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Notes
See Ott W., and Roberts J. Everyday exposure to toxic pollutants. Sci Am 1998: 278(2): 72–77 (pp. 86–91 on some issues); Whitmore R.W., Immerman F.W., Camann D.E., Bond A.E., and Lewis, R.G. Non-occupational exposure to pesticides for residents of two U.S. cities. Arch Environ Contam Toxicol 1994: 26(1): 47–59; Roberts J.W., and Dickey P. Exposure of children to pollutants in house dust and indoor air. Rev Environ Contam Toxicol 1995: 143: 59–78; Wallace L.A. Human exposure to environmental pollutants: a decade of experience. Clin Exp Allergy, 1995: 25(1): 4–9; Ott W.R. Human exposure assessment: the birth of a new science. J Expos Anal Environ Epidemiol 1995: 5(4): 449–472.
Emission sources traditionally regulated, such as industry and motor vehicles, account for about 2% – 20% of total human exposure to VOCs. See Wallace L.A. Assessing human exposure to volatile organic compounds. In: Spengler, J.D., McCarthy, J.F., Samet J. (Eds.). Indoor Air Quality Handbook. McGraw-Hill, New York, 2001, Chapter 33.
By reducing exposures (rather than just emissions), benefits can be much less expensive: the same reduction in health risk can be achieved at lower cost, or greater reduction in health risk can be achieved at the same cost.
Fisk W.J. Estimates of potential nationwide productivity and health benefits from better indoor environments: an update. In: Spengler J.D., McCarthy J.F., Samet J. (Eds.). Indoor Air Quality Handbook. McGraw-Hill, New York, 2001: Chapter 4.
Centers for Disease Control. Forecasted state-specific estimates of self-reported asthma prevalence — United States. MMWR 1998: 47:1022–1025.
National Cancer Institute. National Cancer Institute Research on Childhood Cancers. 2002, http://cis.nci.nih.gov/fact/6_40.htm
National Cancer Institute. Surveillance, Epidemiology, End-Results (SEER) data base: cancer of the testis, men ages 15–34. 2002, http://seer.cancer.gov
Hypospadias is a congenital misplacement of the urinary opening in the penis, affecting one in 125 live male births. See Baskin L.S., Himes L., and Colborn T. Hypospadias and endocrine disruption: is there a connection? Environ Health Perspect 2001: 109:1175–1182.
Reductions in principal outdoor air pollutants, over 20 years (1981–2000), include NO2 by 14%, ozone 1-h average by 21% and 8-h average by 12%, CO by 61%, SO2 by 50%, lead by 93%, and PM10 by 19% (1991–2000). See Environmental Protection Agency (EPA). Latest findings on National Air Quality: 2000 Status and Trends. Office of Air Quality Planning and Standards, Research Triangle Park, NC, 2001, EPA 454/K-01002. www.epa.gov/airtrends
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Appendix
Appendix
The Proposed Human Exposure Reduction Act (HERA) to Reduce Health Costs and Protect Children
Contributors and Signatories: Wayne Ott, John Roberts, Anne Steinemann, James Repace, Steven G. Gilbert, Richard Corsi and Demetrios J. Moschandreas
Preamble
Research over the past two decades has shown that human exposure to pollutants is widespread.Footnote 1 Americans have many toxic chemicals in their bodies, as evidenced by numerous studies of personal exposure, blood, and human tissue. Through scientific advances in exposure measurement, we can identify the sources and amounts of pollutants that actually reach humans.
This research has revealed an important and surprising result: we have been missing many significant sources of pollutants and health risks. Most of our pollutant exposure comes not from sources traditionally regulated, but rather from within our indoor environments such as homes, offices, vehicles, and schools.
Existing federal laws fail to adequately protect indoor environments, which is where we spend more than 90% of our time. Even pollutants that are regulated outdoors, such as volatile organic compounds (VOCs), can be several times higher indoorsFootnote 2 — from common sources such as cleaning supplies, air fresheners, dry-cleaned clothes, paint, building materials, pesticides, chlorinated water, and second-hand smoke.
Our environmental laws focus on outdoor emissions rather than human exposures — even though exposures are how pollutants actually contact the human body and can harm health. We have successfully reduced outdoor emissions, thanks to these laws. We should continue these efforts, but we need to reduce total exposures to pollutants in order to reduce some major health risks that remain.
A consequence of missing some major sources of human exposures is that we are missing the chance to more efficiently reduce health risks and costs.Footnote 3 For instance, the current allocation of resources for pollution control is grossly disproportionate to actual pollutant exposure. Outdoor air receives about 25 times the research funding as indoor air, yet indoor air contributes several times more to total air exposure than outdoor air. Estimated savings from reducing indoor exposures exceed $100 billion annually, with benefits exceeding costs by 10-fold.Footnote 4
Further, rates of illnesses with potential links to environmental pollutants have been increasing nationwide. Asthma in children under age 5 years has increased by 160% (1980–1994),Footnote 5 childhood cancers by 33% (1975–1998),Footnote 6 testicular cancer in young men by 85% (1973–1999),Footnote 7 and hypospadias by 100% (1968–1993).Footnote 8 These increases occurred while outdoor pollutants were decreasing.Footnote 9
Fortunately, some simple and cost-effective actions, such as changes in household products, cleaning and other practices, can reduce our exposures to pollutants. Unfortunately, most people are unaware of the major sources of pollutant exposure, their health risks, or their remedies. And current regulations provide inadequate protection or public education.
