EDGE Center researchers awarded NIH grant to study environmental influences on child health and development

EDGE Center researchers Catherine Karr and Sheela Sathyanarayana are co-PIs for a $4.7 million award by the National Institutes of Health (NIH). The award to the University of Washington School of Public Health (SPH) is part of a seven-year initiative called Environmental influences on Child Health Outcomes (ECHO) that will investigate how the environment influences neurodevelopment and asthma risk in children.
Dr. Catherine Karr
The NIH ECHO program encompasses $157 million in funding for FY2016-17 for a multitude of projects that will investigate how exposure to a range of environmental factors from conception through early childhood influences the health of children and adolescents. The studies will target four key pediatric outcomes with a high public health impact: airway health, obesity, neuro-development and birth outcomes.
According to NIH Director Francis S. Collins, “These projects will expand the toolbox available to researchers to improve our ability to characterize environmental exposures, understand how environmental exposures affect in utero development and function, and bolster the infrastructure for exposure research.”
 “Our UW-based PATHWAYS study is a microcosm of the national ECHO program, which capitalizes on collaboration among top scientists and existing research populations,” said Dr. Karr, professor of pediatrics and environmental and occupational health at the UW who will co-lead the investigative team with Sathyanarayana and co-PIs Kaja LeWinn and Nicole Bush from the University of California San Francisco (UCSF) and Francis Tylavsky from the University of Tennessee Health Science Center, Memphis (UTHSC). 
Dr. Sheela Sathyanarayana
The UW grant money will allow the SPH’s Department of Environmental and Occupational Health Sciencesto oversee a combined study of more than 3,000 ethnically diverse pregnant mothers and their newborns. The cohorts are in communities across the United States, including Seattle, Yakima, San Francisco, Memphis, Minneapolis and Rochester. After this two-year study, grant recipients will have the opportunity to recompete for five more years of funding.
“We’ve assembled three successful cohorts of mothers and babies that have been collecting data since the pregnancy period,” Karr said. “Our study contributes specialty expertise characterizing air pollution and phthalate exposures as well as social factors such as stress, and examines their influence on child asthma, allergies and neurodevelopment.”
Karr and Sathyanarayana and their partners from UCSF and UTHSC will use maternal blood collected during pregnancy and placental tissues collected at birth, as well as air pollution modeling and surveys, to understand the impact of chemical and non-chemical stressors on the developing fetus. Other collaborating institutions include Meharry Medical College, Mount Sinai School of Medicine, New York University, University of Minnesota, University of Pittsburgh, University of Rochester and Vanderbilt University.
“The large and diverse study population and multidisciplinary expertise of UW PATHWAYS investigators enable us to better understand real-world, mixed-exposures scenarios,” said Karr. “We will examine how these may perturb important biological processes during pregnancy that may result in respiratory and neurodevelopmental problems in childhood.”
NIH Director Collins believes “Every baby should have the best opportunity to remain healthy and thrive throughout childhood. ECHO will help us better understand the factors that contribute to optimal health in children.”
Here’s the award announcement from the University of Washington School of Public Health.
— Marilyn Hair

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The PATHWAYS study is supported by the NIH under award number 1UG3OD023271-01.

10th Anniversary Duwamish River Festival

The UW EDGE Center and Superfund Research Program were among the sponsors of the 10thAnniversary Duwamish River Festival at Duwamish River Park on August 20, 2016. Outreach staff from both groups hosted an exhibit table.
Environmental Health wheel
EDGE Center Outreach Manager Marilyn Hair’s display was about ultraviolet (UV) light, sunburn, and skin cancer. Visitors spun the Environmental Health wheel to land on a question about UV, sunscreen, SPF, Vitamin D, cancer, or cloudy day. Participants received a prize of sunscreen or a UV-bead bracelet. Most people knew how to protect their skin but many don’t use enough sunscreen or apply it every two hours as recommended. Check out our factsheet about Protecting Your Skin from UV Exposure.

