>> GOOD MORNING, EVERYONE.
I'M VERY HAPPY TO BE HERE TODAY
TO WELCOME YOU TO DAY TWO.
YESTERDAY I WAS WATCHING THIS
WONDERFUL WORKSHOP ONLINE AND I
WANT TO THANK DR. CHIDEYA AND I
WAS TOUCHED BY THE COMMUNITY
ENGAGEMENT AND PUTTING A
PERSONAL TOUCH TO THE SCIENCE
THAT WE'RE DISCUSSING.
AS DR. LANGEVIN SAID YESTERDAY
THEY'VE BEEN DEDICATED TO THE
WHOLE PERSON HEALTH AND
LISTENING TO THE TALKS IT'S
CLEAR THE ISSUES WE'RE
DISCUSSING TOUCH MULTISYSTEMS
AND ORGANS AND WAS PLEASED TO
SEE WHAT THE POTENTIAL
COMPLEMENTALLY AND INTEGRATIVE
HEALTH CAN BRING TO THAT
DISCUSSION.
SO YESTERDAY'S TALK ON LIFESTYLE
INTERVENTION YOU, THE
MICROBIOME, THE NATURAL PRODUCTS
AND MIND AND BODY APPROACHES
WERE HELPFUL.
AS I WAS LISTENING TO THE TALK
YESTERDAY THOUGH I WAS
CONNECTING THE DOTS BECAUSE I
THINK THERE IS A LOT THAT CAN BE
DONE.
THE PROBLEM IS ENORMOUS AND
NCCIH OBVIOUSLY IS A SMALL
CENTER AND THEREFORE WE'VE
ALWAYS LEVERAGED EXISTING
INITIATIVE TO ACTUALLY
ACCOMPLISH THE LOFTY GOALS THAT
WE HAVE.
SO ONE OF THE INITIATIVE I'D
LIKE TO BRING YOUR ATTENTION TO
IF YOU'RE NOT ALREADY FAMILIAR
WITH IT IS THE IMPROVE
INITIATIVE WHICH IS LED BY THE
NATIONAL INSTITUTE OF CHILD
HEALTH AND HUMAN DEVELOPMENT AND
THE OFFICE OF WOMEN'S HEALTH
RESEARCH.
IMPROVE STANDS FOR IMPLEMENTING
MATERNAL HEALTH IN PREGNANCY
OUTCOME VISION FOR EVERYONE.
THEY'RE VERY INTERESTED IN
LOOKING AT FUNDING RESEARCH THAT
REDUCE PREVENTIBLE CAUSES OF
MATERNAL AND IMPROVE HEALTH FOR
WOMEN, BEFORE, DURING AND AFTER
PREGNANCY.
SO OBVIOUSLY WE TALKED ABOUT THE
BEGINNING OF LIFE ALSO EARLY
CHILDHOOD AND THIS INITIATIVE
WOULD BE A GOOD OPPORTUNITY FOR
RESEARCHERS INTERESTED IN THAT
SPACE.
WE CURRENTLY HAVE FUNDING
OPPORTUNITIES THAT'S CURRENT.
THE NEXT RECEIVE DATE IS OCTOBER
25, 2024 AND THE INITIATIVE WILL
GO ON THROUGH 2027.
THIS IS ONE OPPORTUNITY I'D LIKE
TO HIGHLIGHT.
THE OTHER ONE SOME OF YOU THAT
ARE ALREADY IN THE SPACE
PROBABLY ARE AWARE OF THE ECHO
PROGRAM WHICH IS ENVIRONMENTAL
INFLUENCES ON CHILD HEALTH
OUTCOME.
AGAIN, THIS IS AN OPPORTUNITY TO
COLLABORATE WITH INVESTIGATORS
FUNDING THROUGH THE PROGRAM AND
INSERT THE RESEARCH WE TALKED
ABOUT YESTERDAY INTO THE
INITIATIVE.
THE OTHER INITIATIVE THAT I'D
LIKE TO HIGHLIGHT IS ONE THAT
THE NATIONAL INSTITUTE OF DRUG
ABUSE HAS SPONSORED THE PAST
CLOSE TO 10 YEARS NOW THE ABCD
STUDY THE ADOLESCENT BRAIN
COGNITIVE DEVELOPMENT STUDY.
THEY JUST RENEWED THE PROGRAM
FOR ANOTHER SEVEN YEARS AND ONE
OF THE AREAS OF INTEREST OF THEM
IS EXPOSURE TO ENVIRONMENTAL
INFLUENCES.
SO AGAIN, UTILIZING EXISTING
PROGRAMS AT THE NIH AND
POTENTIALLY NESTING NEW STUDIES
INTO THE PROGRAM.
FOR NCCIH A YEAR AND A HALF AGO
WE HAD A VERY IMPACTFUL WORKSHOP
ON PRECISION PROBIOTICS AND I
CAN'T GIVE YOU THE DETAILS BUT
WATCH OUT FOR AN INITIATIVE
COMING DOWN SOON IN THAT
CONTEXT.
AND SO AGAIN THAT WOULD BE
ANOTHER OPPORTUNITY.
SO THE MESSAGE I WANT TO GIVE
YOU IS THAT THERE IS A LOT OF
WORK TO DO BUT WE DON'T NEED TO
START FROM SCRATCH.
THERE'S A NUMBER OF EXISTING
INITIATIVES AT THE NIH THAT ARE
VERY APPROPRIATE THAT WOULD
ACTUALLY FOSTER
MULTI-DISCIPLINARY RESEARCH AND
COLLABORATIONS AND THAT'S
THE MESSAGE I HAVE FOR YOU AS I
DEVELOP THIS FIELD OF
INCORPORATING COMPLEMENTARY AND
INTEGRATIVE HEALTH APPROACHES TO
TACKLE THE VERY VEX BEING
PROBLEM.
SO I LOOK FORWARD TO LISTENING
MORE IMPACTFUL PRESENTATION
TODAY AND THANK YOU VERY MUCH.
>> THANK YOU SO MUCH
DR. EDWARDS.
JUST TO INTRODUCE MYSELF AGAIN
I'M DR. SAKAI CHIDEYA AND WE'RE
GLAD YOU'RE HERE FOR THE SECOND
DAY OF WHAT'S TURNING OUT TO BE
A WONDERFUL AND INSPIRING
WORKSHOP.
I APOLOGIZE FOR THE TECHNICAL
GLITCHES WE HAD YESTERDAY
MORNING.
I HOPE PEOPLE SIGNED ON AGAIN
AFTER HEARING A LOT OF SPANISH
THE FIRST 10 MINUTES.
I WANT TO REMIND FOLKS THERE'S A
QR CODE AS WELL AS AN URL AND
THAT WILL SHOW THE FULL PROGRAM
AGENDA AS WELL AS THE BIOS OF
ALL THE SPEAKERS.
SO WE'RE NOT GOING TO BE
SPEAKING THE BIOS ALOUD AT THE
BEGINNING AND THE WORKSHOP IS
BEING REPORTED AND IT WILL BE
POSTED ON THE NIH WEB PAGE AND
FREE FOR ANYONE TO ACCESS.