Thus, our regulatory lens needs to focus on human exposure. We need to strengthen our ability to protect adults and children, workers and the general public, from all sources of environmental pollution. We need to exploit advances in measurement methods that can accurately tell us how people are exposed to pollutants. We need to educate the public on ways to reduce exposure to common pollutants such as mold, dust mites, pesticides, solvents, lead, and cigarette smoke.
A recommended solution is the proposed HERA that seeks to assess and reduce all human exposure to environmental pollutants. The result will be a more efficient and cost-effective approach to protecting public health by addressing the sources that contribute most to human exposures and health risks.
An Act
Intent:
The purpose of the HERA is to assess and reduce human exposure to pollutants in all media, and to reduce health costs more efficiently and effectively. A major objective is to reduce exposures to children because of their increased susceptibility to health effects caused by environmental pollutants.
Findings:
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1
Americans are regularly exposed to a range of pollutants that enter their bodies and can harm health.
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2
Existing laws fail to adequately address many of the major sources of pollutant exposures and health risks.
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3
Pollutant exposures are not measured routinely among the American population, even though these measurements provide critical information and can be made with high accuracy.
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4
The American public is generally unaware of their personal exposures to toxins through daily activities and would benefit from increased education on this issue.
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5
A more effective regulatory approach would address the sources that contribute most to human exposures and health risks, without abandoning existing protection.
Objectives:
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1
Identify and measure sources of human exposure to pollutants from all environmental media (air, water, land, food, dust, dermal) in a single balanced approach.
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2
Reduce pollutant exposure, with priorities based on relative contributions of each source to cumulative exposure.
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3
Conduct regular monitoring and exposure studies of the general population, and quantify changes in human exposure to pollutants over time.
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4
Assess and compare the exposure reduction effects of different environmental regulations and initiatives affecting all environmental media and exposure routes.
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5
Require testing and labeling of consumer products, building materials, and other significant sources of pollutant exposures.
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6
Perform independent studies of toxicity and health effects of chemicals, chemical mixtures, and other pollutants found in everyday life.
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7
Develop new exposure measurement methods, including personal monitoring systems and exposure models that will facilitate routine, less expensive exposure monitoring studies.
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8
Conduct health studies that combine epidemiology with actual exposure measurements.
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9
Obtain national probability samples of air exchange rates in buildings to assess how existing controls are functioning in the microenvironments where the population spends more than 90% of its time.
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10
Support programs that provide training, information, and public outreach about pollutant exposures and reduction strategies in homes, workplaces, schools, and other environments.
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11
Support academic institutions in their education of a new generation of human exposure scientists.
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12
Support research to develop new technologies and products that reduce pollutant exposures, such new building materials, new consumer product formulations, and easy to employ control systems.
Principles:
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1
To effectively protect health and reduce health costs of the American public, we need to understand accurately the causes of human exposures to environmental pollutants, the ways in which these exposures can be altered, and the trends in population exposures overtime.
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2
To understand trends in population exposures over time, routine exposure monitoring programs are needed, much like the nationwide ambient air and water monitoring networks now operating, but instead focused on routinely measuring the status and changes in personal exposures.
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3
Environmental epidemiology should include, wherever possible, as an integral part of its methodology, the direct measurement of physical, chemical, and biological indicators of actual exposure, in addition to surrogate indicators of exposure such as questionnaires.
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4
Research should be conducted to improve our understanding of the individual variation in the susceptibility of different persons to environmental chemicals, as well as the nature, extent, and variability of the population exposure to these pollutants.
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5
Regulations adopted under existing environmental laws should be evaluated comparatively across all media (air, water, land, food, dust, dermal) for their effectiveness in reducing population exposure, especially the exposure of susceptible persons and children.
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6
Accurate information should be available to the user of a consumer product about whether the product contains an appreciable concentration of certain listed chemicals, the specific concentrations of those listed chemicals, the likely exposure that might result from using the product, and the ways that the product should be used safely to reduce or eliminate these exposures.
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7
Educational programs should be developed and experts should be trained in the emerging science of exposure analysis and exposure assessment, including outreach programs to demonstrate new methods for reducing exposure in the everyday lives of our citizens.
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8
Government should require testing, labeling, and evaluation of the toxic pollutants emitted by consumer products and building materials, just as they require for food and drugs. At a minimum, the manufacturer should submit accurate and complete information about the toxic pollutants their products contain and the levels of exposure that might result from typical use.
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Moschandreas, D. The whence, wherefore and whither of the new scientific discipline of environmental inquiry: Exposure Analysis The 2002 Wesolowski Lecture. J Expo Sci Environ Epidemiol 13, 247–255 (2003). https://doi.org/10.1038/sj.jea.7500279
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DOI: https://doi.org/10.1038/sj.jea.7500279
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