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Welcome to PSR's Environmental Health Policy Institute, where we ask questions -- then we ask the experts to answer them. Join us as physicians, health professionals, and environmental health experts share their ideas, inspiration, and analysis about toxic chemicals and environmental health policy.

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How can our regulatory system more effectively protect the health of the developing fetus?

By Laura Anderko, PhD RN

This essay is in response to: How is the developing fetus vulnerable to toxic chemical exposures, and how can our regulatory system more effectively protect our health in the prenatal period?

There is a growing concern regarding the vast number of environmental exposures that can negatively impact the health of children through pre-conceptual and prenatal exposures to the mother and father. Common exposures to toxins such as pesticides and heavy metals such as methylmercury (MeHg) impact critical windows of growth and development in the fetus and may result in life-long adverse health effects.

Despite our increasing knowledge about the untoward effects of environmental exposures on the long-term health of children, the regulatory system does little to protect mothers, fathers, and ultimately, children.

One example of a common yet unregulated exposure is methylmercury (MeHg) found at varying levels in fish. Mercury, a potent neurotoxin, crosses the placenta, with levels substantially higher in the umbilical cord blood than in the maternal blood supply. Historically, research findings indicate that prenatal exposure to MeHg can cause lifelong adverse developmental and cognitive effects, even at low doses.1-3 Children who are exposed in-utero through mother’s consumption of fish contaminated with MeHg are at increased risk of poor performance on neurobehavioral tests such as those measuring attention, fine motor function, and language skills. There is some evidence that early life exposure may also affect cardiovascular, immune, and reproductive health.4-9  

Severe health effects as a result of high poisoning events include cerebral palsy, mental retardation, deafness, and blindness, which were evidenced in the sentinel case that occurred in the 1950s in Minamata Bay, Japan. 10-11

Underscoring these findings are estimates that over 600,000 U.S. children could be exposed to unsafe levels of MeHg as a result of prenatal exposure and that of women who eat any fish at all, 50% consume more than safe levels.12 Despite these and other disturbing research results, and until very recently, there has been little political will to actively protect children from the potentially harmful health effects associated with fish consumption and MeHg exposure through regulatory mechanisms.

Two encouraging exceptions bring hope to this discussion. The first is the landmark Mercury and Air Toxic Standards that will protect children by limiting emissions of mercury and other air toxics from power plants. It is estimated that by 2016 130,000 cases of asthma among children will be prevented annually. This ruling has significant implications in protecting children prenatally as well, as reductions in mercury emissions will eventually lead to reductions in MeHg found in the fish childbearing women consume.

The second example is work currently conducted by the Children’s Health Protection Advisory Committee under the guidance of the Office of Children’s Health Protection (OCHP) of the Environmental Protection Agency (EPA). Last year, CHPAC advised the Administrator on criteria for identifying chemicals of concern for children.

More recently, a workgroup of the CHPAC was convened to specifically explore and advise on environmental exposures in the prenatal period. Areas identified as important for EPA to consider include the development of policies and practices that address the prenatal period (e.g., expanding bio-monitoring to include prenatal period); incorporating social determinants of health and environmental justice into existing programs and policies; developing a national agency-wide campaign to educate the public about prenatal hazards and prevention; and funding research that addresses the prenatal period including key outcomes and mechanisms.

These recommendations will provide a framework for action that can begin to address a stage of human development that has been all but ignored from a regulatory perspective. The potential for serious, long-term health impacts in children resulting from a wide range of pre-conceptual and prenatal environmental exposures is a legitimate concern based on evidence. It is essential that our government address them through innovative strategies that support expanded research for the preconceptual/prenatal period, collaboration between federal agencies, and improved regulatory mechanisms informed by the evidence, to protect the health of future generations.

1. Environmental Protection Agency (2012). Mercury: Human Exposure, Retrieved January 20, 2012.

2. Chalupka, S. & Chalupka, A. (2010). The impact of environmental and occupational exposures on reproductive health. JOGNN, 39, 84-102.

3. Sakomoto, M., Kubota, M., Liu, X. J., Murata, K., Nakai, K., & Satoh, H. (2004). Maternal and fetal mercury and n-3 polyunstaurated fatty acids as a risk and benefit of fish consumption to fetus. Environ Sci Tech, 38(14), 3860-3863.