Superfund Research Project display
The Superfund Research Program Community Engagement Core’s display demonstrated river water turbidity and sedimentation rate variations that occur in the Lower Duwamish Waterway site. Program manager Katie Frevert asked children to invert test tubes filled with water samples and imagine the different environments experienced by fish. The samples ranged from cloudy, sediment-filled water to quick-clearing water from a rocky substrate. Participants then used an aquarium net to capture Swedish-fish gummy candies.  A plankton net and dose-response lab glassware caught additional inquiring eyes. 
The 10th festival included 44 tables hosted by a variety of government, non-profit, community, and commercial organizations. Festival-goers were entertained by 11 groups of performers, including the Duwamish Tribe, Ballet Folklorica Angeles de Mexico, Kapulli Tlaloktecuhtli Aztec Dancers, the Somali Youth Perforance Group, and a Zumba demonstration. 700 people attended the festival on a hot, sunny day, 97 ° to be exact, a perfect day to talk about sunscreen. We were grateful to be under a tent. 
— Marilyn Hair & Katie Frevert  
Kalpulli Tlaloktecuhtli Aztec Dancers

EDGE Center hosts ATHENA Teacher Workshop for Washington Health & CTE teachers

What is environmental health? That was the first question for 20 high school health and career and technical education (CTE) teachers from Washington State who attended the EDGE Center Academy for Teaching about Health and Environment Associations (ATHENA) Teacher Workshop on August 2-3, 2016. The teachers came from Selah, Sunnyside, Wenatchee, Moses Lake, Kenniwick, Blaine, Olympia, Puyallup, Gig Harbor, Mukilteo, Edmonds, Shoreline, Tukwila, Bellevue and Seattle

The teachers weren’t all clear in the beginning, but by the end of the workshop everyone knew that environmental health is the effect of anything from outside our bodies on human health – air, water, food, pesticides, UV light, drugs, chemicals, vitamins, stress, and on and on. They also learned that environment + genetics + choices interact to affect our health. 

Dr. Rose James talked to teachers about cancer.
Over two days, the teachers met six University of Washington Department of Environmental and Occupational Health Sciences (UW DEOHS) scientists who discussed environmental health topics ranging from nutrition, vitamins, cancer and lung health, to ethics. 
One topic of particular interest was electronic cigarettes, as students are using them but many teachers don’t know much about them. There were many questions about the health effects of using electronic cigarettes, or vaping, but we couldn’t answer them yet because the FDA has only begun to regulate and study Electronic Nicotine Delivery Systems (ENDS). One teacher wondered, “Which is better, smoking or vaping?” PhD candidate David Scoville hesitated to choose – the best choice, he said, is not to use at all.  

Electronic Cigarettes and E-Juices

The American Lung Association’s Beverly Stewart presented about kids and tobacco, describing various tobacco products such as e-cigarettes and hookah, and smokeless tobacco products that include strips, orbs, sticks and chewing tobacco. Beverly discussed tobacco marketing, showing teachers that tobacco products are packaged to look like candy and observing that tobacco products are displayed in convenience stores at a 10-year-old’s eye level. Kids don’t like to be fooled, she said. Talking with them about tobacco marketing is one strategy to discourage tobacco use: “Look how low that display for electronic cigarettes is. I can hardly read that. Whose attention do you think they’re trying to get when they put it down so low?”

Teachers visited the Xu lab
Young researchers explained their work
 The teachers also toured  Libin Xu’s research lab in the UW Department of Medicinal Chemistry and listened to PhD students and post-docs describe their projects studying lipids. 

Teachers worked in small groups

ATHENA-trained teachers Lindzee Alvarez and Tori Marcum from the Bellevue School District introduced ATHENA environmental health classroom lessons about Sugars and Artificial Sweeteners, GMO Salmon, UV Exposure and Sunscreen, Electronic Cigarettes, and Ethics. The teachers were given lesson plans and resources as well as classroom kits for two of the lessons. The ATHENA curriculum is posted on the website and can be downloaded for free.

The teachers appreciated being able to talk with the researchers and also trying out the environmental health lessons alongside practical suggestions for the classroom from experienced teachers Marcum and Alvarez. 

Here are a few comments from the teachers:

Teachers listen to a UW presenter

I feel so fortunate to have been able to attend the workshop. Looking forward to trying the lessons in class this year … I appreciate your enthusiasm for education. I can’t wait to incorporate the lessons that were taught … I have been telling everyone how much fun the workshop was. Thanks for a lovely, educational time … ATHENA is a wonderful program that changed the way I teach environmental education. It is now part of our daily class discussion instead of just a few lessons over the semester.                                                                                                                                                    –Marilyn Hair

Costa Lab finds toxic PBDE flame retardant BDE-47 increases glutamate in the brain

Flame retardant chemicals are all around us. They are found in computers, upholstered chairs, and mattresses. They were added with good intentions, for safety in case of fire. But many flame retardants are now thought to be toxic. One class of flame retardants, polybrominated diphenyl ethers (PBDEs), which is now banned, has been found to be toxic to the brain, liver, and other organs. 

