Hey everybody, welcome today to National Cancer Prevention Workshop Environmental Panel. We're super excited to have each of you here. We are going to start with Veena Singla. Veena could you share with the audience who you are, what you do? Let's talk about it. Thank you so much Bill. I'm really excited to be here. I'm a scientist working with the Natural Resources Defense Council, or NRDC for short. NRDC is an international non-profit that employ scientists, lawyers, and policy experts to advocate for science-based policies to protect human health and the environment. We have a staff of about 700 and offices across the United States, including beautiful San Francisco, California, where I am, as well as in China and India. As I mentioned, I'm a scientist and I work at the science policy inner section on healthier communities. I do research and analysis to bring the most current scientific principles and data to inform policies to advanced public health protections. Especially thinking about the most impact on populations like people of color, low-income communities, workers, women, and children. I just want to say too before I move ahead with the question that Eric [inaudible] from NRDC really produced this panel today. I know I speak for the Board of Directors of Less Cancer, how proud we are to work with you on this today. We're so impressed with your work and the world would be different without you, so we're really grateful. Veena, can you tell us a little bit about the environment in our homes? How does this all affect our health? Can you share a little bit with that? Sure, that's a great question. Broadly, I work on environmental health and that's how the environment impacts our health. When you think really simply about factors that impact our health, there's the genes that we're born with, there's what we can do as individuals, our behavior, and our environment. That includes the air we breathe, the water we drink, and what's in our homes and neighborhoods. That environment can have a really big and unappreciated impact on our health. For example, in the past few decades, we see these rising trends of certain diseases in children like certain cancers, asthma, and developmental disorders. Studies find that environmental exposures, like pollution and chemicals contribute significantly to increased risks of these kinds of diseases. Now when I say environmental exposures, what I mean by that is chemicals and pollutants that get into our bodies when we eat, drink and absorb them from the food that we eat, the water that we drink, products that we use, and the places where we live, learn, work and play. That environment encompasses the outdoors, certainly like outdoor air that we breathe, but also inside. Developed countries, like the United States, people spend about 90 percent of their time indoors on average. That's at home, the office, at school, the gym, transportation. The indoor environment is also a big part of our environment. Unfortunately, there's a number of environmental exposures in the home that can pose health threats. For example, things like mold and moisture, pests, insects, rodents, and volatile organic chemicals or VOCs, all of these kinds of environmental exposures in the home can cause and exacerbate asthma. There's also materials and chemicals used in our buildings to build our homes and construct them like asbestos, formaldehyde and per and polyfluoroalkyl substances or PFAS, which we'll hear a lot more about, I think, from other panelists later. All of these substances are linked to cancers. There's other chemicals used in buildings like lead paint and lead water pipes, flame retardant chemicals used in furniture and children's products, and pesticides used to control pest. These kinds of chemicals are linked to developmental disorders, including cognitive learning and memory problems. When we look at contaminants in the indoor environment in our homes, what we see often is higher levels of certain chemicals indoors compared to the outside. Some of these chemicals I mentioned before, are volatile organic chemicals, formaldehyde, La mer cartons. These key fast chemicals. We often find them higher levels inside. That's because indoor sources, like the products that we buy and use and building materials, contain these chemicals and they can emit and shed these chemicals into the indoor air and dust. Then the chemicals can get into our bodies when we breathe in that contaminated air and come in contact with that contaminated dust. I have so many questions I have to ask you right now because your information avail lots of thoughts that were running down obviously the greatest threats, to all of these exposures are children. Then when we talk about some of these illnesses that are environmental or genetic, there is a piece I wonder if you could share about epigenetics that when we live in a certain place or we live in a certain way, can you share with us any piece on how that can create a shift to, I think often people will think, "Well, we do this every day, we do this all the time. We've never had a problem with us." But I think it fits into that. All the things that are in the natural landscape of our lives that we brought into our homes seem normal and a lot of them are. I know that it impacts people immediately, sometimes, sometimes not immediately. As I had suggested, epigenetically, generationally. I'm not a scientist, but I was wondering if you could share a little bit about some of those impacts on children, the next generation as they evolve. Because I'm not a scientist, but I've always believed that children, I have two, are under construction. That was one of the reasons I was interested in founding Less Cancer was because I didn't believe people really understood the impacts of what was outside coming in, especially for our children. Can you share anything on that? Yes. Those are some really important points, Bill. As I mentioned, when we think about these diseases, there's a number of factors that we have to think about. They have really complex and complicated origins. It's our genes, our environment, and the interactions between the genes and environment in many cases. What we can think about when it comes to our environment is that there's these factors like pollutant and chemical exposures that we have control over. We can reduce pollution, we can stop bringing harmful chemicals into our homes. That can really reduce these harmful exposures and reduce the risks related to environmental exposures. We can't change our genes, at least not yet, but we can change our environment. I think it's just so important to understand that we can make our environments healthier, and that can really help support public health and make communities healthier. Especially as you mentioned, children whose brains and bodies are still growing and developing, and they're particularly vulnerable to toxic