"We Should Be Alarmed": Protecting Children's Environmental Health

Nsedu Obot Witherspoon is the executive director of the Children’s Environmental Health Network (CEHN) and a leader in the field of children’s environmental health. “Our founding director would have never expected that 25 or 26 years later we would still be needed,” she says.

This bothers Nsedu (and it should bother you too). “What about when the information and the science is there and we still don’t act and we still don’t make [children’s health] a priority?” she wonders. Nsedu provides an abundance of sobering statistics on asthma, autism, cancer and reproductive health complications being seen in children on an increasingly frequent basis. “We know that there are direct connections to some forms of cancer pertaining to exposures to certain forms of pesticides. … The science on that is extremely clear.”

She continues, “We should all be not only concerned but completely alarmed,” adding that, in her opinion, “We are living in an almost unprecedented time as far the amount of dismantling and rollbacks that are occurring under the current US EPA.”

Nsedu joins many other recent Rootstock Radio guests in emphasizing that it’s more important than ever to be involved in government. “The canary in the coal mine here is that it’s not a matter of if, it’s a matter of when the next major atrocities will happen,” she warns. And the only way we can stop such atrocities from happening to our children is by getting our legislators involved.

THERESA MARQUEZ: Hello, and welcome to Rootstock Radio. I’m Theresa Marquez, and I’m here with Nsedu Obot Witherspoon, who is the executive director at the Children’s Environmental Health Network we call CHEN [correction: CEHN], where she has served for the last 18 years as a spokesperson for children’s vulnerabilities and the needs for their protection, conducting presentations, lectures across the country. And she is also a proud mother of four children, as well as doing all this work. So please join me in welcoming Nse.

NSE WITHERSPOON: Thank you so much, Theresa. It’s a pleasure to be here.

TM: I just started to mention to our listeners just a few of the things that you are involved with, and the list is so long. You served as a member for the National Institutes of Health. You’ve been on the Science Advisory Board for the Centers for Disease Control and Prevention. You’ve been on the Science Board of the Environmental Influences on Child Health Outcomes. You’ve been actually involved with the National Collaborative on a Cancer Free Economy. And then, currently, Nse is also on the board of the Pesticide Action Network of North America. And I am just so honored and want to say right now, Nse, because you are someone who has spent the greater part of your career working for the health of children, and I just can’t imagine anything more important than that right now.

You mentioned, when we were talking earlier, about this is 25 and 30 years of CEHN, and the people who have gathered together to support and start CEHN, working on children’s health, and in some ways you were almost disappointed in that. Tell us, why is it that we really need this organization, Children’s Environmental Health Network.

NW: Thank you so much. Yes, I’m the third director in line, I’m honored—it’s just an honor, honestly, to get up every day and have the ability to have, even if it’s a little piece, of a pie here that’s working towards this collaborative movement, quite frankly, that we are still in the midst of, where children clearly still need to have a voice, an advocacy arm, and to be leveraged and prioritized—which I would offer. And it took me a while to admit this, because I’m one of the most optimistic people, I think, you’ll run into.

But I did finally have to get to a point where—especially even living here in D.C., the heart, if you will, of policy development and theory—where I had to recognize that maybe there’s a lot more lip service here happening, at least in the U.S., than we would all like to maybe acknowledge. And it really took some soul searching and some assessing for me to really just validate that that could be a piece of this. Why else could we look at, in our case, a quarter of a century of work, where at first maybe we were one of the first organizations out in California in the Bay Area—which was not surprising that this type of a movement kind of generated from that space, as many did. There were only a few organizations that were really prominently talking about and asking, what about the vulnerabilities of children. And just asking the questions in every forum, increasingly—research, policy development, education and training. But how will Fed practice standard-setting policy impact children. Those questions weren’t really being asked in a rigorous way, and that’s clear by how our current policy standards are arranged.

For example, TSCA—the Toxic Substances Control Act—very inefficient way of the rule making, chemical policy assessment and rule making that was supposed to give EPA the authority in this country to regulate the chemicals by which we all come into contact with through our consumer products. Fast-forwarding from its development to the revised bill, the Senator [Frank R.] Lautenberg Safety Chemical Act [Chemical Safety for the 21st Century Act] that was finally passed in June of 2016, it took us all that time to get to a place to finally acknowledging in this country that that rule was not actually doing at all what it supposed to be set up to do. And in the midst of all that were decades of harm happening.