Dr. Lucio Costa

A new finding from the lab of CEEH member Dr. Lucio Costa in the Department of Environmental and Occupational Health Sciences (DEOHS), University of Washington School of Public Health, has found how one of these PBDEs, tetrabrominated diphenyl ether (BDE-47), exerts its toxic effects. Researchers from UW and the Department of Neuroscience at the University of Parma, Italy, found that particular types of receptors in the brain are involved in toxicity from BDE-47. 

The results in mouse neurons suggest that BDE-47 increases the amount of the neurotransmitter glutamate. More glutamate in turn activates glutamate receptors and leads to increased calcium levels and oxidative stress. This causes brain cells to become over-activated, culminating in cell death. This sequence of events is especially harmful to the developing brains of infants and toddlers. It can lead to higher impulsivity and diminished attention and motor coordination.

The level of BDE-47 in people in the United States is about ten times higher than in Europe or Japan, because, in trying to prevent deaths from fires, the US required that flame retardants be used in furniture. After realizing their toxicity, manufacture of PBDEs in the US was banned and the levels in people are going down. However, the safety of substitute flame retardants remains an issue for further investigation.

Because of public concern about exposure to flame retardants, and a slow response from the federal government to regulate them, activist groups are focusing on state regulations. California passed a law that took effect January 1, 2016 that stopped the requirement that flame retardants be used in furniture. In April, Washington passed the Toxic-Free Kids and Families Act (ESHB 2545) that prohibits the manufacture, sale, or distribution of children’s products or residential upholstered furniture containing any of five flame retardants. The law also mandates the WA Department of Ecology to investigate whether six additional flame retardants meet the criteria of a chemical of high concern for children. Here is a one page summary of the new law.

For more information about flame retardants and regulation, see the presentation slides from The Alaska Community Action on Toxics (ACAT) webinar, Toxic Safety, presented by Dr. Alissa Cordner, Assistant Professor of Sociology at Whitman College in Walla Walla, Washington. Dr. Cordner discussed flame retardant chemicals, health effects, federal and state regulation, and current activism. She presented six conceptual risk formulas distilled from stakeholder interviews. 

Dr. Costa’s team’s paper can be found here. Other authors include Dr. Pamela Roqué from the University of Washington and Dr. Sara Tagliaferri and Dr. Claudia Pellacani from the University of Parma. Their research was supported by the National Institute of Environmental Health Sciences Grant #ES07033.

Another summary of this research is at AASPH, the Association of Schools and Programs of Public Health > Members Research & Reports.

– Marilyn Hair

The Green-Duwamish Watershed Symposium: Hope for a Healthier River

200 people attended the Inaugural 2016 Green-Duwamish Watershed Symposium on February 29, 2016. The event was sold out! Government agencies, non-profit organizations, industry, teachers and students were represented. Twenty speakers arranged in 5 panels spoke about their projects in the watershed. The Symposium was held at the Tukwila Community Center beside the Duwamish River on traditional Duwamish land. Symposium coordinators kept on schedule by blowing an elk bugle call when a speaker’s 10-minute presentation time ran out.
The panels covered these topic areas:

  • Sharing Knowledge
  • Building Partnerships
  • Fostering Collaboration
  • Innovating Solutions
  • Connecting for Success
Here’s the Symposium schedulePosters and exhibits offered more information.
King County Executive Dow Constantine welcomed the audience, encouraging efforts to come together, build alliances and collaborate to restore our environment. King County is promoting a broad understanding of restoration and preservation through the Green/Duwamish Watershed Strategy. The County Executive emphasized that the Green-Duwamish watershed is an integrated whole and the approach to restoration must be interconnected. One good thing is that all constituents have a shared desire to protect the environment and build a healthy watershed. 

