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Even though Americans are exposed every day to potentially harmful chemicals, the U.S. government currently does not have in place a comprehensive system to protect the public in such situations.
However, the National Conversation on Public Health and Chemical Exposures is a collaboration of RESOLVE, a nonprofit consensus-building organization; the American Public Health Association; the Association of State and Territorial Health Officials; the National Association of County and City Health Officials; and others.
As part of their mission to advance the public’s health, the Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and Disease Registry (ATSDR) supported the National Conversation. Dozens of government agency, nonprofit and industry experts and thousands of members of the public were involved in developing the recommendations.
Available online at http://www.nationalconversation.us, “Addressing Public Health and Chemical Exposures: An Action Agenda” explains that “the United States lacks a comprehensive system that fully protects the public’s health from harmful chemical exposures. The recommendations described in this Action Agenda illustrate how we can enhance and continue to build such a system in the United States.
… [The] Action Agenda calls for an increased emphasis on preventing harmful chemical exposures, reforming outdated and ineffective policies, promoting the health of children and other vulnerable populations, and improving our ability to make or engage in difficult decisions, often in the face of uncertainty. The Action Agenda also recommends improving data access and management, expanding systems for monitoring chemical exposures and health outcomes, and building scientific knowledge on many fronts, such as through faster evaluation of chemical hazards.”
Dr.Christopher Portier, director of the National Center for Environmental Health and Agency for Toxic Substances and Disease Registry at CDC, said: “The National Conversation on Public Health and Chemical Exposures was grounded in the vision of a nation that uses and manages chemicals in ways that are safe and healthy for all people. This vision grows out of the nation’s rising awareness that human health and the environment are deeply intertwined. Many Americans have important questions about chemicals and health that have not yet been answered adequately. Are the products I use every day safe? Are they safe for my children? Where can I go for clear information? What accounts for the health problems I see in my community? These and other similar questions are legitimate and deserve our nation’s attention. I look forward to carefully reviewing the Action Agenda and considering ways that it can help NCEH/ATSDR better protect the public from harmful chemical exposures.”
Nsedu Obot Witherspoon, executive director of the Children’s Environmental Health Network, said: “Imagine a nation where families with children and other members of a community know their water, soil, air, homes, schools and places of work and recreation are healthy for everyone and free from chemical hazards. The National Conversation was born out of this vision, and out of a widely shared desire to consider past successes, identify current challenges and highlight solutions that would promote a health-protective chemical safety system. The National Conversation Action Agenda includes steps that each of us can take to bring us closer to the vision of a nation that uses and manages chemicals in ways that are safe and healthy for all people.”
Gail Shibley, administrator of the public health division, office of environmental public health, at the Oregon Department of Human Services/Oregon Health Authority, said: “States play an important role in setting and enforcing protective policies and conducting surveillance, and take seriously their responsibility to protect their citizens. The recommendations in the Action Agenda reflect the input of many state and local public health and environmental health practitioners, and include several concrete actions that would significantly improve state and local efforts to protect the public’s health from harmful chemical exposure.”
Dr. Daniel Goldstein, lead, Medical Sciences and Outreach at Monsanto, said: “The National Conversation was a collaborative process, and the Action Agenda reflects the input of thousands of individuals who bring a wide array of experience and perspectives. I served as one of the voices of industry involved in this process. While we in the chemical industry have made important progress in better protecting the public’s health, there are clearly areas in which industry can and should collaborate, and sometimes even take the lead, in doing a better job. The Action Agenda contains specific recommendations that will fairly, effectively and collaboratively promote public health, and includes suggestions for ways industry can work with government agencies and other partners to that end.”