So some would say, people like Dr. Dick Jackson at UCLA, maybe we are actually conducting some form of unintentional child abuse.

TM: Oh dear!

NW: Because it’s one thing when you don’t know and don’t have information, and I guess you can claim ignorance. But what about when the information and the science is there and we still don’t act, and we still don’t make it a priority, and we still cut needed public health funding or prevention funding.

So, I’m not saying that that’s what we as a network stand on, but there are those out there that certainly are starting to get to the point of exhaustion, where we have now been in this realm, we now have had a field established for protecting children’s environmental health for the better part of a quarter of a century. Many more organizations involved, many more voices, additional funders coming to the table, and funding capacity exclusively devoted to protecting children in a wide variety of chemical exposure considerations. But yet we look at health outcomes, and a majority of them are all still going the wrong way. And then we look at funding for programs and they’re still very, very inadequate.

So yes, there is unfortunately still a need. Our founding director would have never expected that 25 or 26 years later we would still be needed. But I offer, the time is even more precedent [correction: prescients] than even the beginning because of the information we have right now that is not, unfortunately, being moved into activism and actions.

(6:33)

TM: Wow, there’s so many parents out there that are probably just going, “Ooh, ooh, maybe I should be doing something.” So when you started talking about when you all started CEHN, the Children’s Environmental Health Network, 25-plus years ago, was it Dr. Landrigan who started? And who was the founder? Excuse me for being a little bit ignorant here.

NW: No, no, great question. Many people may or may not know Joy Carlson. She was out in, and still lives in, the Bay Area of California, and she was the one that really started having the foresight, started asking some questions. The original stimulus for this work came from healthcare professionals. It really shouldn’t be that surprising, but healthcare professionals were recognizing that they were starting to get an influence [correction: influx] of younger patients with all kinds of health outcomes and they were showing all kinds of concerns. And they were not necessarily ready and trained for this.

So what we now know is that they were seeing a lot of lead-poisoned children—which was not new even at that time in the late 1980s, but the amount that they were seeing. A lot of pesticide exposures because of farming communities and agricultural communities in the area, for sure, and the residual impacts from that; a lot of reproductive health concerns as well; mercury. So there was this huge rise and acknowledgment that, hey, it’s happening, and we don’t have the type of training in typical medical and nursing school to really address this.

So that was the original stimulus for what then started a conversation in the state of California. They then started a Children’s Environmental Health Agenda, and then quickly it was realized, hmm, it’s not just healthcare professionals that require this, what we call Children’s Environmental Health 101—just the basic, basic fundamentals to why children are more vulnerable to most environmental hazards of concern, how these hazards start working negatively over long courses of time, and sometimes short time, for their little bodies and their development, and what should we as a society be doing to counter that. So they started bringing farm workers to the table, policy makers, researchers. And that was the original stimulus.

And then by 1992 they realized, okay, this is not just a California challenge—this we need to take to the entire nation. And that’s when the Children’s Environmental Health Network was incorporated as a national nonprofit.

TM: Well, you know, it’s so interesting to note that what used to be deadly for children decades ago, and that would be—well, I have a friend who had polio, for example; he’s in his seventies. Well, we don’t have polio anymore; measles, mumps, all of those contagious diseases are no longer even showing up as the kinds of things that really are hurting children. But the number two new is cancer, and that’s actually continuing to grow. And of course cancer—people who get cancer, I think the statistic is something like 15 or 20 percent of them have genetic inclinations to it, but actually more like 80 percent of our children get cancer because of exposures to environmental toxins. So that’s something preventable.

NW: Yes. And unfortunately childhood cancers have been steadily increasing since the middle of the 1970s, since we’ve really been tracking, at about a 0.5, 0.6 percent increase—so not, if you will, not huge numbers, one would say, but the fact that there’s a steady trend of increase should be concerning. And like, you just mentioned, the science is there, NIH science, NIEHS—National Institute for Environmental Health Sciences is the environmental health research arm out of the NIH, exclusively devoted to helping us give us the science for the foundation of all this work that we all collectively do. They acknowledge the numbers you just mentioned: 75 to 80 percent of known cancer diagnoses do have some form of direct connection to environmental exposures, which is very concerning.

