Wednesday November 25th 2015

Rising threat of environmental toxins, link to chronic diseases

By Kathy Attar, MPH, and Karen R. Bowman, MN, RN, COHN-S

In recent years nurses have witnessed increasing numbers of patients being treated for chronic diseases. Obesity rates have skyrocketed in children and adults; in 2010, more than one-third of U.S. adults (36 percent) were obese, as were 17 percent of children and young people, according to the Centers for Disease Control and Prevention (CDC). Developmental disabilities in children increased 17 percent between 1997 and 2008, as noted in “Trends in the prevalence of developmental disabilities in US children, 1997-2008,” published in 2011 by the journal Pediatrics. Most childhood cancers are on the rise; in fact, according to the National Cancer Institute, the incidence of acute lymphocytic leukemia increased by 73 percent and primary brain cancer by 70 percent from 1975 through 2010 among children 0-14 years.

Also increasing is exposure to hazardous chemicals in homes, workplaces and neighborhoods. Many health professionals believe that chemicals are tested before they are put into products such as furniture, toys, food packaging and beauty products, but on the contrary, they get onto the shelves with very little scrutiny. More than 80,000 chemicals are on the market today, and only a tiny percent have been tested for health effects. This is worrisome, since the evidence continues to grow that exposure to harmful chemicals can lead to serious disease. The chemical BPA provides a good example. Tests have shown that almost every person in the United States has BPA in his or her body. Polycarbonate plastic is a major source of exposure, along with canned food, dental sealants and thermal copy paper.

BPA exposure has been associated with adverse neurobehavioral development, cancer, asthma and fertility problems. In addition, laboratory studies suggest that BPA promotes obesity and may increase cardiovascular risks. The alarming rise of chronic diseases in the United States costs lives, inflicts suffering and drives up health care spending. In 2014, Health Affairs published research by Leonardo Trasande, MD, which shows that BPA-associated childhood obesity and adult coronary heart disease cost our nation $2.98 billion annually. Nurses and other health care providers must advocate for a federal chemical policy that is health protective and must include:

1) Measures to ensure that states continue to have authority to pass stronger safe chemical bills.

2) Rules that require chemicals be shown safe to remain in use, rather than requiring they be shown harmful in order to be removed.

3) Protections for disproportionally disadvantaged populations in any reform bill — children, elderly, pregnant women and infants, and people with disabilities, as well as families that live within a close radius of chemical plants.

4) Regulatory authority for the Environmental Protection Agency (EPA) to make chemical determinations based solely on health in order to address the practice of replacing one toxic chemical with another.

Unfortunately, reform proposals in the Senate Chemical Safety Improvement Act (S. 1009) and the House Chemicals in Commerce Act (draft legislation) fall far short of protecting the public from the health impacts of hazardous chemicals found in our air, water and consumer products.

Fixing our broken system of chemical regulation is a win-win. Reducing the exposure of toxic chemicals in our everyday products found at work, home and community will improve our health and well being. Additionally, it will reduce the emotional and financial toll on families and reduce the pressure on our already overburdened health care system by mitigating preventable causes of disease. Prevention is the key.

— Kathy Attar is the toxins program manager at Physicians for Social Responsibility.
Karen Bowman is the president of Karen Bowman & Associates, Inc., and the
environmental health specialist for the Washington State Nurses Association.

ANA resources

ANA has long advocated for universal reduction of toxic chemical use.

Read ANA’s 2006 House of Delegates’ resolution “Nursing Practice, Chemical Exposure and Right-to-Know”  at

Read ANA’s Principles of Environmental Health for Nursing Practice with Implementation Strategies on

In ANA’s Scope and Standards of Practice, standard 16 “Environmental Health” states that the RN practices in an environmentally safe and healthy manner. To order, visit

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