Reply-To: [log in to unmask]
Subject: [spiritof1848] Poor Children Subject to "Environmental Injustice":
JAMA

JAMA
June 21, 2000
Vol 283, No. 23

Poor Children Subject to "Environmental Injustice"

M. J. Friedrich

Boston-A number of toxins, such as lead, polychlorinated biphenyls
(PCBs), and organophosphate pesticides are disproportionately
concentrated in environments where disadvantaged children live, said
Philip Landrigan, MD, chair of the Department of Community and
Preventive Medicine at Mount Sinai School of Medicine in New York
City, at the joint meeting of the Pediatric Academic Societies and
American Academy of Pediatrics. "As it turns out, many of the
children who are most heavily exposed in our society to environmental
toxins are the same children who are poor, the same children who
have either no access or inadequate access to medical care."

The notion that there exist disparities in the level of protection from
environmental health hazards among children and adults of different
races, ethnicities, and socioeconomic backgrounds is called
environmental injustice, said Landrigan.

LEAD STILL A PROBLEM

Lead exposure provides one example of this sort of inequity. A
neurotoxin that causes a spectrum of symptoms depending on the
blood lead level concentration, lead has been reduced in the
environment in the last 25 years in large part because of its removal
from gasoline in the 1970s and 1980s. Great declines in blood lead
levels in children have been observed, with mean blood lead levels
falling from 0.77 µmol/L (16 µg/dL) in 1976 to less than 0.14 µmol/L (3
µg/dL) today. Despite this achievement, there are still areas in the
United States where blood lead levels are too high, said Landrigan.

"Lead is a problem that has been ghettoized," he said. Deteriorating
housing units in which lead paint still remains are the culprits, and
these environments disproportionately affect African American
children in the inner city. He pointed out that in 1991, 35% of African
American children in New York's inner city areas had elevated blood
lead levels, compared with 4% to 5% of white children in the suburbs.
While numbers have dropped in the intervening years-to about 27%
for inner city children and 2% for suburban children-"this is a 10-fold
discrepancy, which is an enormous difference," he said.

LOWER LEVELS AT FAULT

Recent research shows that cognitive defects can be caused by
blood lead levels lower than the currently acceptable level of 10 µg/dL.
Using data from the National Health and Nutrition Examination Survey
(NHANES) III collected from 1988 to 1994, Bruce Lanphear, MD,
MPH, of the Children's Hospital Medical Center at the University of
Cincinnati, and others assessed the relationship between lead
exposure and cognitive defects in math, reading, short-term memory,
and visual construction skills in 4853 children between 6 and 16 years
of age.

The researchers found an inverse relation between blood lead
concentration and all cognitive function scores, a result that was seen
in math and reading scores for concentrations as low as 2.5 µg/dL.
They concluded that many more children than have previously been
thought have been adversely affected by lead exposure. Lanphear
said these results argue for cutting the acceptable blood lead level in
half, if not more.

TOXIC TABLE FOOD

Another type of toxic substance disproportionally concentrated in the
environments where poor minority inner city children live are PCBs,
said Landrigan. Cities such as New York, Cleveland, Detroit, Buffalo,
and Chicago have been heavily polluted by PCBs, which were
prinicipally used as liquid insulation in electrical transformers,
generators, and capacitors. These heavy, oily compounds were made
in vast quantities in this country from the mid 1940s until 1976, when
their manufacture was banned.

PCBs may no longer be in use, but they still wreak their effects on
biological organisms, said Landrigan. These compounds persist for
years without breaking down, and therefore are still as toxic today as
they were when they first entered the environment. Because of their
indestructability, PCBs bioaccumulate in the food chain.

This phenomenon means that when the toxins wash into river or lake
beds, they are taken up by plankton whole and not broken down.
Then the plankton are eaten by fish, and those fish in turn are eaten
by larger fish, with PCB concentrations increasing through each level
of this aquatic food chain. The result is that top predator species such
as striped bass, blue fish, and lobsters have very high concentrations
of these intact toxins.

How does this relate to environmental justice? Landrigan explained
that it is predominantly people who are poor or who do not work who
find that a good source of cheap food can be supplied by fishing. But
if the fish they bring home are contaminated by PCBs, the lipophilic
chemicals pass up the food chain into humans to bioaccumulate in
the adipose tissue. If a woman who has eaten fish contaminated with
PCBs becomes pregnant, these accumulated PCBs can cross the
placenta into the fetus. Studies have shown, said Landrigan, that
infants exposed in utero to PCBs have dose-related deficits in IQ and
alterations in behavior similar to those produced by lead. The
mechanism is almost certainly different, but the end product is the
same, he added.

Landrigan said his group has done surveys in New York City and
found that the people who are most likely to eat East River fish are
not fishermen from Connecticut, who come down to fish the river
because the fish are biting. "They throw what they catch back," he
said, "but poor people take them home, serve them to their families,
and share them with their neighbors. We're just now organizing an
epidemiological study to look at the long-term consequences of that."

TOXIC CLASSROOMS

A third neurotoxin that is disproportionately concentrated in inner
cities are organophosphate pesticides. Landrigan said survey data
from all of New York state looking at pesticide use county by county
showed that the two counties with the highest use are Manhattan and
Brooklyn.

"It turns out pesticides are being heavily applied in daycare centers,
apartments, and schools, and they're being most heavily applied in
poor neighborhoods because their principal target is cockroaches."

Landrigan pointed out that if something is not done to address the
disproportionate concentration of such toxins in the environment,
"we're going to perpetuate a population of poor minority kids whose
intellects are eroded by toxins like lead, and who will continue for
generations to come to be environmentally, medically, and
economically disadvantaged in relation to majority kids."

© 2000 American Medical Association. All rights reserved.


Visit our Web Site for information about our Seniors Participatory and
Community Quality of Life Projects!  Free Reports Also.

  http://www.utoronto.ca/qol      http://www.utoronto.ca/seniors

  ********************************************************************
  Long have I looked for the truth about the life of people together.
  That life is crisscrossed, tangled, and difficult to understand.
  I have worked hard to understand it and when I had done so
  I told the truth as I found it.

  - Bertolt Brecht
  ********************************************************************

Dennis Raphael, Ph.D.
Associate Professor
Department of Public Health Sciences
Graduate Department of Community Health
University of Toronto
McMurrich Building, Room 101
Toronto, Ontario, CANADA M5S 1A8
voice:    (416) 978-7567
fax: (416) 978-2087
e-mail:   [log in to unmask]