THAT WILL PROBABLY BE POSTED A
WEEK OR TWO AFTER THE EVENT IS
OVER.
IF YOU MISSED SOME OF THE SEGS
OR MISSED DON'T FRET BECAUSE IT
WILL BE ON THE NIH WEBSITE.
LET US START WITH TODAY A GREAT
OPENING SPEAKER MS. LAURENE
ALLEN FROM THE MERRIMACK CITIZEN
FOR CLEAN WATER SOMEONE
PERSONALLY AFFECTED BY ENDOCRINE
DISRUPTORS CHEMICALS.
COME ON UP.
>> NO SLIDES JUST ME AND MY
STORY.
I LIVE IN MERRIMACK, NEW
HAMPSHIRE.
I'VE LIVED THERE SINCE 1985 AND
A CLINICAL SOCIAL WORKER AND
WENT THERE TO RAISE A FAMILY AND
MASSACHUSETTS WAS GETTING BUSY
IN THE '80s TO MORE SPACE, GREEN
SPACE.
WHAT I BELIEVED WAS A REALLY
PRISTINE ENVIRONMENT, SAFE, GOOD
SCHOOLS, ALL THE THINGS YOU
WOULD WANT TO RAISE A FAMILY.
I AM A PERSON WHO LIVED MY LIFE
PAYING ATTENTION TO THINGS LIKE
EDCs AND PLASTICS AND THINGS
LIKE THAT AND RAISED MY KIDDOS
TO READ LABELS.
I HAD THE PLEASURE OF LIVING IN
A TOWN WHO HAD THE BEST TASTING
WATER IN NEW HAMPSHIRE FOR MANY
YEARS.
PFAS ARE INVISIBLE AND TASTELESS
AND TOXIC CHEMICALS.
TO MY SURPRISE IN 2016 TO BE
TOLD THE WATER WE BELIEVED TO BE
SAFE AND WE DRANK FREELY FROM
THIS TAP -- WE DID NOT BUY
BOTTLED.
WE FELT SECURE ABOUT IT WITH THE
WATER REPORTS AND FILLED UP THE
GLASS AND THOUGHT WE WERE DOING
THE RIGHT THING.
WE LEARNED A MANUFACTURING
FACILITY IN THE NORTHEAST PART
OF MERRIMAC HAD BEEN EMITTING
AND POURING CHEMICALS AND MANY
ACTS ILLEGAL.
THE REGULATORY IS A WHOLE OTHER
TALK.
FOR MANY YEARS THEY USED PFE TO
COAST FABRIC SO THE FABRIC
COATING IF YOU'VE BEEN TO LONDON
WHEN THE MILLENNIAL DOME CAME
OUT THEY CREATED THE FABRIC
WHICH IS LIGHT FIBERGLASS CLOTH
SOAKED IN TEFLON BASICALLY AND
SATELLITE COVERS AND THE BRONCO
STADIUM COVER THERE, THE DENVER
AIRPORT, THOSE TYPES OF THINGS
YOU SEE UP THERE IS THEIR PATENT
AND WHAT THEY'VE MADE.
THEY'VE PROFITED FIVE YEARS.
THE FIRST FIVE YEARS IS
INVESTIGATION, $94 BILLION
PROFITS IN OUR EXPENSE LITERALLY
PHYSICALLY AND DOD CONTRACTS
PRIMARILY AND I DIDN'T KNOW WHAT
THEY WERE DOING.
AS THE INVESTIGATION DEVELOPED
OVER THE YEARS IT'S DESIGNATED
AS THE LARGEST CONTAMINATION
INVESTIGATION IN NEW ENGLAND AND
NOT JUST NEW HAMPSHIRE AND WE'RE
AN AREA THAT HAS A VERY DECENT
INCOME SO THIS IS NOT A TOWN
THAT YOU WOULD EXPECT TO SEE
THIS IN, WHICH IS NOT OKAY.
SO THE UNDUE BURDEN IS THERE.
THE SOCIAL ECONOMIC IS STRONG SO
GIVEN WHAT WE WOULD SEE AS A LET
MORE PRIVILEGE, A LITTLE MORE
POWER YOU WOULD THINK THAT STORY
WOULD GO DIFFERENTLY IN WHAT
YOUR ASKS WERE AND THE RESPONSES
ARE THE SAME EVERYWHERE, DENIAL,
MINIMIZATION AND SEPARATION OF
EXPOSURE TO OUTCOME VERY
ENGRAINED.
SO IN THE BEGINNING THE STATE
GAVE AN INFO MEETING PRIMARILY
FOCUSSED ON WHAT THEY WERE DOING
AND WHAT THEY WERE GOING TO DO
IN THE INVESTIGATION.
IT WAS VERY LIMITED TO A SMALL
AREA.
WE WERE TOLD IT WAS ONLY A FEW
PRIVATE WELLS AND TWO PUBLIC
WATER WELLS CLOSE AND THAT
WASN'T TRUE.
AT THAT POINT THEY WERE LOOKING
AT WHAT TESTED OVER 100 PARTS.
THEY CONTINUED TO TEST PRIVATE
WELLS AND FOUND MORE AND MORE
OVER 4,000 WERE IDENTIFIED OVER
THE 70 PART MCL AND NOW WE'RE AT
THE FOUR-PART FEDERALLY AND THAT
WILL SHOW MORE HOMES WHO WERE
TOLD SIX YEARS AGO THEY WERE
SAFE.
SO THIS FALSE SENSE OF SECURITY
AND NARRATIVE WAS GIVEN FOR A
LONG TIME.
LET'S GO BACK TO THE FIRST
MEETING.
I SAW OLDER NEW ENGLANDERS STOIC
AND OF OLDER AGES WHEN YOU ASKED
HOW THEY'RE DOING THEY SAY FINE
AND I'M MARRIED ONE OF THOSE NEW
ENGLAND DIE-HARDS.
THEY'RE ALWAYS FINE.
THEY WERE GOING UP TO THE
MICROPHONE AND DISCLOSING AND
LOOKED NERVOUS AND HADN'T SPOKEN
THIS WAY BEFORE AND THIS IS WHAT
MY WIFE STRUGGLED WITH AND I'VE
STRUGGLED WITH AND WHAT MY
NEIGHBOR HAD AND MY CHILD AT 14
HAD THEIR THYROID REMOVED.
COULD IT BE THE WATER?
THE STATE WILL NOT SAY YES, I'M
NOT NAIVE BUT THE RESPONSE WAS
SILENCE, SILENCE, SILENCE AND
LAST DISCOMFORT FROM THE PEOPLE
WHO WERE THERE WHOSE JOB IT WAS
TO GUIDE US.
AT THIS POINT IF YOU DISCOVERED
YOU HAD ANYTHING GOING ON IN
YOUR COMMUNITY YOUR RESPONSE IS
BETTER AND WE WORKED WITH THE
STATE AND FEDERAL GOVERNMENT AND
THE RESPONSES WERE A TRAVESTY.
