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Testimony on Healthy Kids, Healthy Maryland Act

By Jenny Levin
Public Health Advocate

Health and Government Operations Committee
HB 727 -- Healthy Kids, Healthy Maryland – Toxic Chemical Identification and Reduction
Position: Favorable

Position: Maryland PIRG supports HB 727, requiring the Department of the Environment, in consultation with the Department of Health and Mental Hygiene, to publish on its Web site lists of specified chemicals of concern and specified chemicals of high concern designated in accordance with specified criteria.

 Why list chemicals of concern?

Every year, lawmakers hear about new toxins that require action. HB 727 creates a streamlined process for the identification and evaluation of toxins in children’s products.

 It puts manufacturers on notice that these chemicals are of concern to state agencies and sets the stage for phase-out or other steps such as incentives for innovation.

  • It helps parents make safer consumer product decisions and raise general awareness.
  • It’s a great way to begin to educate parents, consumers, agencies and other’s that the current regulations are inadequate as evidenced by the fact that problem chemicals are allowed in children’s products.  It provides an important opportunity to educate on health effects of exposures to these chemicals.
  • It provides a framework to identify the worst chemicals for exposure reduction action whether through regulation, manufacturer action or consumer decision-making.
  • It can serve as a foundational tool critical to helping state agencies develop a system for replacing toxic chemicals with safer alternatives.
  • It can serve as a foundational tool for other statewide efforts to reduce exposure such as product labeling, or targeted intervention efforts to help those at risk reduce their exposure to chemicals Maryland has identified as of high concern.

Toxic exposures place a health and economic burden on Maryland families.

While industrial chemicals have had many undeniable benefits for society, from improved medical care to increases in economic productivity made possible by electronics, the benefits have come with unintended side effects – harming our health often without our knowledge or consent. Scientists studying the effects of toxic chemicals on living organisms have discovered hundreds of different substances that could be harming human health by interfering with the process of development. These chemicals are capable of interfering with the transmission of signals within and between cells, the building blocks of life; or damaging important parts of cells, from genetic material to key proteins.

Of those that have been studied, approximately 1,400 chemicals with known or probable links to cancer, birth defects, reproductive impacts and other health problems are still in use today.[i] The 2010 President’s Cancer Panel noted that the true burden of disease induced by chemicals to which people are regularly exposed in their daily lives has been “grossly underestimated.” Diseases linked to chemical exposures “needlessly increase health care costs, cripple our Nation’s productivity, and devastate American lives.”[ii]

While not every incidence of cancer, learning disability or reproductive problem is due to exposure to toxic chemicals, the rising trends in so many chronic illnesses, coupled with rising exposure and greater understanding of the potential for chemicals to cause harm, signals the importance and urgency of taking steps to reduce exposure to toxic chemicals.

 

  • The incidence of childhood cancer increased more than 20% between 1975 and 1990. Since 1990, the incidence has remained roughly at this elevated rate. Cancer is the second leading cause of death for all ages, including children. Although improved treatment options have led to a decline in the percentage of children who die from cancer, the percentage of children who are diagnosed with leukemia, brain, and other cancers has increased (see Figure 1). In 2008 the direct medical costs of cancer were $93.2 billion and the overall costs were $228.1 billion.[iii]

