Environmental justice: partnerships for communication.


NIEHS News-
Middle East Agricultural
Health Study

An agreement to study the human health
effects of pesticides in the Middle East
enthusiastically adopted by foreignR 3
ters and other officials from sevet4
East countries, the West Bank,,
the European Community,
the United States. TheM s"
Agricultural Health Study,cbev y
the NIEHS and the Fogarty International
Center at the National Institutes of Health,
was approved at a meeting in Manama,
Bahrain, in October 1994. The next step
took place in December, when technical
experts from the Middle East and North
America met at a workshop in Cairo to
iron out the details of the NIH initiative.

The Agricultural Health Study is part
of the broader Middle East Peace Initiative.
While the meeting of foreign ministers in
Bahrain set the NIH proposal in motion,
the regional workshop in Egypt addressed
logistical issues related to gathering data,
current collaborations on pesticide use, and
implementing the study.

Scientific experts from academic insti-
tutions and government agencies from the
Middle East region expressed concern
frustration that dramatic environment
impacts of population changes and agrc
tural, technological, and industrial ad-
vances in the region have not been ade-
quately studied and are often unrecognized
by government officials and the general
public. Participants proposed collaborative
research, communication, and education
strategies to address these environmental
concerns. Studies on the health effects of
agricultural chemicals were identified as a
top priority.

Agricultural chemicals are usually mix-
tures of chemicals, some of which can
damage the environment and accumulate
in ecosystems, including ground- and sur-
face water, and contaminate the food sup-
ply. Many agricultural chemicals can cause
a range of adverse human health effects.
Children may be particularly vulnerable.
The NIH proposal attempts to better de-
fine the extent of adverse health effects in
the Middle East region, promote the safe
use of pesticides, and ensure the applica-
tions of the most effective pesticide-man-
agement guidelines.

In densely populated areas, large quan-
tities of pesticides are used annually. In
addition to pesticides, fertilizers, growth
regulators, food additives, synthetic dyes,
detergents, and dusts are sources of pollu-
tion in the environment. There is an

urgent need to
health ts

reand e
chanisms of to
e major compo
1 is a research

.,ncer conse
c8tittf | | exposure f
populations. Potential collaborators for
these health effects studies have been iden-
tified in Egypt, Israel, Jordan, the West
Bank and the Gaza Strip, and the United
States. Scientists from other nations in the
region will also be invited to particia.

The experimental plan will address
neurological deficits, childhood develop-
ment, birth defects, od hypertension as
health endpoints tc measurements
will assess ner*"4" velocity, ace-
tylcholinest vuci, ale-
assessmet, hearing,
bloo and gross

po f the
is the Peace E ships
designedi rjunior-

frot cipating
Uni to gain experi-

rch that will be used
irho S. The training ini-

IV a cadre of young
ea s dedicated to environ-

me o ccupational health in estab-
lish torships and enhance the work-
ing retionship among scientists in the
United States and the Middle East.

The proposed collaborative studies
among scientists within the region will
allow new intervention and prevention
approaches to better manage the risks of
agricultural chemical use. Furthermore,
communication and health education
strategies involving the NIH proposal will
assist national policymakers and local

cow, ens of he

* Communities n n, d

*Assessment ofAviable Dat
* Training Peace Felos
* Humn Health Effcs Reseac

authorities in devising mitigation plans on
the use of agricultural chemicals.

ental Justice:
ips for
ation

ng the goals of the NIEHS
f search aimed at achieving

F P If+~htajustice for all populations.
Assays of the health effects of environmen-
tal pollution, as well as regulations based
on such assays, are often performed with
little or no input from affected communi-
ties. The purpose of the communication
program is to institute mechanisms to
brie this communication gap so that the
communities involved have a role in iden-
tifyng and defining problems and risks
related to environmental health and in
shaping future research approaches to such
problems.
A Request for Applications was initially

issued in January 1994. Applications were
evaluated by a Special Review Committee
composed of environmental health
researchers, health care providers, and
community representatives. Three awards,
two of which address Native American
issues, were made in September 1994.

Environmental investigators at Clark
University, in collaboration with Native
Americans for a Clean Environment and
Citizen Alert Native American Program,
are seeking to increase the awareness of
Native American communities exposed to
radiation contamination. These communi-
ties bear a disproportionate burden of risk
from nuclear activities, ranging from urani-
um mining to waste disposal. Members of
the affected communities are ill prepared
to understand and deal with the hazards of
radiation contamination. The grantee will
design and implement a plan for risk man-
agement and prevention activities at the
Western Shoshone Nation near the
Nevada Test Site and at the Cherokee
Nation at Sequoyah Fuels, Oklahoma, a
uranium processing facility in operation
for 23 years. Education modules of two
types will be implemented: community
modules, created exclusively by Native
American collaborators; and health educa-
tion modules, created by scientists and
health care provider trainers. Each of these
components involves the community in
learning about health risks and in sharing
their perspectives of this risk with scientists
and health professionals. Relevant materi-
als and strategies will be shared with other
Native American communities.

