The primary focus of efforts to address the burden of chronic disease in the US is on secondary prevention: measures to catch the disease early and manage it effectively so that symptoms are prevented and people can live well with it. To the extent that there is focus on primary prevention—preventing disease in the first place—it tends to be on individual “lifestyle” improvements, rather than on population-level actions that would reduce factors or exposures associated with the onset of disease. Though these “healthy lifestyle” activities are critically important (efforts to reduce smoking and improve diet are yielding impressive results), they miss the full range of avoidable causes found in the environment in homes, schools, workplaces and communities.
As ongoing research continues to uncover new associations between chemicals and a range of health problems, and monitoring shows how ubiquitous these substances are, there is a growing awareness among environmental health scientists and policy advocates that environmental and occupational exposures must be addressed in our cancer and asthma prevention efforts. Understandably, patients suffering from chronic disease, their families, their doctors and disease advocacy groups focus on how to live with the illness rather than on how to prevent it in the first place. As they learn more about causal factors, they may be able to expand their attention, but primary prevention also needs new constituencies. By building a common understanding of the potential health benefits of eliminating toxic chemicals and introducing clean technologies, powerful new coalitions including health providers, health charities, community development organizations and clean technology entrepreneurs, can come together to make fundamental changes in health and technology policy leading to improved health outcomes.
The Lowell Center’s close working relationship with our sister organization, the Toxics Use Reduction Institute, gives us unique capacity to understand associations between environmental exposures and disease and to promote technologies, materials and products designed to enhance rather than undermine human health.
Activities
“Chronic Disease Prevention through Safer Materials, Products and Technologies” engages and educates public and private health organizations in Massachusetts about links between chemicals and health and about safer alternatives, and encourages them to embrace a broader vision of preventing the onset of disease at the same time as they work to improve disease management on behalf of those who are already afflicted. The
- The first project activity was to review data about chemicals used in the Commonwealth In late 2008, we released a report entitled “Asthma-Related Chemicals in Massachusetts: an Analysis of Toxic Use Reduction Act Data,” which explored the extent to which chemicals that can cause the initial onset of asthma or trigger subsequent asthma attacks are being used by Massachusetts businesses that report under the Toxics Use Reduction Act (TURA) program—a Massachusetts law passed in 1989 to encourage the reduction in amounts of toxics and toxic byproduct used or generated by Massachusetts industries. This report and presentations on it made by EHP staff has resulted in the addition of a chemical’s capacity to cause asthma as a criterion in identifying higher hazard chemicals, which are subject to lower reporting thresholds and where efforts to find safer alternatives are targeted.
- A second activity was to contribute to the development of the state Strategic Plan for Asthma in Massachusetts 2010-2014. Thanks to work by EHP and its partners, the plan calls on the Department of Public Health (a) to develop a road-map to better understand the causes of asthma and the role of primary prevention, and (b) to understand uses and releases of chemicals in Massachusetts that have been found to trigger asthma attacks and also cause asthma in some cases, and develop strategies for replacing them with safer alternatives. EHP is seeking funding to convene researchers and stakeholders to develop the Roadmap. We are also inviting employers and health payers to partner with us in implementing the three strategies we recommend in our Purchaser Business Case, including ensuring healthy work environments by reducing the use of toxics associated with asthma.
- For 2010, we are planning projects to watchdog the health hazards associated with so-called “green technologies,” and engage constructively in promoting safer alternatives. We believe that the threat of climate change warrants urgent action to promote technologies that reduce reliance on fossil fuels. Yet for these technologies to be viable over the long-term, they must be designed so that they do not threaten human health. Our first project in this area will examine the hazards associated with large-scale burning of biomass, and seek a way forward that addresses both energy needs and health concerns.