exposures that can harm the developing brain and body like lead. The other thing I wanted to mention in terms of the home is that many toxic chemicals and pollutants do collect indoor dust. Young children crawl, they play on the floor, they put their hands in their mouths, so they come into a lot greater contact with this contaminated dust. Well, you touched on something that we can't change genes, which we can't, but the environment seems to be able to. Which is why we need to be so careful with the unnecessary and preventable exposures out in the world today. At which so many we're bringing in our home thinking it's going to solve our next convenience issue, and not realize it's going to impact human health in the way that it often does. I do know that you've worked with some pesticide issues, and I remember one of the first issues that we tried to work on here, and we did with some success, was creating barriers between pesticides and health affected communities like schools. Can you share with us? Because in the news, we don't hear maybe as much about pesticides today as maybe we did 10 years ago. Can you tell us about what's going on in that space with pesticides? Sure. That's a great question. I'd say, unfortunately, there are pesticides that we're concerned about. Some pesticides that we use in our homes and on our fields are hazardous and linked to diseases like cancers, developmental disorders and other serious illnesses. I'll mention one particular hazardous class of pesticides known as organophosphates or OP pesticides. These pesticides are related to nerve agents that were used for chemical warfare. These OP pesticides poison agricultural workers every year, they're also linked to harming the developing brain. What we see is that during pregnancy, exposures to OP pesticides are linked to developmental harms to children, loss of cognitive capacity, learning and memory problems. The people who are most at risk are agricultural workers and people who live near fields where these pesticides are used. Pesticides don't stay where they're put, they can drift away from the fields and get into people's bodies through contaminated air and drinking water in their communities. These folks are not just exposed to one pesticide, it's many pesticides that are used on the fields all around them. I wanted to mention there is still an OP pesticide that's allowed for use in the home, but in flea collars on pets in the United States. Children are particularly at risk from that use because kids really love to play with dogs and cats, pet them, they can really be exposed to that chemical that's used on pets. Well, I know being a dog owner, dogs love looking eye to eye, and so kids are closest to them on the eye to eye thing, which is tricky. Many people now sleep with their pets. They have a long exposure to some of these pets that are on there laps, or they're in their bedroom or in their spaces where they continue to be exposed with that. I want to thank you for being here today, and I appreciate all your help and your leadership on these critical issues, keeping people safe in their homes. Thanks so much Singla, I appreciate you a lot. Thank you Bill. Next up is Wilma Subra. Wilma, I'm wondering if you can tell us a little bit about what you're doing? I provide technical assistance to community groups dealing with environmental and human health issues. Community groups all over the United States and in some foreign countries. I formed super company in 1981, and then Louisiana Environmental Action Network formed in 1986. I have been providing technical assistance through those two organizations. I also served on a whole host of environmental protection agency advisory committees dealing with the issues that the communities are up against. Two of those was, for six years I served on the National Environmental Justice Advisory Council, which is really important right now to the new administration. Then I served for seven years and I was vice chair of New Jack which deals with policy and technology. Wow, you really are a pioneer in this area actually by the way. You have really been at the forefront of so much hard question, asking and answering and bringing to light. As a scientist, can you tell us a little bit about your scientific background and what pulled you into this? Like what was the thing that really got you ignited? I'm the oldest of six girls, so I was the first one that ventured off to college. I received a masters in microbiology and chemistry and computer science all combined together and those were the infancy days when the computers used punch cards. But I was always interested in science. I had very good science teachers in high school. As a result, even while in college, community members were come into our university and asking for help with environmental issues and issues that were causing human health impacts. After I finished college I went to work for a research institute for 14 years. At that point I decided I need to be available more to the communities to help them reduce their exposure. Love that. I love your leadership. You really have been an approachable resource for people to reach out to to get help with. Can you share one of your first experiences around industry or regulatory things that you worked on? Processes? Mostly it was all in gas drilling and production. Louisiana has oil and gas drilling and production in every parish or county in Louisiana. Then of course we had the offshore development. Frequently people were told they had to have a well in their yard. They didn't have all these and then they left all the waste behind and people were getting very sick and a lot of those waste were in agricultural land and the farmers were complaining that it degraded the soil. I was one out there doing say a plane and identifying the chemicals of concern and the pathways of exposure. Then I work within the agencies to get the rules and regs adopted for the oil and gas drilling and production which is still regulated as non-hazardous feel waste. But in the late '80s they had a damage case to Congress and I had given the most cases of damage case to Congress. But Congress still decided to do [inaudible] field waste. After that EPA put together a committee of industry, community members and regulators, and we developed guidelines and went into state and reviewed their programs and gave them recommendations. I'm so grateful for you. Personally I'm grateful for you and I'm grateful for my children that there has been people like you charging ahead and leading the way. What was really the first trigger? Did somebody tab you on the shoulder or were you like, hey, wait a minute, get that thing out of my yard. What was that first action that you took? In biology there were a lot of rendering plants on the Vermilion River which flow through Lafayette where the end first city was located. People would come in