THE SLIDES SHOWN TO US WITH
INFORMATION ABOUT PFAS AT THAT
POINT KEPT THE FOCUS ON PFOA AND
WERE TOLD IT WAS AN EMERGING
CONTAMINANT AND NO SCIENCE AND
NO WAY TO SHOW YOUR HEALTH COULD
BE RELATED TO EXPOSURE.
SO IT DIDN'T SEEM RIGHT TO ME.
IT WASN'T BUYING IT AND HAD A
BAD FEELING AND WAS THINKING
ABOUT ALL THE STORIES I HEARD
AND THE PATTERNS OF CANCERS AND
DEATH AND MULTIPLE HEALTH
CONDITIONS AND STARTED READING
THE CHATTER ON SOCIAL MEDIA
BECAUSE PEOPLE CONTINUED TO TALK
AND I REALIZED THIS IS A PROBLEM
AND JUST NOT IN A CONCENTRATED
AREA WHICH IS ALL OVER TOWN
WHICH CAUGHT MY ATTENTION.
AS I DID MY OWN RESEARCH ON THIS
CLASS OF CHEMICALS PFOA I WENT
TO THE STATE AND SAID YOU'RE
SAYING THERE'S NO SCIENCE WHAT
ABOUT THIS THERE'S A SAMPLE OF
70,000 PEOPLE SEEMS DEFINITIVE
TO ME THE HEALTH ACKNOWLEDGED
ARE EVERYWHERE AND THERE'S MORE.
WELL, THAT ISN'T REAL SCIENCE IT
WAS A LAWSUIT.
IT WAS CONTINUAL -- THERE'S NO
SCIENCE, NO WILLINGNESS TO COME
AND HEAR PEOPLE, COLLECT HEALTH
DATA, DO SURVEYS.
A REFUSAL TO BLOOD TEST PEOPLE
AND ON AND ON IT WENT.
AND IT CAME TO ME WHEN A
POLLUTER IS NEGOTIATING WITH THE
STATE THEY'RE WORKING BEHIND
CLOSED DOORS TOGETHER AND THE
PUBLIC IS NOT IN THAT
DISCUSSION.
SO IT WAS REALLY IMPORTANT TO ME
TO BECOME INFORMED AND START
ORGANIZING WITH PEOPLE,
EDUCATING EACH OTHER,
ADVOCATING, HAVING COFFEES WITH
PEOPLE AT THE WATER DEPARTMENT
WHO WERE NOT THE ENEMY, THEY
FOLLOWED THE LAW TO SAY HOW ARE
YOU GUYS DOING WITH ALL THIS
STRESS?
WE BUILT BIT BY BIT LOCAL
REPRESENTATION AND LOCAL
GOVERNMENT AND WATER UTILITIES
ALL TOGETHER.
WE EDUCATED EACH OTHER WITH THIS
CITIZEN GROUP AND HAD MEETINGS
AT THE LIBRARY TWO NIGHT A
MONTH.
LISTENED TO PEOPLE WHO CAME WITH
STORIES TO TRY TO GIVE THEM
RESOURCE AND GUIDANCE BECAUSE NO
ONE WAS DOING THAT.
IT WAS NEIGHBOR HELPING
NEIGHBOR.
AS IT PROGRESSED WE PUSHED FOR
NO LAWS AND NO ONE FELT ANY
EXPOSURE WAS SAFE AND WE WERE
HEARING THIS PHASE.
YOU'RE UNDER 70 PARTS.
THE TWO WELLS CLOSED WERE OVER
100 BUT YOUR PFAO IS RANGING
FROM 17 SO 34 PARTS AND YOU'RE
BLENDED AND SAFE AND I WAS
SAYING DO NOT USE THE WORE WORD
SAFE.
IT'S IT'S IN COMPLIANCE AND IT'S
AN EVOLVING AREA OF INTEREST
DON'T TELL PEOPLE THEY'RE SHAVE.
SO PRIVATE WELLS THE ONES
GETTING CONCERNED AND SAYING
SHOULD WE TEST WATER AND THEN
GET THE RESULTED AND IF ANY HAVE
SEEN THE FORMS THEY'RE NOT EASY
TO INTERPRET.
SO THEN I START GETTING CALLS.
CAN YOU COME OVER AND TELL ME
WHAT THIS MEANS?
I THOUGHT I BETTER GET A CRASH
COURSE IN HOW TO INTERPRET THIS
AND REACH OUT TO SCIENCE FOLKS
EN MASSE AND THEY HELPED AND I
SAID FINE.
OVER AND OVER THEY'D SAY THE
PFAO IS UNDER 70 AND I SAID NO
WHY ARE WE TESTING FOR THE WHOLE
PANEL IF THEY AREN'T OF CONCERN
AND THEY SAID THAT'S A GOOD
POINT.
I STARTED SEEING THE PROFILE
AFTER PFA O IS PHPPA AND WHAT I
KNOW NOW ARE THE C3s AND SOME
C2s AND SOME C 6s AND THE
SCIENCE OF PFAS GOES ON AND ON.
TO MAKE A LONG STORY SHORT,
THERE'S MORE THAN PFAO IN YOUR
WATER.
I WOULD SAY LET'S ADD THIS YOU
WILL UP.
THERE'S SO OF THIS AND THIS.
ALL TOGETHER IT EQUALS 143 PART
PER TRILLION NOT 17 FOR PFAO ARE
YOU COMFORTABLE WITH THAT AND
THEY'D STOP AND SAY DO YOU THINK
ALL ARE A PROBLEM?
WELL, YEAH.
I SAID TO ME THEY'RE A PROBLEM.
WE WORKED HARD AND GAINED 93% OF
THE VOTE IN MY COMMUNITY WHO
VOTED FOUR AND A HALF YEARS AGO
TO REMEDIATE ALL OUR PUBLIC
WELLS TO NON DETECT.
THIS IS NOT MANDATED BY FEDERAL
AND NEW HAMPSHIRE MCLs HAD NOT
PASSED YESTERDAY AND WIE'RE
WORKING ON THAT AND WE ARE
LOOKING FOR RESOURCES AND NOT
SCARING PEOPLE AND THERE WAS
POSITION GUIDANCE WAS LACKING
AND THE LATEST VERSION IS MUCH
BETTER.
I GAVE INPUT AND STILL ISN'T
WHERE IT NEED TO BE.
SILENT SPRING WAS PUTTING OUT
THE BEST WE COULD FIND.
THAT WAS THE WEBSITE I WAS
USING.
I WAS URGING THE STATE TO
UTILIZE AND ADOPT THE RESOURCES.
WE WEREN'T REALLY GETTING
ANYWHERE THEN AND ENGAGED WITH A
GREAT ACADEMIC PARTNER AT
DARTMOUTH UNIVERSITY AND THEY'VE
BEEN FABULOUS AND RIGHT BY OUR
SIDE SAYING WE NEED THE NASEM
ACKNOWLEDGED AND THE SILENT
SPRING AND CAN'T GO BY WHAT CDC
AND NEW HAMPSHIRE IS POSTING.