Speaking of the watershed: The Green-Duwamish watershed is a 500 square mile corridor of water, industry, transportation structure, diverse communities and urban centers that stretches for 93 miles from the Cascades to Elliott Bay. Among the wide-ranging issues discussed at the Symposium were salmon, habitat restoration, planting trees, wetlands, water quality, stormwater, source control, remediation, farmland, parks, environmental justice, youth, careers, partnerships and funding.

Climate change was mentioned frequently and is a definite player in Puget Sound. But the Keynote Speaker, Guillaume Mauger, Research Science in the University of Washington Climate Impacts Group, said that climate change doesn’t trump the other stressors; it’s just a new issue that has to be integrated into all the other factors affecting Puget Sound.

The Duwamish River Cleanup Coalition’s (DRCC) Community Outreach Coordinator, Paulina Lopez, and Carmen Martinez, DRCC Youth Program Coordinator, presented about the Duwamish Valley Youth Corps (DVYC). This is a grant-funded program that engages youth from South Park in paid internships to address health disparities and respond to community priorities. There are now 100 DVYC alumni. Youth Corp members learn about and help restore the Duwamish River.

Linn Gould of Just Health Action introduced the social determinants of health and JHA’s eight Environmental Justice Lesson Plans which were piloted by the Teen Employment Project and Duwamish Valley Youth Corps.

University of Washington researchers Nancy Rottle and Mason Bowles from the UW Green Futures Lab offered their prototype floating wetlands and proposed trying them on the Duwamish River to improve habitat for juvenile salmon.

The presentations showed progress in restoring habitat for salmon, planting trees and native plants, filtering toxins through rain gardens and soil, improving parks, salmon recovery, and cleaning up legacy pollution. The tone of the day was hopeful and collaborative with lots of community involvement. It demonstrated the progress that’s happening and was a welcome contrast to the contentious meetings about contaminants and cleanup a few years ago when the EPA cleanup plan was being negotiated.

At the end of a fast-moving day, James Rasmussen offered “The Long View”. Rasmussen is Coordinator of the Duwamish River Cleanup Coalition and a member of the Duwamish Tribe. James reminded us that it’s spring, a time of renewal and change. He talked about changes on the Duwamish, from the ice age, to salmon runs that lasted year-round, to the opening of the Ballard Locks that dropped the water level in Lake Washington and dried up the Black River. Yet, amazingly, there is still a run of wild salmon on the Duwamish. Because of the cleanup, eagles, otters, heron, and egrets are returning to the watershed. Today there is more wildlife on the Duwamish than in any other part of Seattle.

Everybody wants the best, he said. We may sometimes find ourselves on different sides, but we must remember the goal and work together, staying open to new ideas. Do we still have time to save the salmon? Let’s hope so. From the Native perspective, the Duwamish watershed is a living, breathing thing. It’s important for us all that it survives.

More resources:

— Marilyn Hair

UW scientists find increased risk of breast cancer from exposure to a component of diesel exhaust

Center for Ecogenetics & Environmental Health (CEEH) researchers Joel Kaufman and Kerryn Reding are interested in understanding the effects of exposure to air pollution from diesel exhaust on human health. 

Dr. Kaufman, who is also Director of the UW DISCOVER Center: Cardiovascular Disease and Traffic-Related Air Pollution, researches the effects of exposure to fine particulate matter (PM2.5), a component of diesel exhaust, on the cardiovascular system. Recently, Joel discussed his team’s work in a podcast for the National Institute of Environmental Health Sciences Partnerships for Environmental Public Health (NIEHS PEPH).

Now, a study by Dr. Kerryn Reding from the UW School of Nursing and Fred Hutchinson Cancer Research Center shows that women exposed to nitrogen dioxide (NO2) have an increased risk of developing the most common form of breast cancer, hormone receptor-positive breast cancer. NO2 is another a component of diesel exhaust.

Some past studies looking for possible connections between breast cancer and air pollution have reported associations with both PM2.5 and NO2. To get a clearer picture, Dr. Reding and her group, who represent the UW Schools of Nursing and Public Health, the Fred Hutchinson Cancer Research Center, University of Bergen, Norway, and the National Institute of Environmental Health Sciences (NIEHS), undertook a large-scale study that spanned 4.5 years. They analyzed data from 47,591 women in the Sister Study, a National Institutes of Health Study of the Environmental and Genetic Risk Factors for Breast Cancer. The researchers adjusted for demographics (age, income, education) and health behaviors (body mass index, smoking) to estimate the risk of developing breast cancer after exposure to NO2, PM2.5 and PM10 from air pollution.