and say there are dead cows floating down the river. I kept remembering and reminding them that you don't drink the water from the Vermilion River where people in New Orleans drink the water from the Mississippi River. Therefore you don't try and protect your water source. You need to act like it is your water source and do as much as possible to clean up that river and we're still trying to clean up that river. Wow, absolutely. I just want to remind our listeners that that was at a time really when people couldn't see some of these exposures. They instantly translated it to the fact that it must not be there. Until they saw a floating cow, your pet was a pretty difficult one to sell. Because people were making money, people were supporting their families this way, and then there was this other piece impacting human health. I appreciate your bravery on that a lot. Can you share with us anything around like accidental releases that occurred at that time or any stories of human health impacts relative to this? A lot of the work I do is on what's called Cancer Alley where industrial development started in the early 1900s. Again, at that time there was little to no regulations and no control of the emissions. Over the years particularly in the '60s, a huge number of industrial facilities started moving in and constructing on plantations. When you'd ask the Department of Environmental Quality, what was that coming out the stack they'd say, oh, it's just steam. I would go in and look at the permit application and help the community understand these are the chemicals that are being released out of the stack, these are the chemicals that are being released from different portions of the facility, and these are the health impacts, the chronic health impacts and the acute health impacts. Then they'd start saying, oh, I have that acute impact, I have that acute impact. Then they really wanted to work to get those emissions to reduce so it didn't have such a negative impact on their health. It could be a small facility not along the Mississippi River that even it could be a sewer plant and the people would come and say, we have a problem can you help us understand what's going on. When you first started with Cancer Alley and some of these explaining the chemicals, what year was that? It started in the '70s, that community members were questioning what they were being exposed to. I can't really even imagine that then because I know in the 2000s people had such a hard time understanding so much of this stuff. You really started from ground zero and connecting the dots, showing people how this impacted human health and the environment. That it was more than just even a floating cow which is so horrendous floating down the river but really you were able to talk about some of the health effects. What were some of the pressing health effects there? Was it cancer? At first the issue was respiratory, skin rashes, asthma attacks, the acute impacts. They say, when the weather sits down in Louisiana, when the weather sits down we have fog, like this morning it was totally fog and all those emissions are held close to the ground. That's when they would get the asthma attacks and the respiratory impacts. Then they'd start saying, well, this is how many people in our community have cancer. Let's look at the different kinds of cancers. Then I was able to correlate the types of cancers to the types of chemicals that were associated with those cancers. Then associate that with the emissions from being different facilities in the area. Amazing. Tell me Wilma, were their issues going on in schools at that time? Were they seeing trends with school health? Now we have x amount of kids out of school because of asthma. What did it look like at that time and what was the explanation? It looked really bad particularly on bad days. The kids would bring their nebulizer to school. In some schools they had to check it in at the office and then when they needed it they had to go to the office and they gave them their nebulizer. But then the school started being locked into say how many students were on nebulizers. We were have a difficult time with saying 20 percent of the kids are having respiratory problems. Sometimes it happened when they're in school. Oh, by the way, there was a [inaudible] from a spray and still an emissions from the sprays came in. Or oh, there was a flare going at an industrial facility down the road releasing lots of smoke and the kids were all rushing to the office to get their nebulizers. Then you started doing a cause and effect. Even though a lot of the people work for the industrial facility, the mothers were always protective of their children and they wanted reductions to occur so their children weren't so sick. In my area we have sugarcane farmers and they burn the fields and the mothers here, even though they're involved in the industry say they want the farmers to pay for their medical bills, their medicine bills, and their children's health. It's always back to cause and effect. I could sit here and listen to you all day, I'm not kidding. You are an amazing person, I'm certainly grateful for all your contributions and I really just want to thank you for being here today and making National Cancer Prevention day and workshop such a priority. I appreciate you. Thank you. Thanks for being here. Next up we're going to talk to Sherry. Sherry, hi. Good morning. How are you? I'm good. Could you share with our listeners today who you are, where you work. Tell us about yourself. Obviously I'm Sherri White-Williamson. I currently serve as the Environmental Justice Policy director at the North Carolina conservation network which is an organization of about 70 non-profits across North Carolina. In that role I'm responsible for making sure that we consider environmental justice in all of the work that we're doing there. I am also the co-founder of a non-profit organization here in Samson County to work with citizens on issues of K pallets and wood pellets and landfills and all of the things that we have here in the county. Prior to joining conservation network I retired from EPA from the Office of Environmental Justice and was designated federal officer to the National Environmental Justice Advisory Council as well as managing the interagency working group on environmental justice. Wow. We are grateful for you. I wanted to ask you what groups are considered environmental justice communities? That's always an interesting discussion because the definition of environmental justice says low-income communities and communities of color. The conversation I've tried to have with many people is the fact that low-income communities and communities of color are not necessarily the same thing. When we talk about low-income communities, we are not only talking about communities of color but we're also talking about low-income communities. Think of