PROBLEM IS IT'S ON THE WEBSITES.
WHAT AVERAGE PERSON KNOWS THE
WEBSITES AND HOW TO GET TO THE
WEBSITE AND PEOPLE ARE GOING TO
THEIR DOCTORS WITH HEALTH
CONDITIONS NOT IN THEIR FAMILY
HISTORY.
MY HUSBAND I HAVE PHENOMENAL
GENETICS AND LONGEVITY IN OUR
FAMILY AND THE ONLY ONES WITH A
POTENTIALLY A KIDNEY DOCTOR MORE
ME AND THEY'RE NOT GENETICS OR
LIFESTYLE.
I LIVE ON A STREET A CUL-DE-SAC
WITH 20 HOMES.
SEVEN WOMEN ON THAT STREET HAVE
HAD BREAST CANCER.
7 OF 20 HOMES.
SO SCREENINGS AND WE'VE WORKED
TO GET THE WORD OUT ON OUR OWN
TO BE VIGILANT AND THYROID AND
VITAMIN D DEFICIENCIES AND
NODULES AND I HAVE AN ODD GROWTH
ON AN ADRENAL GLAND AND YOU'RE
SUPPOSED TO LEARN TO LIVE WITH
THESE THINGS AND THE
RESPONSIBILITY IS NOT THERE AND
THE EXPOSURE IS KNOWN.
WE HAVE AMAZING DATA IN NEW
HAMPSHIRE FOR TESTING.
WE HAVE AIR MODELLING THAT GUYS
BACK 15 YEARS PRIOR TO THE
DISCOVERY.
INTERESTINGLY ENOUGH THIS
POLLUTER WAS ON A CORRECTIVE
ACTION PLAN IN 2001 AND I HAD
KNOWN I WOULD HAVE DONE
SOMETHING WITH AN 11-YEAR-OLD
AND 13-YEAR-OLD DAUGHTER AND
THEY HAD UNUSUAL PATTERNS IN
REPRODUCTIVE HEALTH.
THE PATTERNS I'VE SEEN AND THE
CLINICAL PRACTICE I HEAR STORIES
AND HIGH RATES OF AUTISM AND
ADHD AND NEURAL DEVELOPMENTAL
PATTERNS ARE INCREASING
EVERYWHERE AND MORE SO.
IF WE DID A COMPARISON
POPULATION AND INCIDENT REPORT I
THINK WE WOULD FIND SOME
SIGNIFICANCE THERE BY THE
OBSERVATION OF MYSELF AND
OTHERS.
SO EVERY SYSTEM OF THE BODY
REPRODUCTIVE HEATHER,
CARDIOVASCULAR HEALTH AND KIDS
WITH HEART ARRHYTHMIAS
UNEXPLAINED AND MONITORS THAT
TRACTOR A WEEK TO TWO WEEKS TO
VERIFY WHAT'S GOING ON ONE THE
HEART RHYTHMS AND THEY'RE
CONSIDERED BENIGN, MANY OF THEM
AND THEN SAY THINGS LIKE WELL,
ADD MORE SALT OR LITTLE TWEAKS
THAT I'VE HEARD PEOPLE SAY TO
KIDS, BONE AND GROWTH DISORDERS
THAT I SEE YOU WENT OUT IN
SUMMER 2017 AND DESIGN AN
INSTRUMENT THAT WOULD GATHER
HEALTH DATA OF OUR COMMUNITY AND
NEIGHBOR TO NEIGHBOR AND DID
THIS AND THE PURPOSE WAS -- I
DID IT AS PROPERLY AS I COULD
WITH THE METHODOLOGY AND THE
GOAL WAS TO BRING THIS TO THE
STATE SO PEOPLE COULD FEEL
VALIDATED AND BE SEEN.
IT DIDN'T REALLY AMOUNT TO MUCH
AND WHAT I DID IS SORTED THE
DATA IN A WAY THEY COULD SEE
MULTIPLE CONDITIONS WITH PEOPLE
NOT THAT YOU WOULD EXPECT
TOGETHER WITH ULCERATIVE COLITIS
AND CARDIOVASCULAR AND METABOLIC
AND REPRODUCTIVE AND A FEW OTHER
THINGS.
YOU'D SAY, HMM, THAT'S AN AWFUL
LOT GIVEN THE AGE OF THIS PERSON
IN THEIR 30s.
SO WE STAYED AWAY FROM THE
CANCERS AND THAT GATHERING
BECAUSE AT THAT POINT WE STUCK
TO WHAT WAS ACKNOWLEDGED BY THE
STATE ON THEIR WEBSITE AND PUT
ANOTHER QUESTION IN THERE THAT
BASICALLY SAID IS THERE ANYTHING
ELSE YOU WANT US TO KNOW OTHER?
THAT WAS A WEALTH OF INFORMATION
AND IT WAS BEASTLY DATA AND IT
DUMPED INTO AN EXCEL SHEET AND I
WAS WAY OVER THE HEAD AT THAT
POINT AND PEOPLE SAID JUST BRING
THE TO IT STATE AND SAY THERE'S
A PROBLEM AND THEY'LL TAKE IT
FROM THERE.
YOU KNOW THAT ISN'T GOING TO
HAPPEN?
THEY ARE GOING TO SAY IT'S NOT
SCIENTIFIC.
IT'S A VALID SAMPLING AND THE
METHODOLOGY I'LL TALK ABOUT AND
THAT'S THAT.
SO THERE ARE PATTERNS HERE WE
NEED LOOKED AT.
THEN WE HAVE A DISCUSSION ABOUT
THE CANCERS BECAUSE WE DIDN'T GO
THERE AND WE GAVE CANCER
OBSERVATIONS AND PEOPLE CAME
FORWARD AND WE ENGAGED BY THAT
SUMMER AT THE FIRST NATIONAL
PFAS CONFERENCE IN BOSTON SOME
MEMBERS IMPACTED FROM YAS THE
NATION MET AT LUNCH AND STARTED
CHATTING ABOUT EACH OTHER'S
STORIES AND OUT OF THAT WE'RE
ALL DOING OUR CORNERS OF THE
NATION LET'S GET TOGETHER
BECAUSE YOU'RE SAFETY SHOULD NOT
DEPEND ON YOUR ZIP CODE AND
WHERE WE'RE MAKING PROGRESS AND
NOT IS APPALLING TO ME.
SO I COFOUNDED THE NATIONAL PFAS
CONTAMINATION COALITION AND
WE'VE DONE IMMENSE WORK ON
POLICY AND WE HAVE WORKED WITH
SOME PHENOMENAL PARTNERS AND I
WAS ASTONISHED TO DISCOVER THAT
ACROSS THE NATION THERE WERE
ACADEMICS AND SCIENTISTS WHO
WERE VERY FAMILIAR WITH THIS
CHEMICAL CLASS AND THEIR
RESEARCH HAD GONE BACK YEARS AND
LINDA I MET YOU IN SUMMER 2017
AND KNOWN YOUR WORK BECAUSE I
WAS READING YOUR WORK AT THAT
POINT AND READING AN iPAD IN BED
AT NIGHT BECAUSE I SHOULD BE
SLEEPING AND I WORK FULL TIME
I'M THINKING ABOUT THIS IS
TERRIBLE LOW DOSE AND YOU WERE
SITTING RIGHT THERE NEXT TO ME
AND SOMEBODY WAS SHOWING A SLIDE
AND THEY TALKED ABOUT SOMETHING
AND I UNDERSTOOD IT CONCEPTUALLY
BUT I'M NOT A SCIENTIST AND I
CAN'T REPEAT IT AND MUTTERED TO
MY FRIEND, CAROL, THAT THE
INTERESTING.