The study found no increased risk of breast cancer from PM2.5 or PM10. In the women who had higher than average exposures to NO2, it found a 10% increased risk of hormone receptor-positive (ER+/PR+) breast cancer. 

People who live or work near major roadways have a higher than average exposures to diesel exhaust and NO2. According to the US Environmental Protection Agency (EPA)48 million people in the United States live within 300 feet of a major highway, railroad or airport. Living near a major roadway confers a higher risk of asthma, cardiovascular disease, impaired lung development and childhood leukemia, low-birthweight babies, and premature death. 

Dr. Reding’s research was published in the December 2015 issue of Cancer Epidemiology, Biomarkers & Prevention. Another summary of Dr. Reding’s study was published in UW Health Sciences NewsBeat.

— Marilyn Hair

Cadmium exposure affects Coho salmon ability to smell … and why it matters

Chase Williams, PhD candidate in the UW School of Public Health Department of Environmental and Occupational Health Sciences (DEOHS) has defended his dissertation. The title is: Mechanisms and Biomarkers of Cadmium Induced Neurobehavioral Impairment in the Olfactory System of Coho Salmon (Oncorhynchus kisutch).  Dr. Evan Gallagher, Director of the University of Washington Superfund Research Program (UW-SRP) and a member of the Center for Ecogenetics and Environmental Health, was his Supervisory Committee Chair.

Chase Williams
Chase Williams

First, I can’t resist observing that the defense was held in Roosevelt 2228, a conference room with glass doors commonly called the Fishbowl.

Pacific salmon populations are threatened by many factors, and one contributing factor is thought to be disruption of the olfactory system, the sense of smell, by waterborne pollutants. The salmon olfactory system is in direct contact with the water column making it a sensitive target for chemical disruption by waterborne pollutants. This is important as salmon rely on their sense of smell for many critical functions, such as navigation, finding food and avoiding predators.

The metal cadmium (Cd) is a common pollutant in industrialized and agricultural waterways. Sources of Cd include discharge from industrial operations and fertilizers used in agricultural areas. Research has shown that Cd can impair the function of the olfactory system in zebrafish and trout. It is also known that wild juvenile salmon migrate through pollutant impacted waterways, many of which can contain Cd. 

Chase investigated three questions: (1) Do acute Cd exposures change salmon behaviors that depend on the sense of smell? (2) Does the olfactory system recover after being exposed to Cd? (3) Can we develop a set of molecular biomarkers that reflect Cd induced olfactory dysfunction and injury?

First, juvenile Coho were exposed to two concentrations of Cd for between 8 and 48 hours, followed by a 16-day recovery period. Chase observed the Cohos’ behavioral responses to an alarm odorant in a two-choice maze, after which he examined their olfactory rosettes for changes in histology (tissue anatomy) and gene expression. 
Here is what he found: Exposure to a low-level (3.7 parts per billion or ppb) and a high-level (347 ppb) of Cd disrupted the Cohos’ “olfactory driven alarm behavior”. In addition, the 347 ppb exposure level completely blocked their sense of smell within 48hrs. After the 16-day recovery, the fish exposed to both levels of Cd showed only partial recovery of olfactory function. Tissue analysis of the olfactory sensory epithelium (thin tissue lining of hollow structures) showed that the high-level Cd exposure killed many olfactory sensory and non-sensory epithelial cells, explaining the loss of smell. Gene expression of cellular stress/injury biomarkers that were measured in the olfactory rosettes (hmox1, mt1a, nrn1) hinted at the mechanisms.

Based on those findings, Chase then investigated how exposure to Cd impacted Coho salmon behavioral responses to multiple types of odorants, and the effect of Cd on different types of olfactory sensory neurons. Two experiments were done: (1) Juvenile Coho salmon were exposed to one of two concentrations of Cd (2 and 30 ppb) for 48hrs, followed by 16 days of recovery; (2) Another group of juvenile Coho salmon were exposed to lower-levels of Cd (0.3 and 2 ppb) for 16 days, followed by 16 days of recovery. Chase analyzed olfactory driven behaviors in a two-choice maze, using odorants that elicited 3 possible responses: an attraction, an avoidance, or an alarm response. Following the behavioral trials, he again analyzed changes in histology and gene expression within the olfactory rosettes.

