Rachel’s News #762, Feb. 6, 2003
by Carolyn Raffensperger*
[Continued from Rachel’s #761.]
Greening the Clinic
Healthcare practitioners have a special obligation to provide healthcare services that do not in themselves add to environmental degradation, which can cause illness. The use of polyvinyl chloride (PVC) plastics, mercury thermometers, and other hazardous materials can be phased out and comparable tools of less dangerous materials may be substituted. A coalition called Health Care Without Harm is a good resource for information about problematic healthcare practices and safer alternatives.[14]
Alternative healthcare practitioners, particularly those who use herbal remedies, have an opportunity to promote the preservation of biodiversity. Any herbs should be sustainably grown and harvested. The United Plant Savers posts a list of plants that are at risk because of human activity.[15] They have a precautionary goal: “Our intent is to assure the increasing abundance of the medicinal plants which are presently in decline due to expanding popularity and shrinking habitat and range. UpS is not asking for a moratorium on the use of these herbs. Rather, we are initiating programs designed to preserve these important wild medicinal plants.”[15]
Plants from other countries are generally governed by the 1992 Convention on Biological Diversity,[16] an international treaty that seeks to conserve biological diversity and compensate developing countries who have the most biologically rich ecosystems. Unfortunately, the United States has not endorsed the treaty and continues to seek free trade in plants that might be otherwise protected under the Convention. It is important to know the source of botanical herbs and promote just financial arrangements with countries that are the sources of these medicinal plants.
But every aspect of a medical care facility can be evaluated for its contribution to the environmental burden, and that burden can be reduced. How much waste goes to landfills or incinerators? Are bike racks as available as car parking? Can energy use be reduced at the facility?
Observing Emerging Health Patterns
Healthcare practitioners are also in a unique position to monitor emerging patterns of environmental health problems. The analogy is that of the alert practitioner who is charged with observing and reporting adverse drug reactions or unusual infectious diseases. Are you seeing unusual patterns in your practice and your community that may have an environmental link? Are there places to report these connections?
Dr. Allen Parmet is one such alert practitioner who observed that workers at a microwave popcorn plant developed a rare lung disease, bronchiolitis obliterans, that appears to have been caused by breathing particulates from artificial butter flavoring. Occupational diseases like this are reported to the National Institute for Occupational Safety and Health. There are few places to report environmental health problems if the disease is not occupational, however.[17]
The Minnesota Department of Health recognized the issue of environmental health problems and created a precautionary principle committee based on the model of the alert practitioner. Its goals were to examine science and policy related to specific emerging issues and to consider prudent avoidance measures.
Similar kinds of committees can be set up on the local, state, and national level. It is possible to include in these committees wildlife biologists, teachers, veterinarians, and healthcare practitioners, among others. Such committees are designed to monitor the health of the public, see patterns that may not have been predicted, and take precautionary action to prevent further harm.
Setting Health Goals
Most states keep statistics on many current, pressing health issues, including cancer, birth defects, and the number of children in special education. Hospitals and other institutions maintain their own records of problems, such as emergency room visits for asthma. These statistics can be used by communities and states to set environmental health goals. The U.S. Department of Health and Human Services (DHHS) sets generic health goals, such as reducing obesity or cardiovascular disease. The DHHS has never set environmental health goals. Nevertheless, setting such goals could steer public health policy in new directions. Goals could include reduced incidence of asthma, learning disabilities, and cancers.
Examples of Implementation
Implementing the precautionary principle is a tall order. But several jurisdictions in the United States, Europe, and Canada are trying to implement it. The following initiatives are of particular interest to those working on environmental health matters.
