The precautionary principle: an important issue for women's health activists: by the Boston Women's Health Book Collective.

Between 1980 and 1985, asthma rates in children have more than doubled. Swordfish and tuna are so contaminated with mercury that pregnant and nursing women are warned to not eat them. In the U.S., a woman's lifetime risk of developing breast cancer has risen from 1 in 20 in 1960 to 1 in 8 today.

More than 25 percent of the nation's children live in areas that do not meet national air quality standards for ozone smog, carbon monoxide, sulfur dioxide or lead. U.S. production of synthetic chemicals has increased over 100-fold since 1920. In 1998 alone, 7.3 billion pounds of toxic chemicals were released into the environment.

While it is difficult to know the exact role toxins play in determining our health, the depth of their impact on our ecological system and our individual health becomes clearer every day. A new movement of environmental health activists who believe that environmental and public health regulations do not adequately protect either the environment of human health are promoting a global campaign to create new public policies based on an approach called the Precautionary Principle.

For decades, health and safety regulations on new chemicals and technologies have been based on risk assessment which assumes that our bodies can tolerate and assimilate certain levels of toxic exposure and contamination. Advocates of the Precautionary Principle believe this a flawed strategy and are fighting to replace the risk paradigm with standards that protect people and the environment from potential harm.

A widely used set of guidelines for the Precautionary Principle comes from the Wingspread Statement (http://www.sdearthtimes.com/et0398/et0398s4.html), which states, "When an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause and effect relationships are not fully established scientifically. In this context the proponent of an activity, rather than the public, should bear the burden of proof."

How does this differ from the guidelines that inform our current policies? The Alliance for a Healthy Tomorrow (http://www.healthytomorrow.org/about.html) delineates the four fundamental flaws in our health and environmental regulations:

* Potential toxins are not usually tested for safety before use.

* The government usually takes action only after harm is proven and widespread.

* Certain levels of harm are accepted and allowed by government authorities.

* Powerful special interests obstruct government action to protect our health.

In his article "An Example of the Precautionary Principle at Work: Endocrine Disruption" (http://www.gdrc.org/u-gov/precaution-2.html), JoelTickner explains that implementing the Precautionary Principle would switch the questions currently asked in environmental and public health policy. According to Tickner, "Current decision-making approaches ask, 'How safe is safe? What level of risk is acceptable?

How much contamination can a human or ecosystem assimilate without showing any obvious adverse effects?' The approach stemming from the Precautionary Principle asks a different set of questions: 'How much contamination can be avoided while still maintaining necessary values? What are the alternatives to this product or activity that achieve the desired goal? Does society need this activity in the first place?'"

One of the best sources of information on the Precautionary Principle and environmental health policy is the website of the Science and Environmental Health Network (http://www.sehn.org/precaution.html). "20 FAQs Regarding the Precautionary Principle" (http://www.sehn.org/ppfaqs.html) and "The Importance of the Precautionary Principle" (http://www.senn.org/poltan.html) are both excellent introductions to the Precautionary Principle and the movement behind the push to change environmental policy. The alarming "Pollution is Personal" (http://www.sehn.org/ppfactsh.html), written by the Massachusetts Precautionary Principle Project. points out the depth of toxic contamination within our bodies and details the increased incidence of certain diseases, many of which have suspected links to environmental pollution.

* To find out more about the Precautionary Principle, read the full text of "Women's Health Issues: The Precautionary Principle of Public Health" on the Boston Women's Health Book Collective website at http://www.ourbodiesourselves.org/pp.htm

RELATED ARTICLE: Women's health and the environment.

Women have a particular stake in efforts to research and promote environmental health. Not only do they share many of the same diseases as men and children--in which the environment has an important role, along with other factots such as poverty and genetic susceptibility--but women also are vulnerable to particular environmental diseases related to their gender. Some. such as osteoporosis, involve aging as well--and women on average live longer than men. Women tend to carry more fat in which substances introduced lower in the food chain may accumulate.

Other diseases involve women's role in reproduction and in the bearing and nursing of children, Studies indicate women can pass along substances--lead stored in their bones, for example--to their fetuses. Taking drugs, including prescription drugs and nonprescription drugs as common as aspirin may affect a pregnancy. Smoking is linked to lower birth weight, douching to reduced fertility.