I'M WONDERING WHAT THAT'S ABOUT
IN MY WHATBLOOD WORK AND YOU SA
SOMETHING ABOUT ALBUMIN BINDING
IN THE PROTEIN AND THEN THEY
ANNOUNCED YOU AND IT WAS AN
AMAZING MOMENT.
AS THE THINGS THROUGH THE YEARS
AND SHORTLY AFTER THAT I FOUND
THE PAPER ON AUTOPSY STUDIES
FROM DENMARK SHOWING NOT JUST
LEGACY COMPOUNDS BUT THE SHORTER
CHAIN INCLUDING HPFADA IN EVERY
ORGAN OF THE BODY WHERE THEY'RE
FOUND AND I THOUGHT THERE'S A
LOT OF KNOWLEDGE OUT THERE.
WE HAVE ENOUGH SCIENCE AND DATA
AND TESTING FOR SURE IN NEW
HAMPSHIRE, MY GOSH, WE HAVE AIR
MAPPING, MODELLING, WATER TESTS
UP THE WAZOO BASICALLY BUT NOT
THE ABILITY TO CONNECT THE
EXPOSURE TO OUTCOME BECAUSE IT
CREATES LIABILITY AND THAT'S A
BIG NO-NO NOT JUST IN MY STATE
BUT UNFORTUNATELY EVERY STATE IN
THE NATION.
THAT IS A TRAVESTY.
THAT IS.
WE ARE PAYING FOR REMEDIATION OF
WATER AND KNOW THE POLLUTER IN
THE STATE IS WORKING WITH THEM
ON ALL THEIR PLANS AND HOLDING
SUPPOSEDLY THEIR FEET TO THE
FIRE.
THIS POLLUTER WILL TELL THEIR
INVESTORS THEY'RE ENVIRONMENTAL
STEWARDS AND GOOD NEIGHBORS AND
DONE EVERYTHING ASKED OF THEM.
THEY HAVEN'T.
THERE'S NO MEDICAL MONITORING.
THERE ISN'T GOING TO BE.
THE CLASS ACTION SUIT WAS
WHITTLED DOWN SIGNIFICANTLY BY
THE NEW HAMPSHIRE SUPREME COURT
AND THEY HAVE FRIENDS IN HIGH
PLACES.
WHAT'S MADE IN NORTH CAROLINA IS
MADE AND WHERE THEY GET THEIR
POISON AND CBI AND CONFIDENT
BUSINESS INFORMATION.
YOU'RE NOT SUPPOSED TO KNOW
WHAT'S IN THE MIXTURE.
BUT WE KNOW WHAT'S IN THE DIP
PAN STUDIES AND KNOW THE EPA DID
STACK TESTING FOR US SO WE KNOW
WHAT'S THERE BUT IT'S NOT PULLED
INTO ANY OF THEIR CONSULTATION
REPORTS SO IT'S NOT ACKNOWLEDGED
IN ANY PROPOSALS TO DO AS LITTLE
AS POSSIBLE FOR AS LESS MONEY AS
POSSIBLE TO REMEDIATE WHICH IS
FAR FROM COMPETE.
SO THE RELEASES TO THE
INHALATION IMPACTS THE HOMES
CLOSE TO THE FACILITY HAD
DISTINCT IMPACTS AND I SEE SOIL,
AIR MERRIMACK HAS A WASTE WATER
FACILITY AND THE FIRST TO MAKE
COMPOST FROM BIO SOLIDS.
I REALIZED THIS EARLY IN THE
GAME AND SAY TO MYSELF, HMM, IF
I TALK ABOUT THIS PUBLICALLY
WHILE I TRY TO WIN OVER THE TOWN
COUNCIL AND BUILD THIS ARMY I'M
IN TROUBLE SO I BETTER NOT GO
THERE.
SO I QUIETLY TALKED ABOUT IN THE
LAST COUPLE YEARS.
I KNOW YOU KNOW THERE'S GREAT
ATTENTION TO THE TOPIC SO
EVERYONE CAN SPEAK FREELY NOW
BUT THAT COMPOST WENT OUGHT ALL
OVER NEW ENGLAND.
RESIDENTS COULD TAKE IT.
MANY YEARS AGO THEY USED TO SAY
SPORT FIELDS AND LAWNS ONLY.
I LOOKED BACK TO SEE WHERE IT
WAS AND TRY TO RESEARCH THAT
WHAT I REALIZED IS THEY HAD A
CONSULTANT IN THE GAME AND
RECLASSIFIED IT AS CLASS A FOOD
GRADE BIO SOLIDS.
ANOTHER DISCOVERY AT MIDNIGHT
WHERE IT'S HORRIBLE AND THERE'S
NO ONE TO TALK TO AND WE TALKED
ABOUT MIND, BODY AND STRESS AND
I WAS SMILING TO MYSELF.
THE TOOLS I HAVE AS A THERAPIST
AND OVER THE LAST FEW YEARS, MY
GOSH BETWEEN MEDITATION AND
SOUND THERAPY AND PROPER SUPPORT
AND DIETARY AND SUPPLEMENTARY
ARE THE ONLY THINGS TO GRAB ON
TO BECAUSE THE OFFICIAL GUIDANCE
IS NOT THERE AND WHAT'S SHAPING
UP IS NOT ADEQUATE.
I WORKED WITH RESIDENTS ACROSS
THE NATION AS A COMMUNITY
LIAISON IN THE NASEM REPORT.
MANY GOOD THINGS CAME FROM THAT.
THEY MISDELIVER AND THERE WAS
FEEDBACK GIVEN BY PEOPLE MORE
QUALIFIED TO MAKE THAT
OBSERVATION FEEDBACK SO I THINK
THAT WILL GET FIXED.
THAT'S AN EASY MARKER MANY OF US
HAVE IN OUR BLOOD WORKS TO SPOT
WHAT'S GOING ON WITH TEXAS AND
IMPACTS TO THE BODY.
HERE WE HAVE SCIENCE AND DATA
AND WHAT WE DON'T HAVE IS
VALIDATION.
WILL WE EVER GET THAT?
IT'S THERE IN MANY FASHIONS
FORMALLY AND INFORMALLY IT
DEPENDS.
WHAT WE HAVE IS THIS CRISIS AND
INABILITY TO SEE, REALLY.
WHERE EXPOSURE IS KNOWN.