Appalachia and some of the other places across the United States that I visited that are not necessarily minority, but are impacted because of the lack of power that they have or the access to decision-makers. Communities of color, yes, and when we talk about communities of color, income doesn't necessarily have anything to do with it because it was first reported in 1987, toxic wastes and race, that looked at the correlation between the placement of polluting facilities and race and found that even if you look at two communities, one minority, one white, with the same level of income and there was a decision that had to be made about where to place that toxic material, it was going to go into that community of color. When we talk about the groups, we have to be very clear about what we're talking about because income is not necessarily determinative. Race is definitely the most determinative. But there are communities across the spectrum, all cultures, all races that are impacted, and the commonality there is their access to decision-makers and to the levels of power. Access all around. I always think just in my under-educated way that so many of these areas where there are disparities of whatever the varieties and their vulnerability to outside toxins is, it really is a variable. We do see things, we do see areas where people are impacted, where they might have more wealth, or they might not be people of color but they typically have more access to education, to health care, to being better connected so they can pick up the phone to talk to their legislator. I've always said that literacy was one of the best cancer prevention tools there is. When we see poor education and lack of resources, lack of access, we see more cancer, and of course that's our interest and that's my interest as well. I'm super grateful for your work because there has to be a better understanding. We have to level that playing field. You're absolutely right. I didn't say I also worked with the American Cancer Society back in the day when we were trying to convince folks that they should stop smoking so much. Coming from a rural area, being able to have that conversation with tobacco growers, as I grew up working in tobacco, made a lot of difference in terms of understanding where they were in helping to get them access to elected officials. Once we were able to make those connections, it was amazing how the power of public health and impacted communities going together to talk with decision-makers could make such a difference in the outcome. Where that came from, when we think in my lifetime, Santa Claus used to sell cigarettes, and doctors used to sell cigarettes. I remember my mom who passed away from a small cell carcinoma at a fairly young age, smoked Kent cigarettes, which if you know that story was supposedly the safest cigarette because of their filter tips, which turned out to be some crystallized asbestos situation. My mom thought she was doing, and at that time she was smoking, doctors used to say, why don't you try to relax and have a cigarette. At that time, Kent was sponsoring the American Medical Association meetings. Really interesting stops. The pushback on that was very hard and I appreciate your help in that for sure. Menthol cigarettes, if you think about it, were found in African-American communities, because the research show that they were more addictive to people of color with menthol. There's been a lot of research and a lot of different ways that we can look at as environmental justice issues even today. Kent, I always thought menthol cigarettes were for the first vapes. Because so many kids smoke menthol cigarettes, I used to be a smoker, the founder of Less Cancer used to be a smoker. There is a time I used to think ashtrays should be on stationary bicycles. My whole house smoked, and it was a cultural thing. But for kids, young people, menthol cigarettes were an easy transition from bubblegum to menthol because there was a flavor, there was a whole coolness factor, and an acceptance thing. It was really a hard thing to push back on. We still lose 480,000 people a year to smoking from my understanding. Those numbers may be different on just a layman. Anyway, I wanted to ask you a little bit about some of, you touched on waste disposal, and I just wanted to understand that a little better. I'm in ground zero for waste disposal, not just animal waste. The county that I'm in is the second-largest hog-producing county in the country. The way that the hog waste is stored is in open pits, we call them lagoons. They are larger than the size of a football field. That waste from the animals is washed out of the houses into these pits where they stay for a short period of time and then the waste is sprayed on adjoining fields. As a result of that lagoon and spray field system, predominantly in communities of color and low-income communities, we see a lot of water contamination as a result because the feces and the urine obviously contains many of the chemicals that are fed to the hogs, the antibiotics, the hormones, the things that are fed to make them grow fast and keep them well while they're growing. We see algae blooms in times of year when you would not expect to see them. Folks are fishing fish with sores on them as a result of these chemicals that are soaking into the ground then into the water system. Most of the folks around the hog farms and poultry farms and I'll talk about those just briefly too are mostly on well water. They are not on public water systems and so we see aquifers that are being contaminated and there is no relief for them if the contamination occurs, there's no mechanism within the state to fix it. There is no monitoring of the water in the air in those areas. Spills of those lagoons are supposed to be self-reported by the egg industry. There are a lot of loopholes that allow this to happen. The poultry industry, my county is Number 2 in poultry production in the state, and the state is Number 2 in the country in turkey production, well, turkey is not just poultry turkeys. Poultry in North Carolina is not regulated by the Department of Environmental Quality and so there's a problem now with poultry litter which is piled up. You can only apply so much to the fields as a means of fertilizer and if it's overapplied then we have some situations here where we found water testing we've done with high levels of arsenic because arsenic is used in chicken feed. There are many issues. We have the largest landfill in the state, which is about 1,400 acres. Trash, we've determined now is coming from as far away as probably New York because barges are being unloaded from the port at Wilmington and trash being brought in here. There are multiple ways that the community is being affected by all of the contamination here. There's very little regulation and very little monitoring or testing of what we have coming into