Our bodies, ourselves: first-world women face unique environmental threats.

A typical American woman--let's call her Sara--wakes up to the sound of her toddler crying from the crib. She decides to make coffee and reaches for a paper filter that could leach dioxin. She's heard dioxin causes women's health problems but didn't have time to buy the unbleached kind.

Sara pops a clear plastic bottle into the microwave, adding a little bisphenol A--another hormone-disrupting chemical--into her daughter's milk. She knows it's not safe to microwave many plastics, but couldn't find any glass baby bottles at the store. Next, Sara packs a tuna sandwich to eat for lunch later at work. She spots a newspaper article about canned tuna, mercury and fetal brain damage. Since Sara is trying to get pregnant again, she tosses the sandwich.

After handing the baby over to her husband, Sara takes a shower. She worries about all of these scary chemicals while brushing her teeth. She spots a grey hair in the mirror. Her favorite hair dye has cancer-causing chemicals on the label, but right now she's more worried about dark roots. Then she rolls on some aluminum-filled antiperspirant, wondering if it will give her a nasty case of Alzheimer's disease.

Sara is late for work, so she hurries to get dressed before the babysitter arrives. Maybe she's hormonal--or maybe she's just normal--but all of these toxic threats are giving her a panic attack. Instead of reaching for her briefcase and hopping on the bus, Sara crawls underneath the bed and hides there, curled up in the fetal position.

Women under Assault

For modern American women, dealing with these uniquely female environmental health issues can be overwhelming. In her recent report, Confronting Toxic Contamination in Our Communities: Women's Health and California's Future, Tina Eshaghpour, program officer for the Women's Foundation of California, outlines many examples of toxic exposures that have a disproportionate impact on women in California, and across the country.

Eshaghpour, a new mother, admits all of this information can be frightening. "The issue gets magnified when you think about how your body could accumulate all of these toxins and now you are passing them on to your child," she says. The good news is women have a lot of power when they control their consumer choices. "Whether it's shampoos, cleaning products or the diapers you use for your child, there are a lot of good alternatives out there," Eshaghpour says.

Until recently, government regulators and toxicologists conducted tests on men only, and assumed chemicals affected men and women in the same way. But now scientists are becoming more aware of the biological differences between the sexes. "We're starting to question whether the models used to test chemicals are appropriate for interpreting sex differences," says Dr. Sherry Marts, vice president for scientific affairs at the Society for Women's Health Research. "Nobody has ever asked that question before." The society recently convened a scientific roundtable discussion on sex differences in environmental health.

With the rise of this new field, researchers are discovering hundreds of chemicals that affect women's health differently than men. Often, these differences are driven by the natural fluctuations of female hormones. Based on those cycles, women and girls may react differently to chemicals at puberty, during their monthly menstrual cycles, and as they enter menopause.

The Autoimmune Connection

Autoimmune diseases offer one of the most dramatic examples of the conditions that affect women in greater numbers than men. For example, women are 50 times more likely to develop hypothyroidism and 10 times more likely to develop lupus. Overall, the American Autoimmune Related Diseases Association ranks these disorders as the fourth-leading cause of disability for American working women.

Female hormones seem to play a role in those figures. For example, women with rheumatoid arthritis go into a mysterious remission when they become pregnant. And estrogen hormone replacement therapy reduces the relapse rate for multiple sclerosis.

Researchers also believe hormone-like chemicals may be part of the equation. Hormones affect the development and function of immune cells, says Dr. Allen Silverstone, an immunologist from SUNY Syracuse. "So if you're exposed to something like PCBs, which can mimic estrogen, you can disturb the regulation of the immune system."

In other situations, job-related chemicals are to blame. Dr. Glinda Cooper, a National Institute of Environmental Health Sciences epidemiologist, studied women who inhale silica dust while working in ceramics factories and on construction sites. Those workers developed lupus more frequently than women in other occupations. Female farmworkers also tend to have higher rates of lupus, Cooper says.

"It's still a mystery why women get autoimmune diseases more than men," Cooper adds. "It can't be explained entirely by genetics--there are a lot of other things happening on the environmental side as well."