And then the chronic illnesses. So yes, we were dealing with these infectious diseases, and now it’s chronic diseases, like asthma—the number one reason for school absenteeism in the country and the number one reason for children not being able to get up and go to school, whether it’s homeschool or out school. So just follow that journey for a minute. If a child is not well enough to even get up and go to school and learn, and then there’s a disconnect or a lack of interest at some point, there are stress levels, there are economic variables to a child with asthma, there are days off of work for those parents and caregivers, and on and onhe expense of treatment—so, I mean, that alone is its own category. Lead, as we all know—I mean, Flint is just one of many cities around the country dealing with lots of concerns from remaining old lead paints, as well as lead in our consumer products and lead in, clearly, our water drinking supply. And then there are other contaminants. And then the exposures to pesticides are huge. And we know that there are direct connections to some forms of cancer pertaining to exposures to certain forms of pesticides and tobacco smoke and other things. The science on that is extremely clear.

(12:11)

TM: Well, you know, you talked about pesticides, and one of the things that really bothered me last year is when the USDA overturned a decision that had already been made to ban chlorpyrifos. And that was known to be a neurotoxic to children. How do those kinds of things, where it seems like our children’s health do[es]n’t get the priority they need, even after study after study? And even the USDA under Vilsack had already said we must ban this, and yet now it’s back.

NW: Yes, it is extremely concerning. Now, the Children’s Environmental Health Network is a nonpartisan organization, so I just want to make that very clear. Yet when we see clear destruction of the clear authority that EPA is supposed to conduct under its mission and mandate, we are going to raise concerns, like other like-minded public-health-oriented groups. And we’ve been doing that since almost day one of this current administration. Certainly we have lived under other, if you will, Republican administrations and there have been things along the way, and Democrat administrations, and there have been challenges. But I will say, from my personal opinion, we are living in almost unprecedented times as far as the amount of dismantling and rollbacks that are occurring under the current U.S. EPA.

We should all be not only concerned but completely alarmed and, I would say, need to be calling our congressional leadership on a daily, weekly basis. They need to be hearing from us in the general public. It is not okay that we are rolling back standards related to our air quality which we all rely on. It is not okay that we’re rolling back standards related to, in this case, a very harmful chemical that is otherwise banned for use. EPA already conducted all the necessary science; it was all ready to go to be banned for use. And then to roll that back, it’s just… How do you even describe that, other than helping to appease the manufacturers? It’s completely unfortunate and it should be beyond embarrassing. Because it’s not only us as adults, quite frankly, that are going to feel the brunt of that decision until it is hopefully reversed again and eventually banned the way it was intended, but it will be our children and our children’s children.

And that is what, again, motivates me every single day and, quite frankly, gives me that fire in my belly, because these are children that cannot otherwise—the young children. We’re hearing about the wonderful youth and their amazing voice. I’m talking about the younger children who are going through cognitive learning development in these detrimental stages, influential stages, when they are exposed in school, childcare, home. That’s who we’re trying to be a voice for. And it’s a justice issue, quite frankly. These are vulnerable populations.

And then there are children within the child population that are even more vulnerable because of the zip codes they live in and the various levels of health disparities and injustice that their communities are trying to address every single day. That child still has to get up, try to get some nourishment, try to go to school, hopefully, and have some structure in their lives. And let’s face it: some children just have it a bit easier in that realm than others. So when you magnify these issues on top of social economics, poverty, and safety considerations in a neighborhood, it’s extremely stressful for our families across the country. We know that, we acknowledge that, and we can do better and we will do better.

TM: Hear, hear! And I think we can also do better when parents out there realize that now, to be a parent is also to be an activist. And I want to thank you for encouraging everyone, hey, call your representative every week if you need to.

But let’s back up a little bit, and you started talking about social economics and poverty. Can you say a little bit more about that? I mean, we have the big “A”—asthma, autism, allergies. We have reproductive problems, we have cancer. But isn’t it even worse in economic areas that are poverty or below, and/or middle class and below, actually. What about the socioeconomics of children and their health and the things that are happening to them?

NW: Yes, thank you, Theresa. So, you know, in this field of children’s environmental health we get asked a lot, too, what is the primary focus? We even have these discussions in our board room, right? What’s our primary, primary focus? Is it children as a whole? Or is it the high, high-risk children and then you have a varied level of criteria? I answer that by: it’s all children, at all times, for any circumstances. But, of course, we are very attentive to the realities that there are just children that are increasingly, they have even double, triple the amount of concerns placed on them every single day, unbeknownst to them, unintentionally, if you will. But the realities are there, by the color of their skin, by the zip codes that they live in. These are real criteria that public health is tracking that have a direct connection to one’s health outcomes.