the community and obviously, we're seeing the impacts. There was an air study done back in May, I believe the report was reported out in The Washington Post that clearly connected deaths to exposures on farms. The adjoining county to me, I believe the count was about 70 deaths, in this county was about 90 deaths that could be directly connected to exposures to air toxins by foreign workers and other folks working on farms here. There are a number of issues we continue to be concerned about. We also have wood pellet manufacturing here, so we're seeing deforestation here for the benefit of the UK because none of those pellets are being burned here in the county or in the state. As you all know, we have lots of floods, and so if you're cutting the timber down to produce pellets, then you're creating more problems when we have these storms with flooding and dead animals as a result of the flooding [inaudible]. I just cannot believe everything you've got going on in the poor state of North Carolina, for God's sake, it's really unbelievable how much you have happening there. Well, we would welcome toxic tours so that we can have people really see what's going on here. We did have a visit from some folks from the White House Environmental Justice Advisory Council about a month and a half ago, and we were able to give them a flyover so they can see from the sky exactly what's happening on the ground here and everybody was amazed as they flew over the landfill from 2,000 feet up they said they could smell the odor emanating from the landfill and there are folks who live within 500 feet of the entrance to the landfill, so you can imagine what they are dealing with on a daily basis. It's terrible. It's really, really shocking. It really is. It's really horrible. I wish I had a solution. I mean, you don't have to be a rocket scientist or any scientist to see the correlation understanding of spraying hormones on crops. It makes me think about what the drift looks like for those kids in school or what is all that about. Well, some of them facilities are very close to schools, are built very close to schools. If the wind is blowing the right way in many situations because it is urine and feces, you can feel the spin of the mist so you can actually feel that material sometimes and we are seeing problems as a result of the location of many of the resedents to these facilities. We recently found some homes and had high levels of total coliform. It's up to the resident to determine the source rather than it being done by state agency. Wow. For everybody on this panel today, we are going to let people know how to find you and not to help and pitch in and be part of it. I'm so delighted and grateful that you were here today. I've learned so much from all of you, but I really appreciate you sharing being here. Thanks so much. Thank you for the opportunity. Thank you very much. Our next person up is Ami Zota. Can you share with our listeners a little bit about yourself? Sure, so I'm an associate professor of environmental and occupational health at George Washington University, Milken School of Public Health. I'm located in our nation's capital, here in Washington DC, I guess at the heart of the action. Broadly my work seeks to advance environmental justice and health equity. I do that in a couple of ways. I'm a research scientist. I try to understand what are the major pathways by which we're all exposed to these toxic chemicals. I particularly focused on understanding exposures among women and children and those from systemically marginalized communities. I'm very conscious about the language I use often we say vulnerable populations or communities of color, low-income populations. We really have to underrepresented populations but they're vulnerable because they have been marginalized both historically and in present day. Because power differentials and structural inequalities so really trying to create new frameworks for how we think about these issues, how we study them. Really trying to put an emphasis on upstream modifiable factors rather than always putting the blame on the individual. I follow this through line to understand the health effects, particularly on women of color. I focus a lot on pregnancy because we know that when the fetus is just aiding during fetal development is a really vulnerable period that can affect trajectories across the life course. But I also focus on women's health because often they are ignored. We know that pregnancy is a sensitive period of exposure, not only for the developing fetus, but actually for women and what happens during pregnancy can affect their health for decades further onward. I really focused on women of color because I'm also thinking about intersectionality and how racism, sexism may jointly contribute to elevated environmental exposures as well as health effects. But my work doesn't just end when I publish a paper, I work with groups, whether it's NRDC or grassroots environmental justice organizations like react to move this science forward into decision-making because we want to have an impact with the work we do. I also train students. I'm an educator and I do a lot of work in training underrepresented students and those from systematically marginalized groups. Then the last pillar is actually communication. Just like we're all here, you can be doing great work but if nobody knows about it. It's harder for it to have an impact and so my journey with this is I've done a lot of work in communicating my own research and that of others with the media. Because everyone reads The Washington Post and The New York Times or uses social media. These are great tools to get the word out, and more recently I'm training the younger generation on science communication, so that we can cultivate a new cadre of thought leaders in environmental and climate justice that are well-grounded in not only the technical matters, but also community engagement and communication. Awesome. We need great storytellers to teach people, and I appreciate what you're doing. I have a question for you because you're in a university setting and you work with chemicals and you understand how the environment works, the good and the bad. You had mentioned something that made me think of phthalates and I'm not exactly sure what your background is, but just because I was in a dorm not too long ago, walking you through it and all I could smell was, I don't even know what the smell is. It comes out of a can. It was so horrible. I was like [inaudible] the university. Do you know what that is, and are there phthalates in that? That's what I was thinking. Yeah. I think we covered [inaudible] or something. But I was just like, what is going on in here? Because it was real, I had to get out. My eyes were running. Really it's not like a high test baby powder. I don't even know what it was. I do a lot of work on phthalates. With that, the