Here are some additional conditions in which an environmental factor is being studied as a possible cause, trigger or influence:

Cancer: Environmental estrogens are a variety of synthetic chemicals and natural plant compounds that are thought to mimic the female hormone estrogen, They may act like estrogens or may block the natural hormone. The body's estrogen controls the growth of celts by attaching to proteins called estrogen receptors throughout the body. Many environmental estrogens san attach to these same proteins, fooling the body of tissues by giving them an inappropriate "estrogen" signal.

These compounds are found all around us. We eat them, drink them. breathe them and use them at work, at home and in the garden. They include pesticides such as the now-banned DDT; kepone, polychlorinated biphenyls (PCBs), natural plant products in our diet, and the drug DES which was widely used for more than 20 years beginning in the 1940s to prevent spontaneous abortions. In 1971 researchers showed that daughters of women

who took DES had a high rate of a rare form of cervico-vaginal cancer. The common use of DES as a growth promoter in cattle also was banned by the Food and Drug Administration in the 1970s,

There is a possibility that environmental estrogens might play a role in diseases such as cancers of the breast, uterus and ovaries: endometriosis; and uterine fibroids. There is also a possibility that some of these estrogen-like substances, such as the ones occurring naturally in vegetables, may be beneficial.

Endometriosis is a condition which occurs when endometrial tissue, the tissue that lines the uterus and is shed during menstruation, grows outside the uterus. When this abnormal growth occurs, painful implants can develop, most commonly on the ovaries, the fallopian tubes and the ligaments that support the uterus. Other possible sites for endometrial growths are the bladder, bowel and vagina. Endometriosis affects an estimated 10-15% of premenopausal women. The cause of it is unknown. Many of the risk factors for this disease are related to estrogen exposure. Thus, environmental estrogens may contribute to the development of endometriosis in susceptible individuals.

Uterine Fibroids: The most common tumors in women are benign (non-malignant) uterine fibroids or leiomyomas. These tumors are present in 20-30% of women over age 30; uterine fibroids are more cerumen in African-American women.

Fibroids can cause significant pain and discomfort and are associated with reproductive problems. They are the leading reason for hysterectomies.

Osteoporosis is a debilitating condition characterized by fragility of the bone. It sometimes occurs in men but is generally found in postmenopausal women. Cadmium, lead and possibly other heavy metals found in the environment may be significant factors in developing this disease. Research supported by the U.S. National Institute Of Environmental Health Science (NIEHS) has shown that cadmium exposure results in increased loss of bone mineral in mice whose ovaries have been removed. The bona loss appears to occur from a direct action of cadmium on bona, not through an indirect effect on kidney re-absorption of calcium. Thus, cadmium exposure may be a significant factor contributing to osteoporosis in older women. Continued efforts to study the basic physiology of bona metabolism as well as the mechanisms of heavy metal toxicity in bona tissue should provide insight into the disease mechanisms of osteoporosis.

Other NIEHS studies are investigating the health consequences of lead released into the bloodStream and soft tissue due to osteoporosis. One health effect that has been identified is an increased risk for hypertension. Some of these studies are using lead as a marker to develop hormonal therapies to prevent bone re-absorption.

Autoimmune DiSeases: Women are disproportionately susceptible to autoimmune diseases such as multiple sclerosis, rheumatoid arthritis, scleroderma (a disease of the connective tissue) and systemic lupus erythematosus (SLE).

The body produces antibodies that fight foreign proteins known as antigens. In lupus the antibodies mistake the body's own cells as foreign and attack them. The disease may range from mild to severe and is characterized by periods of flare-ups and remissions, Lupus may cause weight loss, fever, fatigue, aching and weakness and may involve different organ systems such as the central nervous system, the heart, lungs, kidneys, muscles and joints.

Exposures to various chemicals such as pharmaceuticals and solvents have been linked to autoimmune diseases. For example, exposure to hydrazine. an industrial chemical, or tartrazine, a food additive, is associated with lupus. Scleroderma has been associated with workplace exposure to vinyl chloride and silica dust.