What he found was that exposure to Cd altered the Cohos’ behavioral responses to the different scents, and in some cases completely reversed their responses, even at the very-low 0.3 ppb Cd exposure level. Surprisingly, these behavioral alterations persisted even after the 16-day recovery period. He found that the low-level Cd exposures did not induce observable injuries in the olfactory sensory epithelial tissue. He also found that Cd builds up quickly and persists in the olfactory sensory epithelium. The accumulation and persistence of Cd in the olfactory system closely mirrored the observed behavioral changes. Analyzing the expression levels of protein and gene markers of the two main types of olfactory sensory neurons, ciliated and microvillar, he found that exposure to the 30 ppb level of Cd predominantly impacted the ciliated olfactory sensory neurons compared to the microvillar olfactory sensory neurons.

A young Coho salmon (photo credit: kellymrk 


• Exposure to environmentally relevant concentrations of Cd can disrupt salmon olfactory function. There is a partial, but incomplete, recovery of the ability to smell when the exposure ends.

• When the Coho sense of smell is impaired, Coho response to typical odorants changes. Different olfactory neuronal cell types do not all respond the same way to Cd exposures. 

• This data suggest that the mechanisms underlying the behavioral alterations vary depending on the level of Cd exposure. The observed behavioral dysfunction following high-level Cd exposures are likely driven by significant injury to the olfactory epithelium. However, the lack of observable injury to the olfactory epithelium following the low-level Cd exposures suggests that the observed behavioral dysfunction following low-level Cd exposures are most likely driven by disruption of olfactory neuronal signaling.

• The results of this study indicate that juvenile salmon migrating through waterways that contain Cd (and potentially other metals) may have rapid and persistent loss of the ability to smell. An impaired ability for fish to smell has been linked to loss of fitness and increased mortality.
The Superfund Research Program helped to finance this research. Chase was a Student Poster Winner at the 2012 SRP Annual meeting. In 2013 he made a presentation to the SRP Trainee Webinar Series titled: Effects of Cadmium on Olfactory Mediated Behaviors and Molecular Biomarkers in Coho Salmon (Oncorhynchus kisutch). Chase also presented a poster at the 2015 Society of Environmental Toxicology and Chemistry (SETAC) 35th annual meetingDeveloping sensitive markets of cadmium-inhibition of odorant perception in Coho salmon

His work builds on Evan’s Gallagher’s research on Biochemical Mechanisms of Olfactory Injury in Salmon that can affect salmon survival behaviors such as homing, feeding, and predatory-prey avoidance.   

–Marilyn Hair and Chase Williams

NIEHS Hosts Tribal Ecological Knowledge Workshop

Northwest tribal member harvesting camas
Photo: Jolene Grover

Kelly Edwards and Rose James, co-directors of the Community Outreach and Ethics Core at the Center for Ecogenetics and Environmental Health (CEEH), attended the Tribal Ecological Knowledge Workshop held December 3-4, 2015 in Bethesda, MD. The workshop was hosted by the National Institute of Environmental Health Sciences (NIEHS).

What is Tribal Ecological Knowledge?

Tribal Ecological Knowledge (TEK) is a holistic understanding by indigenous people of their relationship to the earth and the universe. TEK encompasses the spiritual, physical, emotional and mental aspects of a person. It is a way of living in harmony with the land, water and environment as our Creator intended. TEK is a subset of Indigenous Knowledge.

At the workshop, Native presenters explained that Tribal Ecological Knowledge is how they understand the environment we live in. TEK is based on an accumulation of observations, and passed down by the elders. A member of the Yupik community on the coast of Alaska said, “We cannot separate ourselves from our environment. Our way of life is intertwined with our environment.”

The TEK workshop explored the contributions Indigenous communities bring to environmental health sciences and biomedical research. NIEHS hopes the workshop will raise awareness of TEK and that input from TEK experts will help identify the best ways to incorporate ancient knowledge and practices into Western research methods. NIEHS wants to increase trust and mutual respect in tribal-academic partnerships.