The Menace of Mercury

One victim of mercury poisoning, Marie (not her real name), says her health started to go downhill soon after she received mercury fillings in her teeth. "I was very dizzy, disoriented and confused," she says. "I could hardly remember anything.... I could not concentrate or get anything accomplished. I was just so tired. I felt like my whole body had just been shut down"' She started feeling better only after the fillings were removed by a sympathetic dentist.

Dr. Ellen Silbergeld, a John's Hopkins University public health professor, says early exposure to mercury can increase the severity of autoimmune symptoms. Mercury also can speed up the onset of diseases like lupus. "At very low levels, mercury doesn't do a lot by itself," Silbergeld explains, "But if you encounter an environmental trigger, you may come down with mercury-related autoimmune disease, or possibly even autism."

In the meantime, activists at Greenpeace are encouraging everyone--especially women who plan to become pregnant--to watch the amount of mercury-laden fish in their diet. Studies show pregnant and nursing mothers who eat a lot of seafood give birth to a higher percentage of learning-disabled kids. In fact, the U.S. Centers for Disease Control and Prevention estimate one in eight American children is born with unsafe levels of mercury in his or her blood.

Most women realize they should avoid swordfish and tuna steaks if they are trying to have a baby because of the high mercury content of these fish. But new evidence shows canned tuna also is harmful: In March, the U.S. Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) issued a warning that pregnant women, nursing mothers and young children should eat only one six-ounce can of albacore tuna (or no more than 12 ounces of light tuna) per week. But many environmental health advocates say those guidelines aren't strict enough.

To be on the safe side, experts from the Center for Science in the Public Interest encourage women to avoid canned tuna altogether for six months to a year before trying to conceive. For women who are no longer of childbearing age, Greenpeace says it's ok to eat canned tuna once a month or less. The Environmental Working Group has compiled a list of less-toxic fish, such as wild salmon.

If women are worried about their mercury levels, they can submit a hair sample to find out if they, and their future children, are at risk. Greenpeace is making the test kits available for $25. The project is part of the group's campaign against a Bush administration proposal that would allow coal-fired power plants to release more mercury pollution into the air.

"Forty percent of mercury contamination comes from unregulated coal-burning power plants," says John Coequyt, a Greenpeace energy policy specialist. "This mercury issue highlights why we need more renewable energy." Other sources of mercury include municipal garbage incineration, some older batteries and medical waste.

Dioxin Dangers

Endometriosis is another women's disease with strong ties to toxic chemicals that mess with our ability to reproduce. Studies show the chlorine byproduct dioxin--yet another chemical that acts like estrogen--makes endometriosis worse. This painful uterine tissue disorder affects nearly six million women in the United States and Canada. Almost half of those six million women struggle with infertility.

Endometriosis Association researchers say women with this disease tend to feel better when they eliminate all sources of dioxin--such as bleached paper, vinyl plastic and high-fat dairy products--from their daily lives. Dioxin occurs in the chlorine-treated rayon fibers that are contained in some brands of tampons (see sidebar), and it plays a factor in Toxic Shock Syndrome (TSS). For Jamie Cash a 13-year-old in the Bahamas, TSS proved nearly fatal, and side effects have continued to plague her for years after the initial exposure.

Like mercury, dioxin has a greater impact on women because it collects in the fat cells they have in greater quantity than men. Dioxin gets into the environment through PVC plastic and paper manufacturing, garbage incineration and the use of certain pesticides.

Risks at Home

Endocrine disrupters are especially troubling because they have a big impact on babies in the womb at very small doses. Some of the most cutting-edge research in this area focuses on bisphenol A. "It's in products we are exposed to every day," said Theo Colborn, a senior fellow at World Wildlife Fund and co-author of Our Stolen Future. "It's in plastics, cosmetics and computers." Even baby bottles made of clear polycarbonate plastic contain bisphenol A.

Bisphenol A is another estrogen mimic. Since excess estrogen can cause breast cancer, scientists are concerned about prenatal exposure to bisphenol A. Now, there is significant new evidence bisphenol A acts on the thyroid gland and affects the onset of puberty in mammals. The chemical also may put infants at a higher risk for Alzheimer's disease. "It affects how tissue develops in the brain and how it changes as you get older," Colborn says.

So far, the FDA has claimed bisphenol A is safe. But new studies are showing the chemical causes damage at lower levels than previously believed. Until government regulations catch up with the science, Colborn says it's best to avoid plastic food and beverage containers--especially rigid, clear polycarbonate ones. Instead, look for tempered-glass baby bottles (Evenflo makes a set).