ACTION AGENDA RECOMMENDATIONS
The new “Action Agenda” outlines a total of 48 recommendations in seven major chapters:
1. PROTECT PUBLIC HEALTH BY PREVENTING HARMFUL CHEMICAL EXPOSURES. A more effective approach to preventing harmful chemical exposures would begin with using inherently safer chemicals, reforming the Toxic Substances Control Act (TSCA) and protecting children’s health. Government and industry can and should support the substitution of hazardous chemicals with less toxic alternatives through multiple means, based on the principles of “green chemistry.” Reform of TSCA should incorporate a preventive, partnership-based approach emphasizing alternatives assessment and encouraging industry action to provide essential health and safety information on all chemicals in commerce. The effects of chemical exposures on children and other vulnerable populations need greater policy attention, and interventions must protect such populations.
2. COLLECT AND USE INFORMATION ON CHEMICALS AND POPULATION HEALTH TO ENABLE EFFECTIVE PUBLIC HEALTH PROTECTION. To protect public health, the United States needs to enhance information collection in at least four areas: chemical use and release, environmental concentrations, levels within humans and other species, and health outcomes. Priorities for action are to improve health outcome data quality, quantity and availability; expand the use of biomonitoring; and improve reporting of information on chemical source, use, discharge and manufacturing volume. A national state-based biomonitoring network is needed to provide better information on human exposures to chemicals in different parts of the United States. To improve reporting of information on chemical source, use, discharge and manufacturing volume, the Action Agenda calls for enhancing the Toxics Release Inventory and increasing the frequency of the TSCA Inventory Update Reporting Rule.
3. ACHIEVE A MORE COMPLETE SCIENTIFIC UNDERSTANDING OF CHEMICALS AND THEIR HEALTH EFFECTS. Advancements in chemical hazard testing, as suggested in the 2007 National Academy of Sciences’ report Toxicity Testing in the 21st Century, are needed to support preventive decision making. Data gaps must be filled quickly to allow federal agencies to identify chemicals posing the greatest potential hazards. Additional exposure assessment protocols and tools should be developed to understand and predict when and where exposures occur along chemical product and process life cycles and across human life stages.
4. PROMOTE HEALTH AND WELLNESS IN VULNERABLE COMMUNITIES AFFECTED BY ENVIRONMENTAL CHEMICAL EXPOSURES. To promote health and wellness in communities and populations affected by environmental exposures, government at all levels must implement policies and practices that overcome environmental injustice and improve the resiliency, safety and health of vulnerable communities. Immediate action should be taken to protect the health of disproportionately affected communities. Developing simplified cumulative risk assessment tools that allow for screening-level assessments can help identify disproportionately affected communities and inform the public. To enhance community health protection, the Agency for Toxic Substances and Disease Registry (ATSDR) should broaden the scope of the actions it takes and supports in communities.
5. STRENGTHEN THE PUBLIC’S ABILITY TO PARTICIPATE EFFECTIVELY IN ENVIRONMENTAL HEALTH DECISION MAKING. Government agencies should develop and implement a multidirectional model for communication efforts concerning chemical exposures and health. Government and industry should improve public access to information on chemicals used or present in products throughout the supply chain. Environmental and occupational health educational opportunities for adults and children should be enhanced to build environmental health literacy. In addition, a comprehensive federal Internet portal should be created through which the public can access information on chemicals and health. Public access to data also can be increased by
balancing confidentiality and data quality concerns, providing study participants with the results of tests performed on them and providing access to quality local studies on chemical exposures.
6. STRENGTHEN THE CAPACITY OF THE PUBLIC HEALTH AND HEALTH PROVIDER WORK FORCE TO ADDRESS THE NEEDS OF PEOPLE EXPOSED TO HARM FROM CHEMICALS. The nation needs to endorse and support public health agency accreditation standards related to chemical exposures, develop clinical practice guidelines for diagnosing and addressing harmful chemical exposures, expand environmental health professional training opportunities and support reimbursement for environmental healthcare services.
7. REDUCE HARM FROM CHEMICAL EMERGENCIES THROUGH PREVENTION, PLANNING AND COORDINATION. The federal government should identify an office or program to create consistency and avoid redundancy of information on chemical emergencies. In addition, the government should coordinate chemical emergencies better, assess and improve the healthcare response to hazardous chemical releases, and develop a toxicologic hazard-vulnerability assessment planning tool for local response.
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