  • Intellectual disability impacts 2%, or approximately 1.4 million children. Attention deficit hyperactivity disorder (ADHD) is conservatively estimated to occur in 3–6%, or approximately 2 million, children. Almost 1% of 8-year-old children are diagnosed with autism spectrum disorder, a 10-fold increase over just a 15-year period.[iv] About 30% of this dramatic rise in autism cannot be explained by changes in the age of diagnosis and the inclusion of milder cases.[v] Experiments show that children exposed to high levels of lead, PCBs , DDT, certain pesticides or phthalates in the womb or early in life are more likely to display inattention and poor impulse control at school, show developmental delays on tests of coordination, learning and memory or develop with lower IQ scores. These conditions impose tremendous psychological and economic costs on the affected children, their families, and communities. Just the cost of providing special education services to students with disabilities amounted to $77.3 billion in 1999–2000, an average of $12,474 per student.[vi] In Maryland, 9.1% of children have been diagnosed with ADHD[vii]
  • Asthma has doubled in children since 1980.  The annual cost of asthma is estimated to be nearly $18 billion, with $10 billion of that total being direct medical costs and $8 billion in lost earnings due to illness or death.[viii] Asthma has been linked to a variety of chemical exposures in the everyday environment, from smog in city air to toxins released from cleaning products. In Maryland , 13.6% of children have a history of asthma.[ix] Among parents of school-aged children with asthma, 16.8% reported that their child missed 1-2 days of school because of asthma during the past 12 months, and 5.7% said their child missed 8-29 days due to asthma.[x]
  • Reproductive disorders that affect certain populations, such as low birth weight, infertility, low sperm count, early puberty, and uterine fibroids are on the rise. Cryptorchidism (undescended testicles) increased 200% between 1970 and 1993.[xi] On average, babies are now born one week earlier than they were 15 years ago.[xii] Low levels of prenatal exposure to perfluorinated chemicals, commonly used in stain-proof and stick-free products, were tied to low birth weight and body mass in newborns born at a city hospital in Baltimore. Babies with higher levels of these compounds tended to be slightly but significantly smaller than those with lower exposure.[xiii] There is evidence of a trend in the U.S. toward earlier breast development and onset of menstruation in girls. A weight-of-the-evidence evaluation of human and animal studies suggests that endocrine-disrupting chemicals, particularly estrogen mimics and antiandrogens, as well as increased body fat, are important factors associated with altered puberty timing.[xiv]

 

In 2002, U.S. patients and their insurers spent an estimated $2.9 billion on infertility treatments.[xv] Hysterectomies for uterine fibroids cost Americans $1.7 billion per year. In 2005, preterm birth cost the U.S. at least $26.2 billion, or $51,600 for every infant born prematurely. The costs broke down as follows:  $16.9 billion (65%) for medical care: $1.9 billion (7%) for maternal delivery, $611 million (2%) for early intervention services, $1.1. billion (4%) for special education services, $5.7 billion (22%) for lost household and labor market productivity.[xvi]

A lack of information on common chemicals puts Maryland families at risk.

 Most people do not think to consider that the products they buy contain harmful chemicals, but simply buy the cheapest or most convenient option. The public has a right to know about chemicals currently on the market, including their specific uses, potential hazards to health and the environment, and potential routes of exposure. Information should enable businesses and consumers to compare the safety of chemicals, identify missing data, and create demand for safer alternatives. HB 727 will require chemicals of concern be published online, so parents, caregivers, schools and daycares can be better informed about where common toxins can pose a risk.

What would a list of chemicals of concern look like?

Minnesota, Washington and Maine have lists, and California and Connecticut have policy that mandates lists but has yet to create them.

Identifying chemicals in table format makes it easier to understand what chemicals have been flagged by a government entity (such as EPA or NIH) as having the potential to harm human health.  HB 727 requires that the Department list chemicals which meet a very basic and universally recognized criteria, being:

 (1) A carcinogen, a reproductive or developmental toxicant, or an endocrine disruptor;

(2) Persistent, bioaccumulative, and toxic; or

(3) Very persistent and very bioaccumulative.

Next, HB 727 asks that the Department identify chemicals for which:

 (2) There is strong credible scientific evidence that the chemical of high concern has been:

(I) Found, through biomonitoring, to be present in:

1. Human blood;

2. Human breast milk;

3. Human urine; or

4. Other bodily fluids or tissues;

(II) Found, through sampling and analysis, to be present:

1. In household dust;

2. In indoor air;

3. In drinking water; or

4. Elsewhere in the home environment; or

(III) Added to or is present in a consumer product used or present in the home.

 

These criteria can be represented in quite simple formats or in more detailed formats. HB 727 does not mandate a particular format. Minnesota’s Department of Health created a simple table format that allows the necessary information for chemicals to be viewed on one page (see attached document).