Another ubiquitous, but relatively unknown set of chemicals that poses a greater threat to women and their babies is perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA). These compounds, which industry prizes for their ability to repel water and stains, show up in everything from rugs and furniture treated with Scotchguard to Teflon pans, Goretex camping gear and certain types of dental floss. Responding to health concerns, 3M stopped using PFOS in 2000, but DuPont still manufactures PFOA at a plant in West Virginia.

Colborn estimated that 90 percent of Americans have these chemicals in their blood. They are of special concern because women and girls accumulate them at much higher levels than men. PFOS affects the thyroid gland and causes early onset of puberty in animals. It also causes birth defects and high infant death rates in rats.

Bird lovers are already wary of these compounds because their feathery pets tend to fall over dead when someone burns a nonstick pan on the stove. (For more on this, visit www.exoticbird.com/teflon.html).Colborn says PFOS and PFOA are perhaps the most persistent chemicals ever found in the environment.

Phthalates, chemicals used to soften plastic, received a lot of media attention after lab tests found these potential carcinogens in baby toys and teethers. Most children's toy manufacturers quit using them. But phthalates are still "alive and well in women's beauty products. A 2000 CDC study shows women of childbearing age have concentrations of phthalates in their bodies that were 20 times higher than the rest of the population. Those levels also exceed the federal safety standard for phthalates.

An Environmental Working Group report entitled "Skin Deep" offers a list of lotions, creams and polishes that contain phthalates. Health experts encourage women to print this list and consult it before shopping for beauty products.

Since companies are not required to list phthalates on product labels, many women do not realize they are slathering them onto their skin and hair every day. Manufacturers like phthalates because they cling to the skin and nails to give perfumes, hair gel and nail polish more staying power. Some beauty products, including hairsprays and dark hair dyes used mainly by women, pose a unique cancer threat. Even tampons have trace levels of dioxin, studies show. Given these risks, health experts like Colborn says it's better to shop around for organic alternatives.

Cleaning products also put women at risk, especially if they stay at home all day. Even if they work outside of the home, most women do the majority of cleaning. Handy gadgets like the Swifter send solvent fumes into the air. Potent stain removers add chlorine gas. Ant traps and bug spray waft pesticide residue around the house.

So it pays to learn about the riskiest cleaners and steer clear. The natural products company Seventh Generation, which offers a nontoxic line, created a helpful online glossary of common household chemicals and their health effects. Other experts, like Annie Berthold-Bond, author of Clean and Green: The Complete Guide to Nontoxic Environmentally Safe Housekeeping, show you how to create healthier alternatives with simple ingredients like vinegar and baking soda.

The Great Divide

Women face the most lethal environmental risks on the job. Women who work in certain occupations, such as house painting, dry cleaning and computer manufacturing have a greater cancer risk. And environmental justice studies show poor women and women of color are exposed to hazardous chemicals in disproportionate amounts--both at home and at work.

"Often, low-income families have limited access to health care and lack information about toxins in their midst," says Eshaghpour. The Women's Foundation of California report highlights Latino farmworkers in the Fresno area who frequently experience symptoms of acute pesticide poisoning (dizziness, headaches, blurred vision). As the report points out, exposure to certain pesticides, such as atrazine, also may increase their risk of developing breast cancer.

A group of women who work and live on dairy farms in rural Tulare County, California documented a link between nitrates, pesticides and antibiotics in the local water and an elevated risk of bladder cancer and birth defects. They launched an education campaign to prevent others from drinking the contaminated water.

Another group of immigrant women from Mexico, who work as housecleaners in the Bay Area, got tired of dealing with health problems caused by chemical cleaning solutions. Instead, they formed their oven cooperative using less-toxic products.

In her book, All Our Relations, Native American activist Winona LaDuke highlights several examples of indigenous women who have been affected by severe pollution in their communities. For example, Inuit women in the Arctic Circle, who rely on fish as their main protein source, discovered they have extremely high levels of polychlorinated biphenyls (PCBs) in their breast milk. When researchers traced the pollution to a garbage incinerator in LaCrosse, Wisconsin, environmental activists sued. They forced the facility's owner, Excel Energy, to spend $14 million to halt toxic emissions.