AI/AN community members and researchers shared spellbinding stories:

On St. Lawrence Island in Alaska, the levels of polychlorinated biphenyls (PCB)* in the marine mammals that are the traditional Yupik foods are hundreds of times higher than the limit recommended by the US Environmental Protection Agency (EPA). Persistent chemicals like PCBs don’t stay where they are manufactured or used, and concentrations have been found to increase from south to north, resulting in high concentrations in the Arctic. The Yupik speaker said, “We are being contaminated without our consent.” She listed her family members who have cancer or have died of the disease: “It isn’t a matter of if I’ll get cancer, it’s when.”

Annie Belcourt (Blackfeet and Hidatsa) from the University of Montana told the traditional story of how the Nez Perce got fire: A boy used his bow and arrow to capture fire from the black buckskin bag in the sky and gave up his life to bring fire to earth. Fire and smoke are sacred, yet too much smoke causes sickness. Ways to improve the use of wood stoves in homes are being explored that preserve the Nez Perce culture and also protect health.

Jose Barreiro (Taino), who works for the Smithsonian National Museum of the American Indian, said that academic papers in the l960s and ’70s that came out of research in Cuba propagated the myth that the Taino were going extinct. In the Soviet era, family farms and traditional foods were replaced by large collective farms that grew one crop – sugar – for export to the USSR. The fall of the Soviet Union in 1989-90 resulted in the collapse of the Cuban economy. The Taino remembered the traditional foods and were called upon to bring this knowledge back to help the people survive. Barreiro suggested Cuba as a harbinger for how TEK can help the world address damage to the environment. He admonished the audience to “take TEK seriously, someday you might need it.”

The Center for Ecogenetics and Environmental Health poster highlights our own Native TEACH ProjectAmerican Indian Environmental Health Stories.

 NIEHS Director Linda Birnbaum summarized the ideas that stood out for her at the TEK workshop:

We need to recognize what the elders are telling us.
We must bridge, not integrate, TEK and Western science.
The earth is our mother. Mother Earth is in trouble.

— Marilyn Hair, Rose James, Kelly Edwards

*PCBs are man-made organic chemicals that were used in industrial and commercial applications until they were banned in 1979. PCBs can cause cancer, as well as adverse health effects in the immune, reproductive, nervous, and endocrine systems. PCBs do not readily break down but remain for long periods of time cycling between air, water, and soil. They are taken up into small organisms and fish; people can be exposed by eating fish that contain PCBs. PCBs are found all over the world.  — EPA

Addressing Children’s Environmental Health Concerns in the Yakima Valley

Dr. Catherine Karr, a member of the Center for Ecogenetics and Environmental Health (CEEH) and Director of the Northwest Pediatric Environmental Health Specialty Unit (PEHSU) spoke November 10th at the Environmental Protection Agency’s Children’s Health Month brownbag webinar in Seattle. Her topic was Addressing Children’s Environmental Health Concerns in the Yakima Valley.

Dr. Karr and her team work with community groups to understand environmental exposures and health effects on children in the Yakima Valley. Their research studies, part of El Proyecto Bienestar (The Well-Being Project), include indoor and outdoor air pollution and childhood asthma, pesticide exposure, and nitrate-contaminated drinking water from wells. Their goal is to make conditions better for the community.

The Yakima Valley is an agricultural area. 50% of the population is Hispanic and an additional 6% belong to the Yakama Nation. Health disparities are widespread. Compared to all US children, children in the Yakima Valley experience higher than average rates of poverty, obesity, premature birth, asthma hospitalizations, and adverse childhood events. Children in the Yakima Valley are found to have organophosphate pesticide metabolites in their urine, substances that are associated with neurological issues such as Attention Deficit Hyperactivity Disorder (ADHD). The Yakima Valley is also home to a birth defect cluster of anencephaly and spina bifida that is 4-times the expected occurrence. The cause has not been determined.

Dr. Karr’s research begins with the community who, through El Proyecto Bienesta, identified their priorities for environmental health research. The first topic the community wanted to investigate was why so many kids have asthma. This is important new research as most air pollution studies have looked at pollution from city traffic. 
58 children with asthma enrolled in the Aggravating Factors of Asthma in a Rural Environment (AFARE)study. The kids were followed for 2 years. Their lung capacity (FEV1) was measured daily, the community health worker called each family every 2 weeks to assess control of asthma symptoms, and participants’ lung function was tested once a year by health providers. To assess air pollution, daily measures of small particulate matter (PM 2.5), fine dust that gets deep into the lungs, were taken in the community, and ammonia monitors were placed at some kids’ homes.

