass spectrometry which measures chemicals by their molecular weight. EOA’s have chemical structures that can resemble hormones causing endocrine disruption to pregnant women and the developing fetus.
In 1997, while serving as the attending physician for the Palo Alto Veterans Administration’s Environmental Health Registry I discovered it is the nation’s largest toxic registry. The free voluntary medical assessment is offered to veterans exposed to environmental hazards during military service including ionizing radiation and depleted uranium. Positive findings linked with a proven exposure and documented health effects can boister a disability or benefits claim.
That transformative experience, coupled with the premature death of my father from pulmonary asbestosis — a career longshore worker at the Hunters Point Shipyard- inspired my commitment to the advancement of environmental public health in the community where I grew up.
Public Health …By and For The People!
The Hunters Point Community Biomonitoring Program in partnership with Golden State MD Health & Wellness propose the implementation of a project drawing upon the science of biomonitoring to establish cause and effect relationships between environmental toxins and their detection and expressions of disease in members of a high risk community living within a one mile radius of the Federal Superfund site at the Hunters Point Shipyard.
A powerful tool in community exposure research capable of measuring chemicals in human body fluids, Genova Diagnostics offers a safe and simple Comprehensive Urine Element Profile that detects 35 chemicals of concern including the dominant toxins known to be present at the shipyard and neighboring industry.
The Hunters Point Community Biomonitoring Program is seeking crowdsource funding via a GoFundMe campaign and submitted proposals for start up and build out funds and fiscal sponsorship by the Rose Foundation for Communities and the Environment. Meetings are currently underway seeking academic and community non-profit sponsorship of the ambitious project.
Members of the steering committee for the program are participants in the Bayview Hunters Point Community Air Monitoring Project. Greenaction for Health and Environmental Justice, Bayview Hunters Point Community Advocates and Literacy for Environmental Justice have formed a Community Advisory Group to decide where to site 10 air monitors in the community to detect particulate matter pollution in conjunction with the California Air Resources Board.
The Hunters Point Community Biomonitoring Program is committed to the advancement of environmental public health and community exposure research through the detection of measurable chemicals in human body fluids. The permanent institution of a community biomonitoring program will guarantee improvements in the provision of medical standard of care to this high risk, marginally served, ethnically diverse, low income community.