Now, you might have some variances here and there, and I would also equate things like learning disabilities in that as well. We have seen a sky-rocketing increased amount of learning disabilities diagnosed in this country. So again, in all these advisory groups I’m on at the NIH and CDC, at some point people are actually have a bit of a discussion or argument about, for example, autism. Is it that we are actually diagnosing it better, or is it actually happening more? Well, finally, thankfully, they just came to an agreement: it’s both. So it use to be 1 out of almost 200 kids, at one point, were diagnosed with somewhere on the autism spectrum disorder. It’s now 1 in 68 children. And we tend to see higher rates in boys.

Yes, and so then there’s other, there’s hyperactivity disorder, attention deficit disorder. A lot of these are linked directly to lead, for example. Lead is a neurotoxicant, it definitely has impeding negative effects on the natural growth and development of a young brain that’s developing. And unfortunately, it’s irreversible. So I get on my soapbox for these type of issues because some of these issues take broader societal impact. We all have our role, but to really see the tides turn, it’s going to require increased policy standard setting and the ground flow [correction: groundswell] of the public demand as we’re talking.

But at the same time, there are things like lead, where an individual case does really make a difference. And it’s totally preventable—we know the major routes of exposure. And yes, older housing stock—so people living in lower social-economic considerations and poverty are already at even higher risk for lead exposure and asthma because of the exposure routes that you see. Asthma is triggered by a variety of different things at times, at different stages of a child’s life, and even adults can have onset of asthma for the first time.

But we have great research out of Columbia University, Ricki [Frederica] Perera and her team, that has shown us that just by a child living 500 feet or less from a major thoroughfare, and they define what that means, you can actually see onset of asthma for the very first time. So, let’s face it, most people living in lower-income communities are probably the ones more likely—and actually they do GIS [geographic information systems] mapping to show this as well—where it’s not surprising, it’s very typical in this country where you will see this over-burdening of communities. So bus depots tend to be in certain parts of the community. It’s not going to be, if you will, in a Georgetown in Washington, D.C. They’re going to be in south of the river, southeast D.C. and other parts of the city.

This is the whole background of environmental justice. And this is a whole field in itself that also came to be during the height of the civil rights movement. It was not coincidental—it was very intentional because the designs and the reasoning is all the same. There are communities that unfortunately today, in 2018 in the United States of America, that still have an over, if you will, even over-burdening amount of their share of environmental exposures. And it’s not right.

So that is one issue on its own. And the reality is we still have children born into these communities, living in these communities, trying to go to school, go to childcare, and eventually maybe even working in these communities, that are being exposed even prenatally just by the nature of the air quality, the water quality, and the housing stock. So certainly, yes, bottom line, asthma and lead, for example, are two notorious children’s environmental health issues that are definitely also impacted by [unclear] disparities, bigtime.

(21:07)

TM: If you’re just joining us, you’re listening to Rootstock Radio, and I’m Theresa Marquez. And I’m with Nsedu Witherspoon from Washington, D.C., and Nse is the executive director at the Children’s Environmental Health Network.

You were talking about Flint, you mentioned Flint. There’s a lot more Flints out there, aren’t there, that maybe we don’t know about? We all are using Flint as, whoa, what happened there we don’t want to happen in other cities. But aren’t there other cities who probably already have that situation?

NW: Oh, definitely. And folks have already mentioned that we have reports upon reports that have been coming out, before Flint and certainly after. Flint, Michigan, unfortunately was a dismal example of how we are not protecting our public’s health, and certainly even further our high-risk population such as pregnant moms, many of which we’ve actually met and been with and done events with. Some pregnant moms are local advocates doing amazing things still, who are making it very clear, we are nowhere clear to being out of the woods yet, even in Flint.

They’re doing a decent job, I think, finally with some federal monies and state monies that have been coming in to help replace the old lead service lines, but they’re not completely done. And so with that said, there are communities that are still very much relying on bottled water. And so we all know then there are negative effects of that. We’ve actually seen pictures and had testimonials of bags and bags and bags of empty plastic water bottles sitting in people’s yards waiting to be picked up, but the recycling program is overwhelmed. They can’t pick up everything all the time. So these bags are mounting up. People are even doing art displays where, if they have a wired fence, they’re putting empty water bottles inside each spoke just to make a point. Because where does it go?