Katsi Cook, a Mohawk midwife in upstate New York, discovered the same problem in her community, Akwesasne: Women had contaminated breast milk due to pollution from industrial plants in the Great Lakes basin. Cook started the Mohawk Mother's Milk project to teach local women how to reduce their exposure.

"Realizing that mother's milk contains an alphabet soup of toxic chemicals is discouraging stuff," writes Cook in an essay entitled "Women are the First Environment." By carrying future generations in their wombs, some activists say, women also have more of a responsibility to educate themselves and protect the environment

Breast Cancer

No matter where they live or what type of economic background they came from, all women worry about breast cancer. The late Karen Holly, an African-American who grew up in a housing project, contracted breast cancer at 34 after a lifetime of exposure, including proximity to a chemical plant, and use of hair straighteners and pest and rodent control chemicals in the home. "Is poverty a carcinogen?" she asked. Since 1960, a woman's risk of developing breast cancer has increased from one in 30 to one in eight. Scientists are questioning why the breast cancer rate is rising in developed nations. Many believe environmental factors are key.

Diet is the best way for women to control their breast cancer risk, says Dr. Samuel Epstein, president of the Chicago-based Cancer Prevention Coalition. Epstein believes women should opt for organic milk instead of conventional dairy milk that contains the synthetic hormone rBGH. This substance, which mimics estrogen, could add too much hormone load to a women's body and increase her breast cancer risk.

Epstein also warns against meat from animals treated with estrogen-like chemicals that make the product more tender. A better alternative is to add more vegetarian meals and shop for organic, grass-fed beef or free-range chicken.

In general, women would be wise to add more fruits and vegetables to their diet, says Dr. Mary Wolff, a professor at the Mt. Sinai School of Medicine Department of Community Prevention. Fresh produce adds antioxidants and vitamins with cancer prevention power. They also add fiber, which flushes excess estrogen out of the body.

Since too much estrogen can lead to trouble, Wolff also suggests avoiding hormone replacement therapy and long-term use of birth control pills. Other doctors are looking at antiperspirants, which block lymph ducts located in the armpit, which may prevent the release of estrogen waste products. A variety of chemical-free deodorants, including crystal products, is available on the natural health market from companies like Weleda and Jason.

Ovarian and Uterine Cancer

Ovarian cancer is another uniquely female health concern, but it has been less well studied than breast cancer. Scientists do know that women who use talcum powder after their daily shower or bath have a higher rate of ovarian cancer. As infertility rates climb, women must contend with another risk factor: Recent studies show a slightly increased risk of ovarian cancer in women who used the fertility drug clomiphene. Ovarian cancer is one of the deadliest types of cancer for women because it evades early detection.

Ironically, tamoxifen--a drug used to prevent the recurrence of breast cancer--has the side effect of causing uterine cancer. So women taking tamoxifen for one type of cancer have to worry about screening for another one.

The Risk of Aging

Alzheimer's disease is another condition that affects women in greater numbers. In fact, women are three times more likely to get Alzheimer's than men. New research shows estrogen may play a role in this disparity. In this case, estrogen appears to have a protective effect. Studies show most women develop Alzheimer's after menopause, when estrogen levels in the body begin to sharply drop. Estrogen levels in men, however, start to rise late in life because their bodies convert testosterone to estrogen.

But something in the environment might be part of the equation. Researchers have long believed aluminum is a factor. A 1991 Lancet study showed women with aluminum contamination in their drinking water had a 46 percent higher risk for developing Alzheimer's.

Women are exposed to aluminum in everything from cookware and baking powder to antiperspirants. Older women living in nursing homes with indoor air pollution caused by mold "also may experience more severe symptoms. Studies show certain types of mold can worsen memory loss.

Women with osteoporosis may also want to check out their water supply. There's evidence that heavy metals such as lead and cadmium can make osteoporosis worse. According to the NIEHS, exposure to heavy metals can have a direct affect on bone tissue, making it weak and brittle. As bone breaks down, it releases lead into the bloodstream, which can also aggravate dementia and Alzheimer's symptoms.