P being silent at the top of the head of the word. It could have been phthalates because phthalates are often found in fragrances as solvents. But unfortunately, if it is in a fragrance, you won't see it labeled on the back of a bottle. Personal care products, beauty products are one source of phthalates. They're found in home materials like the type that Veena was speaking about. They can be in your homes. They can also be in our food supply because we use a lot of plastics in our food systems unfortunately, and none of these chemicals stay put in the products that they're using. They migrate out into our food, into our bodies, our dust. They are associated with all kinds of health effects, whether it's the feminization of baby boys, neurodevelopmental problems in our children, and even a cancer down the road. Can I just stop you for one second when we talk about the feminization of baby boys for the whole audience. Can you explain some of the impacts of phthalates, what the feminization of baby boys really is, and how that impacts them at birth? Can you expand on that a little bit? Sure. Phthalates are hormone hijacking chemicals. Some refer to them as endocrine-disrupting chemicals. At really low levels, these exposures don't have to be really egregious levels although some communities like workers are exposed to those really high levels. But even at really low levels, they can hijack how our hormones behave. Some of the phthalates that are particularly found in PVC plastics can actually block the behavior and the activity and the signaling of testosterone. Essentially, our populations may not be getting enough testosterone at different periods of development. In baby boys, they have found that phthalates was associated with a shorter anogenital distance, which is a marker of feminization. Shorter anogenital existence is also related to lower sperm concentrations, lower sperm motility, so lower sperm function. The same phthalates can also interfere with reproduction in women. It can make it harder to get pregnant or have successful births from your pregnancy. Reproduction all around is a key process that's really impacted by these chemicals that can hijack our home rooms. Sometimes cancer seem so distant, that it isn't really a reality, but when they're having children and they really understand some of the things that they're using has to do with the construction of their child, how their child was put together. I think that knowing that some of those impacts are critical. I believe that the real access comes in educating everybody despite their access. You're right about choices because there's lots of things that go on in communities and neighborhoods or where we live, we listen to Sherry, those people have so limited. But even when you talk about, let's say beauty products. I think some of the same structural forces that are leading to k-fold in Sherry's neighborhood is also at play, because we know that women of color, like black and Latino women have higher exposures to beauty product related chemicals in their bodies like phthalates. They use more toxic products. Why are they using more toxic products? Sure, we could think about this as an individual choice, but really it's because of structural racism. Because societal norms impact who we find beautiful. What we find beautiful. This isn't just a US phenomenon, it's a global phenomenon. Globally at the top of this beauty hierarchy is whiteness and white femininity. The closer you are to that norm, the more social and economic benefits you're afforded. Women of color are inherently outside of that norm. Often because of their workplaces or because of their school norms or in the rules in these places, and also because of peer pressure. They're often using more toxic products to straighten their hair, to lighten their skin, to smell a certain way. They are cheaper chemicals that it's a cost thing as well where chemicals are often added or not because it's a cheaper path to go. The more affordable. Right. But actually in this, I think somebody was talking about this too. With some of these products, they're used across the income spectrum. Because actually the pressures are often greater for women of color working in professional settings. There's a part of this that's related to income, but structural racism operates independent of income. I think what's powerful about the conversation we're having here is a lot of people are working on similar issues but in different contexts. I think when it comes to our food supply or beauty landscape, we often think about it at like individual choices. But these same forces are still operating and playing out. That's also why we need policy level interventions and we need more societal level interventions to balance out this notion that individual choice alone can get us out of this. They're often because I'll speak anywhere. 711, anywhere anybody asked me, I show up. But often people ask me, how can we make change? What can we do to get informed? They have all these complex questions. Many of I don't know the answers for, but I do know that if we believe with our conscience, if we wouldn't want it in our lives, why would we want it in anybody's lives? If we understood that there are options, not necessarily choices but there are options, and we can root for those healthier options, that's great if people have the information, but I also understand that they don't for lots and lots of reasons beyond. It could be literacy, it could be homelessness, it could be any of those things where any option is cut down. It becomes a very complex issue as you're suggesting. With what we're talking about now, are there things that we can do to somebody like me, anybody in the audience can do to help make it better? What can we do on that? Have conversations. You can educate each other. We have to organize to change policy nationally and at the State level. In this case, we can also try to put pressure on the private sector to take these issues seriously and realize that the more that people want cleaner and safer options, the more the private sector will respond. But then we also need a lot of transparency. There's a whole clean beauty industry that's popped up. I think it's because of consumer demand. This is also in the women of color beauty market. But right now, there's no transparency or accountability so anybody can use these labels. There's a lot of greenwashing happening too. I'm so glad we're having this conversation and you're making my head explode with ideas because I'm just thinking about so much now and I appreciate that. But we talk about policy and one thing that people always ask me is, "How is what you're doing in public health different than the treatment or cure of cancer? How is that different?" Often I suggest that policy is just a different tool for public health. Policy and education is how we prevent