In 1999, the Los Angeles Unified School District adopted the precautionary principle to govern pesticide use in schools. The district’s policy affirms that the “principle recognizes that 1) no pesticide product is free from risk or threat to human health, and 2) industrial producers should be required to prove that their pesticide products demonstrate an absence of [human health risks] rather than the government or the public prove that human health is harmed.”[18]
Verizon Wireless sent a brochure in July 2001 to its U.S. cell-phone customers describing the potential harm to children from radio frequencies emitted by cell phones. Verizon described the precautionary principle by name in its brochure and suggested that parents adopt the principle and limit children’s use of cell phones. Similar wording, without acknowledgment of the precautionary principle, may be found on the company’s Web site.[19]
The City of San Francisco appointed an ad hoc precautionary principle committee that began meeting in early 2002 to identify methods by which city departments could apply the principle. The committee stated the following [20]:
Towards that end, the Committee will:
a. Develop and update a Q&A for the general public
b. Develop Precautionary Principle guidelines, forms, and criteria for departments such as purchasing
c. Suggest initial near term goals
d. Develop indicators to help monitor progress
e. Develop trainings for city staff
The Secretary of the Commission on the Environment will establish and update a library of key documents and maintain a binder of letters commenting on the Precautionary Principle.
Both the library and the binder are available to the public.
Conclusion
Past environmental decision making predicated on measuring and managing risk has failed to stave off environmental health damage. Many chronic and debilitating diseases are on the rise, and many of these diseases are rooted in ecological damage. This new and emerging set of problems requires new methods for considering and preventing further ecological injury and thereby preventing human illness. The precautionary principle provides a new way of thinking about environmental health that invites healthcare practitioners to become knowledgeable about the issues and observe and report environmental health links that arise in their own practice. Healthcare professionals also can take environmental action to the workplace by reducing waste and finding alternatives to environmentally harmful medical supplies and therapies.
There is so much suffering in the world. Every child who cannot learn to read because she was exposed to mercury or lead, every child who cannot draw a breath of air because of asthma, every child who was born with a deformed penis because of exposure to an endocrine disruptor suffers for a lifetime. We can envision a healthy world where the offspring of all species are healthy and vibrant. And we can act. We can implement the precautionary principle, which urges us to take precautionary action even in the face of uncertainty. Frogs, white pelicans, sea otters, humans, and Monarch butterflies are worth our every effort. May we not only bear witness to and alleviate suffering but may we bear witness to beauty.
==========
This article first appeared in the Sept./Oct. issue of Alternative Therapies in Health and Medicine. Copyright 2002. Used with permission.
Carolyn Raffensperger, M.A., J.D., is the executive director of the Science and Environmental Health Network in Ames, Iowa.
14. Campaign for Environmentally Responsible Health Care. Health care without harm. Available at: http://www.noharm.org. Accessed July 24, 2002.
15. United Plant Savers Web site. Available at: http://www.plantsavers.org. Accessed July 24, 2002.
16. United Nations Environment Programme. Convention on Biological Diversity convention text; 1992. Available at: http://www.biodiv.org/convention/articles.asp. Accessed July 23, 2002.
17. Associated Press. Popcorn plant workers develop rare lung disease; artificial butter flavoring is blamed. October 4, 2001. Available at: http://abcnews.go.com/wire/Living/ ap20011004_893.html. Accessed July 24, 2002.
18. Kriebel D, Tickner J. Reenergizing public health through precaution. Am J Pub Health. September 2001;91(9):1351-1355.
19. Verizon Wireless Consumer Disclosures. Available at http://www.verizonwireless.com/jsp/disclosures.jsp. Accessed August 5, 2002.
20. San Francisco Commission on the Environment. Available at http://www.sfgov.org/sfenvironment/sfenvcomm/prprin/d042502.htm. Accessed August 5, 2002.
++++++++++++++++++++++++++++++++++++++++
Rachel’s News was published by Environmental Research Foundation (E.R.F.) from 1986 to 2009. All together, 1000 issues appeared. Unless otherwise noted, they were written by Peter Montague.
Over the years the name of the publication changed slightly, starting as “Hazardous Waste News,” then “Rachel’s Hazardous Waste News,” then “Rachel’s Environment & Health News” and finally “Rachel’s Democracy & Health News.” In this archive, we have simply used “Rachel’s News.”
E.R.F. changed its location over the years from Princeton, N.J., to Washington, D.C. to Annapolis, Md. and finally to New Brunswick, N.J.
To contact E.R.F. or Peter Montague, send email to pm8525@gmail.com.