FROM THE NASEM FOCUSSED ON SEVEN
LEGACY CHEMICALS THAT WAS A GOOD
START BUT THEY WERE RESTRICTED
TO THAT UNDER THE LAST
ADMINISTRATION.
THE PROBLEM I HAVE IS AS IT'S
BEING IMPLEMENTED IT'S NOT GOING
TO SWEEP ALONG WHAT WE NEED TO
DO.
SO FOR MY POLLUTER WHAT I KNOW
IS IN 2015 THEY TRANSITIONED
FULLY OVER TO THE SHORT CHAIN
ETFA NEWER FORMULATION.
THERE'S VIGOROUS RESISTANCE
ACROSS THE NATION OF THE
DEFINITION OF PFAS AND BILLS IN
STATES BEING AMENDED INCLUDING
MINE AND THE GOAL THERE IS TO
TAKE THE POLY FORMERS AND NOT
CALL THEM PFAS SIMPLY AND WHICH
IS CRAZY AND IT'S ALL THERE IN
HUGE QUANTITIES MORE THAN MOST
ANYTHING ELSE.
WE HAVE THE INFORMATION.
WE SEE THE PAST EXPOSURE.
WE SEE THE MORE CURRENT EXPOSURE
AND IT'S THE LEGACY IN THE SHORT
CHAIN.
IF WE DON'T PROPERLY ACKNOWLEDGE
THE FULL EXPOSURE IN PHYSICIAN
GUIDANCE AND BLOOD TESTS AND
WATER TESTS AND REGULATORY AND
ALL OF IT WE'RE MISSING A LOT.
WE KNOW FROM THE PROFILES OF
NORTH CAROLINA THAT THEY'RE
ACRONYMS FOR PFAS THEY'RE NOT
LIKE MINE THOUGH THEY MAKE
WHAT'S USED HERE IT'S THE
PRODUCTION AND THEIR HEALTH
PROFILES ARE JUST AS SIMILAR AND
JUST AS DIRE IT'S APPALLING AND
WE LOOK AT WHAT'S GOING ON
FEDERALLY.
WE HAVE MCLs FOR TWO LEGACY
CHEMICALS.
IF WE ADDRESS EACH ONE AT A TIME
WE WON'T GET ANYWHERE.
THE IMPACT ON THE BODY AND EVERY
SYSTEM OF THE BODY WHEN I GATHER
THAT HEALTH DATA I WENT AROUND
TO GET SOMEBODY TO HELP ME
ANALYZE IT AND SAY CAN WE DO
SOMETHING WITH THIS?
WE DID PUBLISH A PAPER CALLED
MAKING THE INVISIBLE VISIBLE AND
UNIVERSITY OF VERMONT HELPED AND
THAT WENT TO THE PROPER
CATEGORIES OF HEALTH AND FOUND
STRONG FINDINGS SHY OF
STATISTICAL SIGNIFICANCE.
IT WAS THERE FOR REPRODUCTIVE
HEALTH AND IT WAS 27 TIMES THE
EXPECTED CARDIOVASCULAR AND MANY
OTHER DISORDERS WERE VERY HIGH
AND SHE WAS QUITE SURPRISED AT
SOME OF THE FINDINGS AND I
LOOKED AT HER AND SAID WILL YOU
STUDY THIS AND YOU'RE WELL
VERSED AND YET YOU'RE SURPRISED.
THIS IS HOW IT IS.
WHAT'S THAT ABOUT?
SO, ON AND ON.
SO I GUESS IN THIS GROUP WHAT
I'M EXCITED TO BE HERE AND MEET
EVERYONE.
WHAT WE NEED HERE IS HEALING.
THAT'S WHAT WE'RE NOT TALKING
ABOUT ANYWHERE.
WE'RE WORKING ON POLICY AND ON
REGULATORY AND TO HOPEFULLY STOP
THE SOURCES AND SO MANY THINGS
AND PHYSICIAN GUIDANCE BUT
HEALING OVER 8 YEARS IN MY
COMMUNITY, WHERE'S THE HEALING.
YOU'RE NOT GETTING WHAT YOU NEED
FROM TRADITIONAL DOCTOR AND THE
INTEGRATIVE METHODS I SEE ARE
MAKING A DIFFERENCE.
THEY MADE A DIFFERENCE IN SOME
OF MY BLOOD WORK.
I'M TRYING TO STAY ON TOP OF
THINGS AND THIS IS A HUGE AREA
OF IMPORTANCE TO ENDOCRINE
DISRUPTOR AND THE 70-PLUS
COMMUNITIES.
WAIT UNTIL WE ADD THE REST.
THIS IS AN AREA WE NEED TO
CIRCLE AROUND.
THANK YOU.
>> TELL PEOPLE WHO YOU ARE FOR
EVERYONE IN THE AUDIENCE,
DR. BURNBAUM.
>> FORMER DIRECTOR OF NIEHS.
LAST NIGHT THE NATIONAL
MANUFACTURE'S ASSOCIATION SUED
EPA AFTER MANY YEARS OF
ESTABLISHMENT OF REGULATORY
LIMITS IN DRINKING WATER FOR SIX
OF THE 15,000-OF PFAS.
I THINK PEOPLE KNEW THEY'D BE
SUED.
THE FILING CLAIMS THAT THERE WAS
INADEQUATE SCIENCE.
ALSO AMERICAN WATER WORKS IS A
SECOND SUIT.
THERE'S TWO SUITS FILED AND I
HAVE MY FILINGS READY TO GO.
EARTH JUSTICE HAS BEEN BY MY
SIDE.
I'VE LEARNED HOW TO PLAY I
ANTICIPATE WHAT THEY'LL DO AND
PREPARE AND BE READY AND WE'LL
BE FILING ON BEHALF OF MANY
IMPACTED COMMUNITIES BIG THE
CIRCUIT COURT SO WE'RE ON IT.
>> YOU'RE RIGHT.
MAKING AN ANALOGY OF A GAME OF
CHESS AND IT'S AN UNHEALTHY
GAME.
INDUSTRY KNOWS THEY WON'T STOP
THE MOVEMENT FORWARD TO REGULATE
THE CHEMICALS OR TO BAN THEIR
ACTUAL PRODUCTION WHICH IS WHERE
WE PROBABLY NEED TO GO WITH MANY
OF THESE THINGS BUT THE LONGER
THEY CAN PROTEST, THE LONGER
THEY CAN SUE, THEY CONTINUE TO
MAKE HUGE AMOUNTS OF MONEY.
HUGE.
>> THEY ALSO COUNT ON THE
STRENGTH OF THE NUMBERS ACROSS
THE COUNTRY IS WHAT KEEPS ME
GOING AND PROPPED UP.
THERE'S PEOPLE I KNOW IN OTHER
STATES THAT I NEVER WOULD HAVE
MET UNLESS I HAD THIS AND YOU
CAN HEAR MY VOICE THE
CONFESSION, THEIR STORIES AND
THEIR HARM -- IT'S HORRIBLE.
BUT SOME OF THOSE FOLKS KNOW MY
TRUTH AND I KNOW THEY'RE TRUTH.
