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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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The Role of Green Chemistry in Primary Prevention

By Lin Kaatz Chary, PhD MPH

This essay is in response to: How can innovations in technology and research reduce exposures to toxic chemicals?

There is a fundamental connection between public health and the principles of Green Chemistry – both are rooted in the core of public health practice, which is primary prevention. Primary prevention is about eliminating in the inherent hazard in any given situation, and thereby making the risk moot. There are two other levels of prevention. Secondary prevention accepts that there are things out there that can cause harm – viruses, microbes, toxic chemicals –  any number of dangers exist in the real world. Secondary prevention focuses on limiting the population's exposure to those dangers, thereby minimizing the risk of harm. Such efforts by definition do not work toward actually eliminating the causative factor itself. Tertiary prevention is the last rung – this is the realm of disease and injury, and the treatment of disease and injury after it has happened to prevent further damage. All three levels of prevention are equally necessary and all are important in maintaining the public's health.

In the history and development of public health practices, we have seen first-hand how innovations in technology and research reduce risk and exposure. Innovations in technology brought benefits such as the ability to purify water to make it safer for drinking, more advanced sewage treatment techniques, safer automobiles – the list is long and impressive. Innovations in research have brought us equally enormous benefits: vaccines to prevent disease, drugs to treat illness and injury, and surgeries that were unimaginable even 50 years ago to treat all kinds of maladies. Public health and medicine have relied extensively on innovations and technology to bring forward the most advanced potential for healing ever known.

Given this remarkable trajectory of progress and imagination, the abject inability of the chemicals industry to use its technology and innovation to transition away from toxic chemicals seems at first glance inexplicable. Human beings have managed to design and create the technology that is the very foundation of tertiary prevention, but we are still incapable of producing lawn chemicals that don't poison children and the environment. We've created the technology to manufacture a staggering number of products that are responsible for the lifestyle most Americans enjoy, but we are unable to persuade cosmetic manufacturers to stop putting lead and other toxic constituents into lipstick and other personal products. We can figure out how to create astonishing prosthetics to replace lost and damaged limbs, but we still haven't figured out how to create the technology to protect the environment and human health from thousands of tons of toxic emissions and discharges into our air and water. What is wrong with this picture?

How do we move from being firmly entrenched in a tertiary prevention mode when it comes to toxic chemicals to a primary prevention mode? The Twelve Principles of Green Chemistry offer a strategy, but at the same time those who promote Green Chemistry recognize that a strategy is not enough. Two additional conditions are mandatory – the non-toxic (and in the interim, the less toxic) chemicals must also be more efficient than the ones they are replacing, and they must offer a competitive market advantage to the user. Creating one-for-one swaps will not be economically feasible, and what's the incentive? Why spend the millions of dollars to retool when what you have is "good enough"? (Good enough for whom, of course, is the question, but that is not an answer that technology and innovation can provide.) This is the exact moment at which innovation and technology are most called for – to seek ways to eliminate or at least greatly reduce hazards, while maintaining market efficiency.  

The practice of Green Chemistry, that is, setting the principles as the aspirational goal for everything that is done, embodies the best potential for this type of innovation and technology, and it is inherently a primary prevention approach. Transitioning to a society, and indeed, a culture, which seeks to free itself from its toxic economy (in every sense) is an enormous effort. We are talking about redesigning the very chemicals and products that underlie the American lifestyle, and doing it in a way that creates not only a safer and healthier environment, but a safer and healthier workplace, and ultimately, a healthier bottom line. And we are talking about transforming our funding priorities and the education of our science and chemistry students from their first exploration of the field. We are talking about putting primary prevention at the top of our checklist when making the wide range of decisions that inform policy, funding, education, and research.

Technology and innovation will always assume the values of those who engage in them, and those who pay for them. It will produce the answers only to the questions asked, and lead to outcomes based only on the objectives for which they are being put to use. Those of us who ground our efforts in promoting the constant interaction between public health and chemicals policy will always focus on primary prevention as the most important value on this playing field. Our toolbox is getting bigger but there is still a long way to go. Innovations in the fields of biomimicry and nanotechnology, for example, have the potential to expand this toolbox, but only if the Principles of Green Chemistry inform them from the start, which has not necessarily been the case so far. Putting technology and innovation into the service of primary prevention must become the guiding principle for the design of chemicals, their by-products, and their end of life. We need only to remember the nearly universal excitement that accompanied the development and accessibility of chemicals such as DDT, PCBs, and many brominated fire retardants – great innovations! – to consider what our future could look like if we remain satisfied with a tertiary approach to chemicals policy. We must demand now that primary prevention be the guiding principle of all innovation and subsequent technologies. It is our only chance to repair past mistakes, and to assure that we will avoid them in the future.

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