4. Myers, G. J., & Davidson, P. W. (1998). Prenatal methylmercury exposure and children: Neurologic, developmental, and behavioral research. Environ Health Perspect, 106 Suppl 3, 841- 847.

5. Goldman, L., & Shannon, M. (2001). American Academy of Pediatrics and the Committee on Environmental Health: Technical Report--Mercury in the environment: Implications for pediatricians. Pediatrics, 108(1), 197-205.

6. Landrigan, P., Kimmel, C., Correa, A., & Eskenazi, B. (2004). Children's health and the environment: Public health issues and challenges for risk assessment. Environ Health Perspect, 112(2), 257-265.

7. Davidson, P. W., Myers, G. J., Cox, C., Axtell, C., Shamlaye, C., Sloane-Reeves, J., et al. (1998). Effects of prenatal and postnatal methylmercury exposure from fish consumption on neurodevelopment: outcomes at 66 months of age in the Seychelles Child Development Study. JAMA, 280(8), 701-707.

8. Salonen, J.T., Nyyssonen, Salonene, R. (1995). Fish intake and the risk of coronary disease. N Engl J Med, 333 (14), 937.

9. Laks, D.R. (2009). Assessment of chronic mercury exposure within the U.S. population, National Health and Nutrition Examination Survey, 1999-2006, BioMetals,

10. Harada, M. (1995). Minamata disease: methylmercury poisoning in Japan caused by environmental pollution. Crit Rev Toxicol, 25(1), 1-24.

11.Takeuchi, T., Morikawa, N., Atsumoto, H., & Shiraishi, Y. (1962). A pathological study of Minamata disease in Japan. Acta Neuro, 2(1), 40-57.

12. Mahaffey KR. Update on recent epidemiologic mercury studies. Proceedings of the 2004 national forum on contaminants in fish; 2004 Jan 25–28; San Diego: National Service Center for Environmental Publications, U.S. Environmental Protection Agency; 2004. p. 31-4.

Comments

Concerned Citizen said ..

Who is regulating the big white elephant in the room which neither our representatives in government nor our esteemed scientists are even mentioning and which, according to the King County Public Health Department in Washington State, they aren't allowed to investigate because it is a "Federal initiative?" What am I speaking of? "Chemtrails", the spraying of our skies with barium, aluminum oxide, and who knows what else? Who is studying the effects which the spraying of these chemicals in our air are having on our children and embryos and all of us??? Most people aren't aware this is happening around the world...until they look UP in the sky in their own community, and do a search on YouTube to see some of the thousands of videos done by citizens around the world. Fortunately, a growing number of citizens are becoming aware of chemtrail spraying and are starting to demand answers. The EPA's HERO database of scientific studies (searchable online) has one study done by a scientist in Minnesota which showed that these chemicals are ending up in our environment and in the antlers of elk. Why is no ONE talking about this? We, as citizens of a democratic society (last time I looked) have the RIGHT to know: 1) Who is calling the shots and ordering this spraying to be done? 2) WHY is it being done? (Weather modification? Attempts at radiation fallout remediation? Geo engineering? Or?) 3) WHAT are they spraying and WHO approves exactly WHICH chemicals are being sprayed? 4) How can we be sure there are no harmful effects on people and our environment? WHAT is the environmental impact and what are its CUMULATIVE, LONG TERM EFFECTS on humans, animals and the environment? (And why weren't environmental impact studies done BEFORE the chemtrail spraying was allowed to proceed? And if such studies have been done, WHY aren't the public notified about them; WHERE are these studies and how can we read them?) 5) Why is no one talking about it??? Talk about terrorizing your own citizens... :-( 6) And finally, who is PAYING for this? If it is our tax dollars, then all the more reason that we have the right to demand complete transparency on the issue (though the hazy cloud effects created by this spraying are far from transparent and cause eye, lung and nasal irritation among other health effects). Would someone in authority in the science world PLEASE step up and do the right thing and investigate and let us know? In the meantime, the world's citizens may be literally dying to find out...Thank you.

February 8, 2012

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