Questions and Answers:

Is this information already available?

Government agencies including EPA, NTP, NIH, CDC, and OSHA have identified thousands of chemicals as being linked to one adverse effect or another, but this information is difficult to find and even harder to understand in the formats provided. Furthermore, this information is fragmented and incomprehensive.

Is there a fiscal impact?

The only resource necessary to implement HB 727 is staff time. There is absolutely no reason the Department would need to conduct additional laboratory research or product testing in order to implement HB 727.

Is this happening federally?

No. Efforts to reform our chemical safety laws and to create a list of chemicals of concern have been persistently squashed by fierce industry opposition for decades. Even though EPA has the authority to create a comprehensive list of chemicals of concern, they have not acted on that authority.

Conclusion

Maryland families deserve to be protected from toxins. Parents deserve the assurance that everyday consumer products are safe to bring home from the store and to use in feeding, clothing, and caring for their families.

Chemical exposure is a factor we can do something about. By enacting the Healthy Kid, Healthy Maryland Act, we can lessen the role of chemical exposures in causing disease, thereby reducing our state’s chronic disease burden and helping to control health care costs. Better protections for our most vulnerable will lead to more healthy babies, fewer women with breast cancer, and lower numbers of Marylanders struggling with permanent learning or developmental problems. For a healthier Maryland, Maryland PIRG and the following organizations request a favorable report on HB 727.

 

Organizations that support this bill:

Audubon Naturalist Society

Environment Maryland

Food and Water Watch

Maryland Developmental Disabilities Council

Maryland League of Conservation Voters

Maryland Nurses Association

Maryland Occupational Therapy Association

Maryland Pesticide Network

The Arc Maryland

[i] Commission of the European Communities, White Paper: Strategy for a Future Chemicals Policy, COM (2001) 88 final, 27 February 2001; Carcinogenic, mutagenic, and reprotoxic chemicals, plus chemicals defined as category 1 or 2 in EU Directive 67/548, plus persistent organic pollutants.

[ii] U.S. National Cancer Institute, President’s Cancer Panel, Reducing Environmental Cancer Risk: What We Can Do Now, April 2010.

[iii] American Cancer Society, “Costs of Cancer,” http://www.cancer.org/docroot/MIT/content/MIT_3_2X_Costs_of_cancer.asp.

[iv] 37 Steven G. Gilbert, “The Scientific Consensus Statement on Environmental Agents Affiliated with Deurodevelopmental Disorders,”(Bolinas, CA: Collaborative on Health and the Environment, 2008), abstracted in Neurotoxicology and Teratology, 31, no 4,(July–August 2009): 241–2; National Institute of Mental Health, NIMH’s Response to New Autism Prevalence Estimate,” http://www.nimh.nih.gov/about/director/updates/2009/nimhsresponse-to-new... (November 4, 2009).; Catherine Rice, “Prevalence of autism spectrum disorders — Autism and Developmental Disabilities Monitoring Network, United States, 2006, National Center on Birth Defects and Developmental Disabilities,” MMWR Surveillance Summaries, 58, no. SS10 (December 18, 2009): 1-20. http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5810a1.htm.

[v] Irva Hertz-Picciotto and Lora Delwiche, “The Rise in Autism and the Role of Age in Diagnosis,” Epidemiology, 20, no. 1 (2009): 84–90.

[vi] Steven G. Gilbert, “The Scientific Consensus Statement on Environmental Agents Affiliated with Neurodevelopmental Disorders,” (Bolinas, California: Collaborative on Health and the Environment, 2008), abstracted in Neurotoxicology and Teratology, 31, no 4 (July–August 2009): 241–2.

[vii]Facts and Statistics. Center for Disease Control and Prevention. Accessible at: http://www.cdc.gov/ncbddd/adhd/prevalence.html.

[viii] Asthma and Allergy Foundation of America, “Asthma Facts and Figures,” http://www.aafa.org/display cfm?id= 8&sub=42 (accessed August 12, 2009).