illness. Treatment and cures are great and we love them and honor them and I've wanted them for a lot of people in my life, but policy is not about really controlling anything, it's about addressing needs that need to be met. People don't understand that when they say, it's my choice to smoke here in public or it's my choice to do this, there are so many at risk when people make those individual choices. Policy, I just want to clear this up for everyday guy here, is really a critical health prevention tool. It's right up there with education so it looks different than band aids or aspirin, but when we talk about policy, it's not just about enforcing rules, it's about protecting human health. I just wanted our audience to really understand that. I think that's a really good point and I'm glad that you're ending there because I think the difference between public health and medicine is one, the emphasis on the collective versus the individual, medicine is about treating individuals. Public health is about the public and especially protecting those most vulnerable. Then the other difference is the point of intervention. Public health seeks to go upstream, their focus is on prevention, whereas medicine is what you use once you're already sick, and so I think those are two key differences. The thing about public health is, if you're doing a good job, nobody knows, because it's almost like the problems don't ever show up so it's thankless job, but I do think policy is an important public health tool. Yeah, absolutely. I want to thank you for being here today because all of you have made me think about so many things today and I appreciate that. Also apologize for my ignorance on some of this. But I really appreciate you guys being here and thank you so much for everything and all your good work. To Emily Donovan, thanks so much for being here. Can you tell us and share with our audience a little bit today about what you do, what you're doing, and fill us in. I live in South Eastern North Carolina in the Wilmington, North Carolina area. My paid job is I work at a church. But I woke up four-and-half years ago to headline news that we had high levels of these toxic chemicals in our drinking water. I formed a grassroots coalition called Clean Cape Fear and we've spent the last four years pushing back on comers and DuPont for releasing these chemicals into our drinking water. We focus a lot on holding elected leaders and other stakeholders accountable. We are grateful for your work, it's so needed. For those that may not know, can you tell us a little bit about PFAS, where they might see it in their house, what it might look like, how do they know? I'm not a biomedical chemical major, but I took a crash course when I found out that I was drinking it and giving it to my kids. PFAS, they're a class of chemicals that represent thousands of compounds and they're all unregulated, so they're not going to show up in your drinking water utility report, and they're not going to be on labels unless you live in a state that's proactively putting them on product labeling. But the technical name for PFAS is Polly Floral Alkyl Substances, which is a mouthful and so we tend to call them then PFAS. I like to refer to them as permanently freakish, altering stuff. Permanent because they live forever. These do not degrade. Freakish because they are not naturally occurring anywhere. The carbon fluorine bond that makes them so durable and used in so many different products and arenas is a forced human made chemistry and it takes an incredible amount of energy to break that bond and that is why they persist and live forever. Altering because they alter us at a cellular level. I know we've heard about thiolates and a whole bunch of other endocrine disrupting chemicals. But that's essentially what these are too, altering us at the cellular level at trace amount so even exposures at very very low levels are showing some high toxic effects. Stuff because they are literally in everything from Teflon coated non stick pans to raincoats and waterproof camping gear, stain resistant carpets. It's been found in dental floss, in makeup, in pesticides. It has been found everywhere scientists have looked for it they have discovered PFAS. Major contamination in military firefighting foam and in the fire industry, and you're going to hear about that in a little bit from a good friend Tony. Now, how is this related to Wilmington, North Carolina? Like I said a couple of minutes ago, they showed up in our drinking water because there is a major chemical company, DuPont, which now they spun off into Chemours, is located about 80 miles upstream of Wilmington in Fayetteville, North Carolina, and that is where they make this chemistry. They've been making it in a very irresponsible manner for decades, releasing it into the air where it's contaminated thousands of private well-owners' water, and then releasing it into the Cape Fear River, which is a major drinking water supply for 1.5 million North Carolinians, 350,000 of them live down stream of Chemours, and we rely on the Cape Fear River as our primary source of drinking water. These chemicals are so slippery and sticky that it's hard for conventional municipal water supplies to filter them out, and that's what was happening in our area. They're showing up in our finished tap water. Yikes. I'm so glad you're working on these issues. We have to move along on here, but I just wanted to ask you if there's one thing that people can be doing to support you, to support this situation. What would that be? Well, that's [inaudible] the chemical question. I wasn't expecting that one. [inaudible]. But I want to make sure that people follow up with everybody here. I really do. I want people to be able to support and help you guys as they feel like they can. You can definitely follow our work on social media, on Facebook, on Twitter @CleanCapeFear. We have a website that gets updated periodically at CleanCapeFear.org. A lot of the work that we do is partnering with great allies and organizations like NRDC, to help affect change and policymakers. Probably some of the biggest things that we can do, if we're talking to the health care community, is please research this chemistry. We just recently worked with the National Academies of Sciences. They're doing a draft guidance on PFAS and populating the body of work on health effects. One of the biggest problems that we're seeing in our community is that medical providers and health care professionals are not able to really meet our needs. We know we've been exposed and we know there's high exposures. But it's difficult to get proactive care because there's just not enough information on that. That's because the information hasn't been correlated through the National Academies of Science or into any clinical guidance. But the information is out there in piecemeal studies, in scientific journals. I