22 Environmental Health Perspectives



9-

The State University of New York,
Albany, in collaboration with St. Regis
Mohawk Health Services, intends to
design community-based strategies for
environmental health education, outreach,
and training in the Akwesasne Mohawk
community, which is adjacent to a Super-
fund site in the Great Lakes Basin-St.
Lawrence River watershed. Environmental
hazards have resulted from the rapid tran-
sition from an agricultural to an industrial
environment. Industry appears to have
produced high levels of polychlorinated
biphenyls (PCBs) from manufacture of
hydraulic fluids until 1973. Sludge con-
taining PCBs was placed in disposal pits
adjacent to the Akwesasne community and
has been found in water and soil in the
area. Sediments have been found in the St.
Lawrence River, which serves as a major
source of fish, a protein staple in the
Mohawk diet. Contaminants have been
found in human breast milk, and a num-
ber of symptom-related health effects have
been experienced by residents. Chronic
fluoride poisoning has been observed in
cattle, resulting from smokestacks emis-
sions of a metal smelter. Lethal levels of
organochlorines have been found in tissues
of some animals in the immediate environ-
ment. This project is led and directed by
members of the target community. It is
implemented, evaluated, and disseminated
explicitly through community members.
The project team has worked together
extensively and has nine years of experi-
ence in communicating information on
health risks to the community.

A third grant funded under this initia-
tive was awarded to a community organi-
zation, Citizens for a Better Environment.
This group, in collaboration with the
Labor Occupational Safety and Health
Program and the Center for Occupational
and Environmental Health at UCLA and
the Community Health Foundation, aims
to educate community members and
health care providers, promote adoption of
pollution prevention measures, and estab-
lish a community-based strategy for reduc-
ing community and worker exposure to
environmental pollutants in southeast Los
Angeles, a highly industrialized area home
to a low-income population, approximate-
ly 90% Hispanic/Latino. Pollution sources
include large, highly industrialized tracts
where chemicals are routinely or acciden-
tally released, severe urban smog, occupa-
tional exposures, and lead exposures. The
zip code area which includes southeast Los
Angeles was identified as the dirtiest subre-
gion within the state of California by the
EPA. About 70 manufacturing firms in
South East Los Angeles reported releases of
1.4 million pounds of toxic chemicals into
the air in 1992. A major objective of this

project is analysis of data to affirm the list
of environmental pollutants already known
and to determine whether gaps exist in the
data. Environmental health issues of prior-
ity to the community will be determined
and addressed. CBE has already received
invitations from mayors and council mem-
bers to help reduce community toxics
exposure. CBE helped to develop LA
CAUSE (Los Angeles Communities
Assembled and United for a Sustainable
Environment), a community education
project that seeks to promote environmen-
tally friendly jobs. LA CAUSE will involve
and educate community members and has
a history of reaching residents and workers
from the region. Sources of health hazards
will be identified, and strategies will be
developed to attempt exposure reduction.

Book Addresses Parents'
Concerns
about Toxins I

"Everything causes
cancer," according to
the old cliche. Now
parents, pediatricians,
social workers, and oth-
ers concerned about
children's health have a
concise guide, Raising
Children Toxic Free, to
help them identify the
real toxic hazards and
adopt practical, simple
precautions to protect chil-
dren and themselves.

The book covers toxins
that impact reproduction,
behavior, development, envi-
ronmental neurotoxins, and
cancer. Agents discussed
specifically include lead, mercury, asbestos,
pesticides, radiation, tobacco, solvents and
PCBs, and air pollution. The book was
written by Herbert L. Needleman, profes-
sor of psychiatry and pediatrics at the
University of Pittsburgh School of
Medicine, and Philip J. Landrigan, profes-
sor of pediatrics and chair of community
medicine and director of the NIEHS
Environmental Health Sciences Center at
Mount Sinai School of Medicine in New
York City. The publisher is Farrar, Straus
and Giroux, New York.

While some of the remedies suggested
require community and political action
(asbestos in the schools), other remedial
action is quite direct. For example, parents
can air clothes just back from the dryclean-
ers outdoors to reduce exposure to per-
chloroethylene fumes in the home.
Avoiding fruits and vegetables imported
from outside the United States, where pes-

ticides may not be properly used, is anoth-
er simple step.

NIEHS Awards Grants for
EMF Research
NIEHS and the Department of Energy are
coordinating the implementation of the
1992 Energy Policy Act (Section 2118 of
Public Law 102-486), which was signed in
October 1992. This is a five-year federally
coordinated effort to evaluate developing
technologies and research related to the
effects on biological systems of exposure to
electric and magnetic fields produced by
the generation, transmission, and use of
electric energy.

The Department of Energy is responsi-
ble for developing technologies to charac-
terize and mitigate these fields, while

NIEHS is responsible for
coordinating and conduct-
ing studies to evaluate the
possible adverse health
effects related to exposures
to these fields and for
communicating of these
findings to policymakers
and the public.

The NIEHS has a
long history of funding
research in this area. In
August 1994, the
National Toxicology
Program began two-
year rodent studies of
the effects of mag-
netic fields. Magnetic
fields, rather than
electric, are being
evaluated because
epidemiological

studies are most consistent for an
association of cancer with magnetic fields.
New grants administered through the
NIEHS Division of Extramural Research
and Training, funded by the Energy Policy
Act of 1992 (Section 2118 of Public Law
102-486) have further broadened NIEHS
research on electromagnetic fields. Newly
awarded grants funded by the Energy
Policy act are:
* Dean Astumian, University of Chicago:

Interactions between low-frequency AC
electric fields and yeast membrane pro-
teins;

* Elizabeth Balcer-Kubiczek, University of
Maryland, Baltimore: Effects of 60 Hz
EMFs on the expression of genes associ-
ated with cancer in human cell lines,
HL-60 and MCF-7;

* David Binninger, Florida Atlantic
University, Boca Raton: Molecular basis
for the effects of 60 Hz EMFs on gene
expression (transcription) in yeast;

* Craig Byus, University of California,

Volume 103, Number 1, January 1995 23