Source: National Institute of Environmental Health Sciences. National Institutes of Health, U.S. Department of Health and Human Services. Women's Health and the Environment. NIEHS Fact Sheet # 10, August 1997. Available on-line at http://www.niehs.nth.gov/oc/factsheets/womens.htm

RELATED TICLE: WEDO on women's health and the environment.

Women are often most sensitive to changes in the environment because they are in closest contact with the home and the land; they are the first line of defense. Survival of women and their families is closely linked to the health of the land, forests, fisheries and other natural resources. There is strong evidence of the irrevocable damage caused by environmental assaults during various stages of the life cycle, particularly to the fetus and growing child

Unsustainable patterns of production continue to generate serious health risks for women, especially their reproductive health, as they become more active in the labor force. Occupational risks to women are still largely unrecognized, uncharacterized and uncontrolled. Increased use Of pesticides threatens women's health and the health of future generations in all parts of the world. Despite governments' commitments on environmental health in Cairo, official action and public awareness of prevention and risk reduction remain inadequate.

* Water pollution in Uzbekistan has led to an increase in birth defects and complications in pregnancy.

* Pesticide exposures in Central Sudan are linked to 22% of stillbirths registered in hospitals.

* Air pollution in the Ukraine has been linked to 21% of all illnesses affecting women and children.

* One in three women in the U.S. will be diagnosed with cancer sometime during their lives.

* Nuclear contamination in Chelyabinsk, Russia has led to a 21% increase in cancer and a 25% increase in birth defects. Half the population of childbearing age is sterile.

* In Guatemala, pesticide residues in breast milk are reported to be 250 times the amounts allowed in cow's milk.

* Most children in China take in DDT from breast milk at levels 10 times higher than internationally accepted maximums.

Source: Women's Environment and Development Organization (WEDO), Risks, Rights and Reforms: A 50-Country Surrey Assessing Government Actions Five Years After the international Conference on Population and Development (WEDO. March 1999). On-line at http://www.wedo.org/monitor/health.htm

RELATED ARTICLE: Multiple chemical sensitivity: it is real.

Unless you have it, chances are you haven't heard much about Multiple Chemical Sensitivity (MCS) even though a 1999 World Health Organization study estimates that there are now at least a billion sufferers, seven out of ten of whom are women and children.

Although MCS is relatively unknown most people either suffer from a very mild form of chemical sensitivity or know someone who does. Chemical sensitivity is becoming more common in today's society simply because of the amount of chemicals we expose ourselves to in the belief they are safe.

In its mildest form, MCS is relatively easy to handle. It usually involves developing a rash when using certain soap or washing powder which you later avoid out of common sense. However, in other cases it will take time to isolate the source of the problem and to try different products until you find one with which you are comfortable. Most people consider the problem solved at this point, but for others it continues.

Imagine a life where it is virtually impossible 10 final a solution because you are sensitive not just to one or two chemicals, but to hundreds found in everyday products. The effects are not limited to a simple rash, but have far more devastating implications. MCS symptoms commonly include difficulty breathing, sleeping and/or concentrating, memory loss, migraines, nausea, abdominal pain, chronic fatigue, aching joints and muscles, and irritated eyes, nose, ears, throat and/or skin. In addition, some people with MCS show impaired balance and increased sensitivity to loud noises, bright lights, touch, extremes of heat and cold, and electromagnetic fields.

Too often, people with MCS are invisible. made so ill by the environment we take for granted that they are unable to leave the relative safety of their own homes. Perfumes, newsprint, hair gel and weed killer are just some of the everyday products that can trigger an attack in sensitized individuals. The only way to reduce the suffering is to avoid the chemicals, but some chemicals are are airborne. This means that the very air you breath can make you ill. When people pass you in the street, when your neighbors paint, even tires miles away can cause problems, For many, suffering is made worse by a lack of understanding or correct diagnosis from the medical profession, many of whom dismiss MCS as "all in the mind."

MCS is not caused by a genetic defector obscure illness. Most MCS sufferers are victims of poisoning by industrial products caused by accident or carelessness of others. This is no longer a condition affecting only a few people who work in certain industries; it can happen to anyone, at home, at work, or on vacation.

* From the MCS international website, http://www.mcsinternational.org and WEN, "MCS--not all in the mind." WEN News, Autumn 2003.