[CPEO-BIF] TCE Testimony

[Lenny Siegel <lsiegel@cpeo.org>]

[This is the third and final scientific written testimony submitted for
the New York hearings on vapor intrusion last November. - LS]

TESTIMONY BEFORE
New York State Environmental Conservation Committee

BY LEONARDO TRASANDE, MD, MPP
and PHILIP J. LANDRIGAN, MD, MSc

ON TRICHLOROETHYLENE AND OTHER ENVIRONMENTAL FACTORS IN CHILDREN'S HEALTH

NOVEMBER 17th, 2004


Thank you, Assemblyman DiNapoli, for the opportunity to speak at this
important forum.  My name is Dr. Leo Trasande.  I am a pediatrician and
environmental health specialist in the Pediatric Environmental Health
Specialty Unit at the Mount Sinai School of Medicine, one of ten centers
nationwide supported by the Centers for Disease Control and Prevention
that provide consultations for children with toxic environmental
exposures and diseases of suspected environmental origin.  I am also the
Assistant Director for the Center for Children's Health and the
Environment at Mount Sinai, a policy research center that works to
protect children against environmental threats to health.

I am joined today with is Philip J. Landrigan, MD, a professor of
pediatrics at the Mount Sinai School of Medicine in New York City,
chairman of the Department of Community and Preventive Medicine, and
Director of the Center for Children's Health and the Environment.

In submitting testimony here today, we hope to provide information about
the health effects of trichloroethylene in humans, and the need to study
and prevent the health effects that can result from the chemical
exposures that have occurred in Endicott.

Trichloroethylene, or TCE, is an organic chemical that has been used for
dry cleaning, metal degreasing and as a solvent for oils and resins.  It
evaporates easily in the open air but can stay in the soil and in
groundwater for years afterwards.  It is one of the most commonly found
chemicals at Superfund sites.  In the body, trichloroethylene may break
down into multiple other chemicals such as dichloroacetic acid,
trichloroacetic acid, chloral hydrate, and 2-chloroacetaldehyde.  These
products have been shown to be toxic to animals and are probably toxic
to humans, especially young children with developing bodies.

The most well-studied and significant health effect of TCE is its link
to cancer.  While studies of workers exposed to TCE are sometimes
complicated to interpret because many of these workers are exposed to
other solvents that also can cause health effects, TCE has been found to
cause cancer in both mice and rats, which suggests that it also causes
cancer in humans.

In 2000, researchers at the Robert Wood Johnson Medical School reviewed
eighty studies that looked for a link between workplace exposure to TCE
and cancer.  They found evidence for an increased risk of kidney cancer,
liver cancer and non-Hodgkin's lymphoma.  They also found possible
associations between TCE exposure and multiple myeloma and prostate,
laryngeal, and colon cancers.

Based on this data, the World Health Organization has classified TCE as
a Class IIA carcinogen, meaning that TCE is probably carcinogenic to
humans.  The Environmental Protection Agency has also stated that TCE
may have the potential to cause cancer in humans, and has set a maximum
contaminant level for TCE of five parts per million in drinking water.

Other effects that can result from heavy TCE exposure include damage to
the liver, kidneys, gastrointestinal system, and skin.  TCE has been
linked to birth defects.  Chronic exposure to TCE can also affect the
human central nervous system.  Case reports of intermediate and chronic
occupational exposures included effects such as dizziness, headache,
sleepiness, nausea, confusion, blurred vision, facial numbness, and weakness.

For all of these reasons, all occupational exposures to TCE should be
thoroughly investigated.  Not only do the workers who have been exposed
to TCE deserve to know the potential health effects they have suffered,
but further research into the health effects of TCE will help clarify
important questions that remain about its health effects.  Dr. Richard
Clapp, a researcher at Boston University's School of Medicine has
studied the health effects of TCE using IBM's Corporate Mortality Files
from workers in other areas of the United States such as San Jose, California.

In addition, we also need to consider the effects of TCE contamination
on people in the broader community.  For example, children are
especially vulnerable to the health effects of TCE, just as they are to
many other chemicals.  Children are more susceptible because pound for
pound, they ingest more chemicals in the food they eat, the water they
drink and the air they breathe.  Their organ systems are just
developing, and injury to these developing organs can cause lifelong
disability.  The health and economic consequences of children's
present-day exposures to environmental toxicants will be experienced by
our society throughout much of the length of the twenty-first century.