Pollution and Politics

For some women, taking political action can be a healing step when dealing with harmful health impacts. The Women's Foundation of California report highlights a group of Laotian grandmothers who formed an environmental group in Contra Costa County after 200 people in their community got sick because they didn't understand government warnings about a toxic explosion at a nearby oil refinery. Officials urged people to stay indoors, but the message was broadcast only in English. Now, the grandmas work closely with health officials to send out warnings in four Laotian languages.

At the federal level, activists from the World Wildlife Fund (WWF) and the Society for Women's Health Research in Washington, D.C. want the government to require industries to test every chemical for more than just potential cancer risk. They also should be looking for hormone-disrupting effects and potential for different health impacts on men and women. "It's not just about women's health," says Sherry A. Marts of the Society for Women's Health Research. "We're going to figure out new things about men by studying women."

Some progress has been made in the past decade, says Colborn, but we still have a long way to go. For one thing, many of the sensitive tests needed to analyze some of the more elusive endocrine disrupters do not even exist yet.

Even if the right testing tools were available, scientists would face a huge backlog. There are 80,000 chemicals that still need to be evaluated for health risks, Marts estimates--and 2,000 new ones enter the market each year.

Given the situation, it makes sense for women to get involved in environmental health issues--whether they operate as individual consumers or as legislative activists, Marts says. "Women tend to be more concerned about their own health, but also about their family's health," she says. "Women are the health-care gatekeepers."

CONTACT: Environmental Working Group, (202)6676982, www.ewg.org. The report on safer seafood is at www. ewg.org/reports/BrainFood/sidebar.html; Health Care Without Harm, [phone], www.noharm.org; Not Too Pretty, a report on phthalates is online at www.nottoopretty.org; Society for Women's Health Research, [phone], www. womens-health.org. Women's Foundation of California, [phone], www.womensfoundca.org.

Practicing Prevention

Being a smart consumer is one of the best ways a woman can prevent environmental illness, says Tina Eshaghpour, women's health researcher for the Women's Foundation of California. "I always assumed if a product is on the shelf, someone has proven it to be safe," she says. "But that is not the case."

Until government oversight improves, women can take the following steps to protect themselves:

* Have your water tested for heavy metals and pesticides like atrazine, especially if you have a well.

* Buy organic produce from local farms.

* Use iron, glass or stainless-steel pans instead of aluminum or nonstick types.

* Avoid carpets and upholstery treated with water and stain-repellant.

* Switch to natural cosmetics, unbleached paper products and nontoxic cleaning products.

* Use glass and ceramic food containers instead of plastic.

* Limit canned tuna.

* Opt for washable natural fabrics and clothing instead of synthetics that need dry cleaning and cause pollution.

Taking Control of Your Body

Many organizations address the intersection between women's health and the environment. These resources can help you become more informed, practice prevention and lead a low-impact lifestyle.

Organizations for Empowerment

Learn about reproductive health and safe pregnancy from the Saving Women's Lives Initiative at www.savingwomenslives.org. To get the straight facts on current health issues, browse through reports and studies released by the Silent Spring Institute (www.silentspring.org), call the National Women's Health Information Center at (800)994-WOMAN or browse through the National Women's Health Network at www.nwhn.org. For fact sheets on how to actively prevent breast cancer, visit the Breast Cancer Fund at www.breastcancer fund.org or Breast Cancer Action at www.bcaction.org. Also see the Campaign for Safe Cosmetics (www.safecosmetics.org), which identifies harmful chemicals in beauty products. For women of color battling cancer, the National Cancer Institute provides links to resources for Hispanic, African-American, Asian Pacific and Native American women (www.cancercontrol.cancer.gov/womenofcolor).

Oils and Supplements

Safe, all-natural supplements formulated specifically for women can be found in health food supermarkets. Evening primrose oil, a traditional Native American remedy, has been praised for its effectiveness in dealing with pre-menstrual syndrome (PMS) discomfort, anxiety and mood swings. Lignan flax oil, high in omega-3 fatty acids, is recommended for fatigue, depression or skin disorders, and as prevention against breast cancer. Rainbow Light carries vitamin, mineral and food-based formulas for prenatal support, bone strength and hormonal balance (available at www.rainbowlight.com). Read about traditional healing wisdom in a 300-page guide entitled Herbal Healing for Women: Simple Home Remedies for Women of All Ages by Rosemary Gladstar and Anna Vojtec (Fireside Books, 1993).

--Rebecca Bowe