I TOLD SOMEONE THIS MORNING THEY
KNOW THAT PART OF ME BETTER THAN
MY CLOSEST LIFE LONG FRIENDS
BECAUSE MY CLOSEST LIFE LONG
FRIENDS DO NOT LIVE IN MY
COMMUNITY AND DO NOT KNOW THE
DEPTH AND THE KNOWLEDGE.
SO THE STRENGTH AND THE
INFORMATION -- YOU HAVE TO
BECOME YOUR OWN EXPERT YOU HAVE
NO CHOICE AND DEVELOP STRESS AND
RESILIENCY FACTORS AND YOU KEEP
EACH OTHER GOING AND THERE'S
DAYS WHEN YOU JUST SAY ENOUGH
ALREADY.
I CAN'T DO THIS ANYMORE AND SAY
I NEED TO AND I'LL BE DOING THIS
THE REST OF MY LIFE.
>> I WANT TO TOUCH ON JUST THAT
BECAUSE YOU'RE LIVING THIS
EXPERIENCE BUT YOU'RE ALSO A
SOCIAL WORKER SO YOU'RE IN A
POSITION WHERE YOU PROBABLY HEAR
OTHER PEOPLE'S EXPERIENCES OF
PAIN AND FRUSTRATION AND
POWERLESSNESS.
HOW ARE YOU AND YOUR COMMUNITY
AND THE BROADER COMMUNITY OF
PEOPLE BEING EXPOSED BY ECDs HOW
ARE THEY NAVIGATING THEIR MENTAL
HEALTH?
THEY HAVE EACH OTHER.
YOU MENTIONED NOW IN THE FACE OF
ADVERSITY FINDING ALL THESE
OTHER CONNECTIONS AND HAVING THE
SHARED EXPERIENCE BUT WITHIN
YOUR NEW ENGLAND COMMUNITY YOU
MENTIONED PEOPLE ARE USUALLY
TIGHT LIPPED.
THEY DON'T SHARE A LOT ABOUT
THEMSELVES.
HOW IS THE MENTAL HEALTH AND HOW
ARE THE MENTAL HEALTH PROVIDERS
IN YOUR COMMUNITY DEALING WITH
THIS AND NAVIGATING THIS?
>> I ADDED TO MY SCREENING
SOCIAL WORKERS DIFFER FROM A
PSYCHOLOGIST IN THAT MY TRAINING
IS BIO, PSYCHO, SOCIAL.
THAT'S HOW I LOOK AT THING AT
THE BIOLOGY AS THE INITIAL FIRST
IF WE TREAT THE SYMPTOMS,
ANXIETY AND DEPRESSION ARE REAL
BUT CAN EMIT FROM MANY LONG-TERM
SITUATIONS AND TRAUMA STORIES
HAVE MANY FORMS AND IT'S A
TRAUMA STORY OF A COMMUNITY AND
VALIDATION GOES A LONG WAY.
THE LACK OF FEAR WHEN YOU LOOK
TO SOMEONE AND SAY HOW ARE YOU
DOING AND THEY SEE YOU SEE THEM
AND KNOW YOU'RE STRUGGLING AND
TALK A LITTLE BIT.
THAT GOES A LONG WAY.
VALIDATION AND KNOWING PEOPLE
AND THE FACT THAT THEY KNOW
PEOPLE ARE IN THEIR COMMUNITY
FIGHTING FOR THEM WHO CAME
FORWARD.
WE HAVE THE FIRST EPA LISTENING
SESSION AND A WOMAN HAD KIDNEY
CANCER TWICE AND LYMPHOMAS AND
TOLD THEIR STORIES.
WE HAD PEOPLE IN TEARS AND YOU
KNOW YOU WERE HEARD IN THOSE
STORIES AND THAT GOES A LONG WAY
AND TURNING WE HAVE A PHRASE IN
MY POSITION OVER HOW DO YOU TURN
VICTIMS INTO SURVIVORS SOUNDS
LIKE A CLICHE BUT IF YOU CAN
FIND THAT STRENGTH IN YOUR NORTH
STAR AND KNOW THERE'S A PLAN
HERE AND IT DOESN'T HAPPEN IN A
WEEK BUT THERE IS A PLAN.
>> THE PANEL IS WHERE WE HAVE
PEOPLE LIKE YOURSELF AND
CLINICIANS WITH WHO ARE
SUPPORTING PEOPLE HELPING US AS
A RESEARCH COMMUNITY BETTER
SUPPORT YOU AS YOU TAKE THIS
JOURNEY BACK TO HEALTH.
I ROOK FORWARD TO YOUR
PERSPECTIVE ON THAT PANEL TOO.
THANK YOU.
I'D LIKE TO INTRODUCE
DR. JULIANNE COURTNEY FROM THE
NIH OFFICE OF DISEASE
PREVENTION.
SHE WILL BE MODERATING OUR NEXT
SESSION AND WOULD LIKE TO
INTRODUCE DR. LESLIAM
QUIROS-ALCALA AND PLEASE BRING
YOUR NAME CARD.
-- DR. JOYANN COURTNEY FROM THE
NIH OFFICE OF DISEASE PREVENTION
WILL BE MODERATING.
>> GREETINGS TO EVERYONE IN
PERSON AND THOSE ATTENDING
VIRTUALLY.
I'M DR. JOYANN COURTNEY SERVING
ON THE HEALTH DISPARITIES TEAM
AND PROUD TO HAVE THIS PANEL AND
ECDs AS DRIVERS AS HEALTH
DISPARITIES.
THIS PANEL AIMS TO IMPACT HEALTH
DISPARITIES AND HOW TO BE
CORRECTED.
PANELISTS WILL DRAW FROM THEIR
RESEARCH AND EXPERTISE TO SHED
HIDE IN EXPOSURES IN
MARGINALIZED COMMUNITIES, HEALTH
OUTCOMES AND POPULATIONS THAT
EXPERIENCE HEALTH DISPARITIES
AND CHALLENGES AND POLICIES AND
REGULATION AUTHORITIES AND
ASSOCIATED COST AND THE
COMPLEXITIES THAT HIGH WITHIN
THESE DOMAINS.
I HAD A SNEAK PEEK AT THEIR
SLIDE SET SO I ANTICIPATE THE
DIALOGUE WILL PROVIDE
INFORMATION FOR THE PRODUCTS
CONTAINING EDC AND POPULATIONS
THAT EXPERIENCE THESE AND
INSPIRATION TO ENGAGE IN
ADVOCACY, RESEARCH AND
MULTI-LEVEL INTERVENTIONS AND
ULTIMATELY CHANGE.
SO NOW TO OUR DISTINGUISHED
PANEL.
MOST ARE WATCHING OR ATTENDING
VIRTUALLY BUT FULL BIOS AND
PRESENTATIONS ARE IN THE PROGRAM
YOU AND USE THE QR CODE TO SEE
THEIR EDUCATIONAL BACKGROUNDS
AND EXPERTISE AND AWARDS AND
THERE'S A SLIGHT CHANGE IN THE
ORDER.