Haze from air pollution
The number of days with PM 2.5 levels above federal standards was found to be more days than in Seattle. In the winter, 5% of days had PM 2.5 above federal standards. High PM 2.5 is caused by winter inversions, woodsmoke, agricultural burning, and ammonia, from animal feeding operations (AFOS).
Karr reports that initial findings show evidence of more asthma symptoms and worse lung function the day after high air pollution days. Only 26% of the children had consistently “well-controlled” asthma, based on symptoms and medication use. But over the course of the study, all of the children improved. Karr attributes this to frequent monitoring and follow-up by the community health worker.

The study suggests that community air pollution contributes to asthma morbidity, and that efforts to reduce air pollution from AFOS and PM 2.5 may reduce asthma morbidity and benefit children. 

Even as Karr prepares to publish the AFARE study findings, she and her team are embarking on a follow-up study. Thanks to a new $2.5 million grant from the National Institute of Environmental Health Sciences, they will conduct an interventional study to evaluate the effectiveness of high-efficiency particulate air and ammonia (HEPA/NH3) purifiers in the homes of a new group of children with uncontrolled asthma. The 5-year study is called HAPI: Home Air in Agriculture Pediatric Intervention Study. Enrollment is now underway. 

Responding to a question from listeners, Dr. Karr said her personal recommendation for an air filter is a HEPA filter with a pre-filter for odor (ammonia). She suggested not using an ionizing filter as it would contribute to harmful ozone in the home.

CEEH provided pilot funding for a component of the AFARE study. Others involved in Dr. Karr’s research in the Yakima Valley include CEEH researchers Chris Simpson, Edmund Seto, and Mike Yost, researchers in the Pacific Northwest Agricultural Safety and Health Center (PNASH), Heritage University, Yakima Valley Farm Workers Clinic, and the Northwest Community Action Center, which includes Radio KDNA.

Read more about Dr. Karr’s research in this February 2015 article in HS Newbeat.

— Marilyn Hair

Joel Kaufman finds a connection between air pollution and heart disease

Joel Kaufman, Professor of Medicine, Environmental and Occupational Health Sciences, and Epidemiology and Deputy Director of the University of Washington Center for Ecogenetics and Environmental Health, was recently featured on a National Institutes of Enviromental Health Sciences (NIEHS) podcast, Air Pollution and Your Heart. NIEHS podcasts are part of the Partnerships in Public Health (PEPH) program of the NIEHS Division of Extramural Research and Training.

Most people think of air pollution as a cause of respiratory problems like coughing and asthma. It turns out that air pollution is also a significant risk factor for developing heart disease, the #1 cause of death in the United States (see statistics from CDC). It appears that high air pollution can trigger heart attacks and strokes in those who are at risk. As evidence, there is often a spike in the number of heart attacks on and after days with bad air pollution.

And now there is growing evidence that living in areas with higher air pollution puts people at risk for heart disease in the long term. Lab studies show that exposure to air pollution can lead to atherosclerosis (hardening of the arteries), high blood pressure, changes in the size and structure of the heart, and increased likelihood of the blood clots that trigger heart attacks and strokes.

There are ways to reduce your risk. One example is to avoid exercising near roads with heavy traffic or at high traffic times. The benefits of being outdoors, exercising and being active outweigh the risks from air pollution, so if you have to choose, choose to be outdoors and exercise. You can reduce inside air pollution by keeping windows closed or by installing a HEPA air filter. Those who have a heart condition can check daily air quality and stay indoors on bad air days.

Yet finally, air pollution is a societal issue which has to be addressed not by individuals but by society. Joel observes that over the past 40 years, the United States has been extremely successful at reducing air pollution. The story is a public health triumph. There is, however, research still to be done. We know that further reducing air pollution levels would reduce negative health effects. We don’t know if there a level where air pollution is no longer a health concern. Also, we measure air pollution by measuring fine particulate matter while traffic exhaust is a mix of pollutants. One or a few agents in the mix may cause the worst health effects; if these can be identified, we could target our public health dollars more specifically and perhaps more effectively.

For more on Joel Kaufman’s and NIEHS air pollution research, see this video of the Virtual Forum, Near Roadway Pollution and Health, with NIEHS Director Linda Birnbaum and other NIEHS researchers.

–Marilyn Hair