[ix] “Asthma in Maryland.” Maryland Department of Health and Mental Hygiene Family Health Administration. http://fha.maryland.gov/mch/asthma_surv.cfm

x GE Dinse et al, “Unexplained Increases in Cancer Incidence in the United States from 1975 to 1994,” Annual Review of Public Health 20: 173-209, 1999; Limin Clegg et al, “Impact of Reporting Delay and Reporting Error on Cancer Incidence Rates and Trends,” Journal of the National Cancer Institute 94: 1537-1545, 2002; Shanna H. Swan, EP Elkin, and L Fenster, “The Question of Declining Sperm Density Revisited: An Analysis of 101 Studies Published 1934-1996,” Environmental Health Perspectives 108: 961-966, 2000; Shanna H Swan et al, “Geographic Differences in Semen Quality of Fertile U.S. Males,” Environmental Health Perspectives 111: 414-420, April 2003; A-M Andersson et al, “Adverse trends in male reproductive health: we may have reached a crucial ‘tipping point’,” International Journal of Andrology 31: 74–80, April 2008.

[x] Cheryl De Pinto, MD, MPH; Yvette McEachern, MA; Rachel Hess-Mutinda, MSW; Linda Nwachukwu, MPH.

2008 MARYLAND ASTHMA SURVEILLANCE REPORT. Maryland Department of Health and Mental Hygiene

Family Health Administration Maryland Asthma Control Program

[xi] Leonard J. Paulozzi, J. David Erickson, and Richard J. Jackson, “Hypospadias Trends in Two US Surveillance Systems,” Pediatrics, 100, no. 5 (November 1997): 831–34.

[xii] M. Davidoff, et al., “Changes in the Gestational Age Distribution among U.S. Singleton Births: Impact on Rates of Late Preterm Birth, 1992 to 2002,” Seminars in Perina-tology, 30, no. 1 (2006): 8–15.

[xiii] Benjamin J. Apelberg, Frank R. Witter, Julie B. Herbstman, et al., “Cord Serum Concentrations of Perfluorooctane Sulfonate (PFOS) and Perfluorooctanoate (PFOA) in Relation to Weight and Size at birth,”Environmental Health Perspectives, 115,no. 11 (November 2007): 1670-6.

[xiv] Susan W. Euling, et al., ”Role of Environmental Factors in the Timing of Puberty.”Pediatrics, 121, S3 (February 2008): S167-71.

[xv] The Collaborative on Health and the Environment,Vallombrosa Consensus Statement on Environmental Contaminants and Human Fertility Compromise October 2005, http://www.healthandenvironment.org/infertility/

vallombrosa_documents (accessed September 28, 1009).

[xvi] Richard E. Behrman and Adrienne Stith Butler, ed, “Committee on Understanding Premature Birth and Assuring Healthy Outcomes,”Preterm Birth: Causes, Consequences and Prevention, (Washington, DC, Institute of Medicine of National Academies, 2006)

 

[1] Commission of the European Communities, White Paper: Strategy for a Future Chemicals Policy, COM (2001) 88 final, 27 February 2001; Carcinogenic, mutagenic, and reprotoxic chemicals, plus chemicals defined as category 1 or 2 in EU Directive 67/548, plus persistent organic pollutants.

[1] U.S. National Cancer Institute, President’s Cancer Panel, Reducing Environmental Cancer Risk: What We Can Do Now, April 2010.

[1] American Cancer Society, “Costs of Cancer,” http://www.cancer.org/docroot/MIT/content/MIT_3_2X_Costs_of_cancer.asp.

[1] 37 Steven G. Gilbert, “The Scientific Consensus Statement on Environmental Agents Affiliated with Deurodevelopmental Disorders,”(Bolinas, CA: Collaborative on Health and the Environment, 2008), abstracted in Neurotoxicology and Teratology, 31, no 4,(July–August 2009): 241–2; National Institute of Mental Health, NIMH’s Response to New Autism Prevalence Estimate,” http://www.nimh.nih.gov/about/director/updates/2009/nimhsresponse-to-new... (November 4, 2009).; Catherine Rice, “Prevalence of autism spectrum disorders — Autism and Developmental Disabilities Monitoring Network, United States, 2006, National Center on Birth Defects and Developmental Disabilities,” MMWR Surveillance Summaries, 58, no. SS10 (December 18, 2009): 1-20. http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5810a1.htm.