Unfortunately, we have learned this lesson the hard way, in part because
of exposures to chemicals such as TCE.  A very high rate of childhood
cancers in Toms River, New Jersey was found to be linked to the amount
of drinking water that women ingested during their pregnancies.  Even
though the water was never found to have levels higher than EPA's
contamination standard for TCE, the researchers' analysis demonstrated
that exposure to TCE in the fetus was associated with cancer, especially
leukemia, in these children.  The epidemiologists who studied this
cluster of cancer suggested that the developing fetus might be
especially vulnerable to TCE and other chemicals that were found in the
drinking water in Toms River.  As the exposure to TCE was removed,
researchers found that the cancer rates in Toms River decreased significantly.

We tell you this story not to scare you, or to distract the needed
attention to your concerns about TCE here in Endicott, but I do mean to
focus your attention on the fact that there are other environmental
health concerns, here in Endicott, in Binghamton, and throughout New
York State.  

Children today face environmental hazards that were neither known nor
imagined a few decades ago.  Children are especially at risk of exposure
to nearly 15,000 synthetic chemicals produced in quantities greater than
10,000 pounds per year and to the 2,800 produced in quantities greater
than one million pounds per year, which are so-called
high-production-volume, or HPV, chemicals.  Many of these materials are
contained in household products and are dispersed widely in the
environment.  Many hundreds of these HPV chemicals have not been tested
for their potential human toxicity, and only 7% have been studied for
their possible effects on development or on the health of children.  

Today, the predominant diseases confronting children in New York and
across the United States are a series of chronic illnesses that have
been termed the "new pediatric morbidity."  Many are increasing in
incidence.  Evidence is growing that environmental factors contribute to
the etiology of these conditions.  Examples include ADHD, autism, and
childhood cancer. 

Health care providers such as pediatricians can help limit children's
exposures to environmental hazards by educating parents, identifying
hazardous exposures, diagnosing and treating children, and advocating
for prevention.  However, physicians have little training in
environmental health.  A study of Georgia pediatricians found that 54%
of pediatricians reported seeing patients seriously affected by
environmental exposures, but found that only one in five had received
specific training in environmental pediatrics.  Pediatricians who do ask
about environmental exposures usually limit their inquiry to lead and
environmental tobacco smoke.

We at Mount Sinai have a Pediatric Environmental Health Specialty Unit
that provides consultation and medical care for children with
environmental exposures and with diseases of suspected environmental
origin in New York, New Jersey, Puerto Rico and the Virgin Islands. 
However, we serve mostly as a telephone consultation resource and many
families find it difficult to come to New York City for a complete evaluation.

That is why we are interested in developing a statewide system of
Children's Environmental Health Centers of Excellence in New York State.
 This system would provide New York pediatricians with the training they
need to prevent and treat environmental exposures in children and serve
as a referral network for children with more serious or complex
exposures.  These six children's environmental health clinical centers
of excellence would increase the accuracy of diagnosis of children's
diseases caused by environmental toxins, improve the prevention and
treatment of children's diseases caused by environmental toxins, and
serve as regional resources for the surrounding area in New York State. 
This system can also track environmental exposures in children so that
we can really determine the number of children's diseases that are
caused by caused by environmental toxins and help public health
officials prevent children from being harmed by toxic environmental exposures.

In the past 25 years in the United States, we have made great strides
against toxic chemicals in the environment that cause disease in our
children.  Under the Clean Air Act, we have reduced levels of pollutants
in the air.  Under the Safe Drinking Water Act, we have improved the
quality of drinking water for millions of Americans.  Perhaps our most
noteworthy achievement has been the reduction of blood lead levels in
American children by more than 90% through our societal decision to
remove lead from gasoline.  This is an enormous triumph. 

But much remains to be done.  Disease of environmental origin in our
children is not yet vanquished.  We appreciate the leadership of
Assemblyman DiNapoli and Congressman Hinchey in placing needed attention
on the role of the environment in health.  We are sorry that we cannot
be in Endicott to present testimony orally, but are happy to work with
you to protect the children of Endicott and of the State from
environmental threats to health.

-- 


Lenny Siegel
Director, Center for Public Environmental Oversight
c/o PSC, 278-A Hope St., Mountain View, CA 94041
Voice: 650/961-8918 or 650/969-1545
Fax: 650/961-8918
<lsiegel@cpeo.org>
http://www.cpeo.org
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