would just really encourage health care professionals to start researching this chemistry and its health effects, especially if you are providing care in communities with known contamination. Listen, we're going to be following you. I want everybody to be following everybody on here and following your work and supporting you in any way that they can. I sure appreciate you joining us today. Thank you. Thanks for being here. Next up is Tony Spaniola from Michigan, my home state. We are so glad that you're here today. Tony, can you please share with us a little bit about yourself and what you're doing. Yeah, Bill, for sure. I'm a commercial lawyer in the suburban Detroit area, and my family owns a home, Bill, you know the term up north in Michigan on a lake in a little town called Oscoda, which sits in the beautiful here on national forest and right near Lake Huron. As a result of that, I'm an impacted citizen, because we're near the former Wurtsmith Air Force Base, which was the first military base in the world at which PFAS contamination was reported. Among other things, I got involved because I found out we can't drink our water at my residential well at our home in Oscoda. I bring unusual background to this, because I'm a former news reporter, in addition to my legal work, and I also have a political and policy background dating back to my father served in the Michigan legislature, at a time in the 1970s and '80s, Bill you may remember the PBB contamination crisis. Absolutely, I do remember That we had here in Michigan, and my father spearheaded the legislation that dealt with that. It was such an amazing thing that went on. I took a year off from school and met the farmers who were impacted, met the scientists, spent a day at [inaudible] laboratory, fought through the political battles with my father. I was one of the biggest political fights I think I've ever seen in my life. Then went on to law school and studied some more about cancer and public policy. I went to my dad and said, hey, we have this problem with PBB in our state. We ought to set up a cancer registry. So he introduced legislation which became law in 1984. I thought my work was done until 2016 when in the midst of the Flint water crisis saw a headline in the paper, much like Emily that said, there's this lake in Northern Michigan that could be the next Flint and there was a picture of our lake. I became involved and reached out to my neighbors, reached out to my friends, reached out to political allies, and we've formed a group much like Emily's and Oscoda called Need Our Water, which is a community action organization there. Then we've networked, we formed the Great Lakes P bisection network to network with NGOs around the region and other communities around the region. We think that building bridges to other communities so that we can collectively lift up our voices politically is a huge thing. I co-founded that, I'm co-chair of that, and also served with Emily on the leadership team of the National PFAS contamination coalition. It's amazing. I do want to mention to everybody on here that both Fred Upton and Debbie Dingell are the sponsors of the United States Bipartisan Cancer Prevention Caucus, the congressional caucus, and this workshop have been very supportive of our efforts and are doing work in the Great Lakes right now to protect those Great Lakes. We're grateful for that. Because time is not on our side now, Tony, can you tell us basically some of the challenges that are going on in Oscoda? Tell me what's going on. How is this impacting you? Sure. In Oscoda we're operating under five separate public health warnings that have been issued because of the PFAS contamination. PFAS chemicals were used in the firefighting foam at the base in the Osabo river, nine miles of the Osabo river have been contaminated, our lake has been contaminated and it flows directly into Lake Huron. We're dealing with health advisories for drinking water, residential wells. Do not eat the fish in nine miles of the river. Some of those highly contaminated fish in the world. Can't eat the venison from that area, can't eat any small game or other wildlife. We have also surface water foam, it's like the firefighting foam that regenerates and it looks sometimes very innocent. Other times it looks pretty bad. But as a result of our work in Oscoda, the State has now issued a State wide advisory, if you see white foam, you shouldn't touch it, and it's particularly dangerous for young children. A study that was done on our lake found that there's a hazard quotient, I'm not a scientist. If you're an excess of one, it's really bad. For little kids, it's 38. It's very, very dangerous even to touch. We're dealing with multiple exposure pathways and trying, first of all, the good the air force to contain and clean it up. Fighting the Department of Defense, as you might imagine, is a massive battle. But we're also dealing with the fact that we have people who have ingested the fish for many years, for decades. We have veterans who served on that base who drank incredibly high levels of PFAS contaminated drinking water, and they're all just out there. We have a very poor community and we have people who can't afford not to eat the fish from the river. We have all these exposures and all these problems with cancers that are popping up in the community, but nobody is bringing a public health approach to it to try to find them, to try to help them try to figure out what the risks and the problems are in the community, and so it's a real battle that we're fighting really on the front lines every day. I think I read something. There was a fish warning, it was in Michigan for something like smell. It was like a teeny fish they are like, yeah, I don't eat the smell. I don't know, was that in Lake Superior maybe? Yes, it was in Lake Superior and it was initially, I think issued by the State of Wisconsin or Minnesota, and then Michigan jumped in as well. But yeah, that's exactly right. We have them. It's hard to imagine. Yeah, and Bill there are similar do not eat advisories if you're familiar with the Huron River, which provides drinking water for the city of Ann Arbor. It's a huge problem across the Great Lakes region. It is huge, and I love Michigan, I love the people of Michigan. We work on many issues there as well, some a lot of other places and I feel heartbroken about it because it's our largest fresh water resource in the world. I'm hoping we can turn it around along with so many of these other issues. I want to thank you, Tony, for being here and I want to thank everybody for being here. I'm sorry, this went longer than I intended. But each of you are so interesting with so many great stories. I'm sorry if I traveled down a different lane for a moment or two, but I really enjoyed meeting you-all and and really appreciate you being here today and being part of this. Thanks so much.