[1] Irva Hertz-Picciotto and Lora Delwiche, “The Rise in Autism and the Role of Age in Diagnosis,” Epidemiology, 20, no. 1 (2009): 84–90.

[1] Steven G. Gilbert, “The Scientific Consensus Statement on Environmental Agents Affiliated with Neurodevelopmental Disorders,” (Bolinas, California: Collaborative on Health and the Environment, 2008), abstracted in Neurotoxicology and Teratology, 31, no 4 (July–August 2009): 241–2.

[1]Facts and Statistics. Center for Disease Control and Prevention. Accessible at: http://www.cdc.gov/ncbddd/adhd/prevalence.html.

[1] Asthma and Allergy Foundation of America, “Asthma Facts and Figures,” http://www.aafa.org/display cfm?id= 8&sub=42 (accessed August 12, 2009).

[1] “Asthma in Maryland.” Maryland Department of Health and Mental Hygiene Family Health Administration. http://fha.maryland.gov/mch/asthma_surv.cfm

x GE Dinse et al, “Unexplained Increases in Cancer Incidence in the United States from 1975 to 1994,” Annual Review of Public Health 20: 173-209, 1999; Limin Clegg et al, “Impact of Reporting Delay and Reporting Error on Cancer Incidence Rates and Trends,” Journal of the National Cancer Institute 94: 1537-1545, 2002; Shanna H. Swan, EP Elkin, and L Fenster, “The Question of Declining Sperm Density Revisited: An Analysis of 101 Studies Published 1934-1996,” Environmental Health Perspectives 108: 961-966, 2000; Shanna H Swan et al, “Geographic Differences in Semen Quality of Fertile U.S. Males,” Environmental Health Perspectives 111: 414-420, April 2003; A-M Andersson et al, “Adverse trends in male reproductive health: we may have reached a crucial ‘tipping point’,” International Journal of Andrology 31: 74–80, April 2008.

[1] Cheryl De Pinto, MD, MPH; Yvette McEachern, MA; Rachel Hess-Mutinda, MSW; Linda Nwachukwu, MPH.

2008 MARYLAND ASTHMA SURVEILLANCE REPORT. Maryland Department of Health and Mental Hygiene

Family Health Administration Maryland Asthma Control Program

[1] Leonard J. Paulozzi, J. David Erickson, and Richard J. Jackson, “Hypospadias Trends in Two US Surveillance Systems,” Pediatrics, 100, no. 5 (November 1997): 831–34.

[1] M. Davidoff, et al., “Changes in the Gestational Age Distribution among U.S. Singleton Births: Impact on Rates of Late Preterm Birth, 1992 to 2002,” Seminars in Perina-tology, 30, no. 1 (2006): 8–15.

[1] Benjamin J. Apelberg, Frank R. Witter, Julie B. Herbstman, et al., “Cord Serum Concentrations of Perfluorooctane Sulfonate (PFOS) and Perfluorooctanoate (PFOA) in Relation to Weight and Size at birth,”Environmental Health Perspectives, 115,no. 11 (November 2007): 1670-6.

[1] Susan W. Euling, et al., ”Role of Environmental Factors in the Timing of Puberty.”Pediatrics, 121, S3 (February 2008): S167-71.

[1] The Collaborative on Health and the Environment,Vallombrosa Consensus Statement on Environmental Contaminants and Human Fertility Compromise October 2005, http://www.healthandenvironment.org/infertility/

vallombrosa_documents (accessed September 28, 1009).

[1] Richard E. Behrman and Adrienne Stith Butler, ed, “Committee on Understanding Premature Birth and Assuring Healthy Outcomes,”Preterm Birth: Causes, Consequences and Prevention, (Washington, DC, Institute of Medicine of National Academies, 2006)

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