So even our secondary approaches—which are awful, but the “Band-Aid” issue, if you will, to allow some form of water to get to people, because everyone needs some form of decent water supply to live—is now causing a residual negative impact on our landfills and recycling that was never really meant to be. We even saw this in D.C., well before Flint. So there are many examples where, just by general testing that happens all the time through our water supplies, elevated levels of contaminants of concern. Lead is not the only exposure of chemical of concern in our drinking water supply.

And let me also say, generally speaking, our water supply in this country, we do a decent job, considering day-to-day that we don’t have atrocities happening like Flint every single day. But the canary in the coal mine here is, it’s not a matter of if, it’s a matter of when the next major atrocities will happen. Because as long as we have not been investing in our water infrastructure, such as Flint has exposed—which we haven’t—there is decay naturally happening of these old lead pipes that are millions of miles of old lead piping in our country, that now many governors are scrambling, states are scrambling to try to figure out, how do we work this out? This is a problem that’s not going to happen overnight. It’s very expensive to replace these lead pipes. But there are many examples: Cincinnati, Milwaukee, Indiana. There are many states and cities that are getting very serious, and they have plans in place and they’re getting serious about how they fund this type of work.

And we’ve been extremely proud to be a part of the Lead Service Line Replacement Collaborative, a collaborative of water municipal leaders as well as public health, policy, community leaders coming together, learning from each other, talking about the realities. How do we make this more effective and efficient? What are some models, best-case example that’s happening in a certain part of the country that we can showcase and model for others? Especially when it comes to the funding. Entities and localities are getting very creative, so we want to share what others are doing. It may not be a perfect fit for your city or your state, but the point is, we cannot just continue to sit idle and just wait for the next atrocity to happen, the next millions of children and pregnant moms and families to get harmed in this country. We need to do better than that.

So there is a website, if you just put in “Lead Service Line [Replacement] Collaborative” and you’ll see this website that we launched last year with this collaborative that has an entrée for people in schools and childcare, health professionals, policy leaders. There’s a whole different way you can navigate through that space. And there’s a toolkit that helps you. If you’re a city or state that just wants to kind of get started, we start giving you some steps and some resources and who you should be starting to talk to, to try to work down what can be a very overwhelming process. But we need to do it.

TM: “Lead Service Line Collaborative.”

NW: Replacement Collaborative, yep.

TM: So I think that all of us now have to say, you know, we need to work in our communities to make sure our communities don’t have these problems with air and water and lead. But the EPA and the FDA, and maybe even the USDA right now, who we have expected to protect us, are more or less being dismantled, aren’t they? And saying so, it’s more important than ever that we start working in our communities.

NW: That’s exactly right. So, our office is literally on Capitol Hill in what’s called the United Methodist Building. It makes it very helpful when we do quickly go across the street to the Senate or the House and make our case by ourselves with our other public health leaders. And we still do that, and we will continue to do that. We will do Hill briefings, we will educate—that’s what we do. We will bring the science. However, the real groundbreaking work, the real important work right now in the vast majority is continuing right now at the state level, city level, for sure.

So the encouragement for all listeners is, do not squander, do not take advantage that your representative in the Congress or in your local level or at Senate is necessarily saying what you would like to say or supporting some of these measures. Emails count, phone calls count—their staff have to count every single time a constituent calls and emails in. So the PTAs, the Girl Scouts, Boy Scouts, whatever clubs you’re in, these all make a difference—the civic societies, as you’re having your meetings. Maybe not everyone can go, but you will learn a lot by going to some of the zoning meetings and some of the other, the school board meetings, and really hearing what they’re focusing on and, quite frankly, what they’re not focusing on.

Bring your physicians, your doctors in—they do make a difference. MDs and PhDs and all that actually do help round out a community story. A lot of congressional leaders do tend to listen to the scientist, usually, and/or the health professional, public health-trained person in the room, in addition to the personal stories that are being amplified. And many groups like ours are happy to help provide technical assistance to any of your listeners that may be interested in having such a meeting. How do you even set up a meeting? There are many of us that do that type of technical assistance. And if you reach out, myself or other groups that we work with would be happy to help in that regard as well.

TM: Wow, I am so grateful that you took the time out of what I know is your intensely busy life to really give us some good information about how we all can work for our children’s health. Thank you so much, Nse.

NW: Thank you, Theresa. It’s an honor, and this is where it all matters.