I'LL QUICKLY INTRODUCE THEM IN
THE ORDER THEY'LL BE SHEPEAKING.
FIRST DR. LINDSEY TREVINO IN THE
DIVISION OF HEALTH EQUITY IN THE
DEPARTMENT.
POPULATION SCIENCE AT THE CITY
OF HOPE, LOS ANGELES.
AND DR. LEONARDO TRASANDE THE
DIRECTOR OF THE DIVISION OF
ENVIRONMENTAL PEDIATRICS AND
VICE CHAIR FOR RESEARCH IN THE
DEPARTMENT OF PEDIATRICS AT NYU
SCHOOL OF MEDICINE AND SERVES ON
THE FACULTY OF WAGNER SCHOOL OF
PUBLIC SERVICE.
AND DR. AMI ZOTA IS AN ASSOCIATE
PROFESSOR IN DEPARTMENT OF
HEALTH SCIENCES COLUMBIA
UNIVERSITY AND DR. LESLIAM
QUIROS-ALCALA IS AN ASSOCIATE
PROFESSOR AT JOHNS HOPKINS IN
THE DEPARTMENT OF ENVIRONMENTAL
HEALTH AND ENGINEERING.
SO EACH PANEL WILL HAVE ABOUT 10
MINUTES TO SHARE.
PLEASE JOT YOUR QUESTIONS DOWN
AND WE'LL TRY TO CATCH THE ONES
ONLINE AS WELL AS IN PERSON.
AND AT THIS TIME I'LL GIVE THE
FLOOR TO DR. LINDSEY TREVINO.
THANK YOU.
>> GOOD MORNING, EVERYONE.
I HOPE EVERYONE CAN HEAR ME
OKAY.
THANK YOU SO MUCH FOR THE
INVITATION TO PARTICIPATE IN
THIS VERY IMPORTANT AND I WOULD
SAY HOPEFULLY GROUNDBREAKING
WORKSHOP WHERE ALL THE
STAKEHOLDERS WHO CAN REALLY MAKE
A DIFFERENCE ARE ALL HERE
TOGETHER AT THE SAME TIME.
I'LL BE FOCUSSING ON ENDOCRINE
DISRUPTING CHEMICALS AND CANCER
DISPARITIES.
SO I WOULD JUST LIKE TO -- WE'VE
BEEN TALKING ABOUT THIS.
IT'S BEEN COMING UP OVER AND
OVER AND ESPECIALLY WITH THE
COMMUNITY PEOPLE THAT WE HAVE
HEARD FROM THEIR EXPERIENCES
THIS CONCEPT OF ENVIRONMENTAL
JUST JUSTICE THE FAIR TREATMENT
AND MEANINGFUL INVOLVEMENT OF
ALL PEOPLE REGARDLESS OF RACE,
COLOR, NATIONAL ORIGIN OR INCOME
AND WITH THE ENFORCEMENT OF
ENVIRONMENTAL LAWS AND
REGULATIONS AND POLICIES.
WHILE THIS MAY BE OF
ENVIRONMENTAL JUSTICE AS WHAT'S
IN THE WATER AND AIR WE CAN
THINK ABOUT THIS IN TERMS OF
EXTENDING TO THE PRODUCTS THAT
WE USE WHETHER IT'S IN THE FOOD
WE EAT OR THE PRODUCTS WE USE
EVERY DAY AND I'M NOT GOING TO
GO TOO MUCH INTO THIS BUT I
WANTED TO HIGHLIGHT THAT
DR. BULLARD IS THE FATHER OF
ENVIRONMENTAL JUSTICE.
IF YOU WANT TO THINK OF HOW THE
TERM CAME OUT IT STARTED WITH
HIM AND STUDIES HE DID IN
HOUSTON LOOKING AT WHERE THE
WASTE FACILITIES, LANDFILLS,
CHEMICAL PLANT AND INCINERATORS
WERE BEING BUILT.
IT TURNS OUT NOT SURPRISINGLY
THAT ALL OF THIS WASTE WAS BEING
DUMPED IN COMMUNITIES OF COLOR
DISPROPORTIONATELY.
IF YOU'RE INTERESTED IN LEARNING
MORE HOW ENVIRONMENTAL JUSTICE
CAME ABOUT, YOU CAN GO AHEAD AND
TAKE A LOOK AT THE BOOK HE WROTE
IN 1990.
ONE THING WE'VE BEEN TALKING
ABOUT ARE THERE ARE DISPARITIES
IN ENDOCRINE DISRUPTORS AND EDC
EXPOSURES.
I'LL HIGHLIGHT A COUPLE STUDIES
THAT HAVE LOOKED AT THAT.
DR. SERGEANT AND HIS GROUP HAVE
A NICE REVIEW LOOKING AT
DISPARITIES AND ECDs RELATED TO
DIABETES.
THIS IS A SNAPSHOT OF ONE OF THE
TABLES IN THAT PAPER LOOKING AT
BISPHENOL A AND LOOKING AT
DISPARITIES AND INCOME AND
WHETHER YOU HAVE ACCESS TO
HEALTHY FOODS.
AGAIN, FOOD SECURITY AND WHETHER
YOU ARE EMPLOYED OR UNEMPLOYED
AND THERE ARE DIFFERENT LEVELS
AND THE LAST SPEAKER SAID I'M
FROM A COMMUNITY WHERE WE MAKE
PRETTY DECENT MONEY AND STILL
HAVING THESE ISSUES.
I HIGHLIGHT THAT THERE ARE
DISPARITIES ON DIFFERENT LEVELS
BUT DEPENDING TYPES OF EXPOSURES
THE ADVERSE EXPOSURES KNOW NO
BOUNDARIES IN CATEGORIES AND
CATEGORIZATIONS.
THE OTHER STUDY WE HEARD ABOUT
PARABENS AND THIS STUDY WHERE
THEY LOOKED AT URINARY LEVEL
ACROSS RACE AND RACIAL ETHNIC
GROUPS AND FOR BOTH THE HIGHEST
LEVELS ACROSS FOR THE MOST PART
ACROSS DIFFERENT AGE GROUPS THE
HIGHEST LEVELS WERE SEEN IN
MEXICAN AMERICANS IN THE BLUE
AND IN WOMEN AND I'LL COME BACK
TO THAT IN THE REST OF MY TALK.
SO THERE'S A REALLY NICE
REVIEWER PROPERTY FROM THE
AMERICAN ASSOCIATION FROM CANCER
RESEARCH.
I WON'T GO TOO MUCH INTO THIS
BUT WHEN WE'RE THINKING ABOUT
THE POPULATION GROUPS THAT
EXPERIENCE CANCER DISPARITIES
WE'RE TALKING ABOUT RACE OR
ETHNIC MINORITY POPULATIONS,
PEOPLE WHO DON'T HAVE INSURANCE
COVERAGE, PEOPLE WITH
DISABILITIES AND INDIVIDUALS
INCARCERATED AND THE LIST GOES
ON.
AND SO I WILL TALK ABOUT RACIAL
AND ETHNIC MINORITY POPULATIONS
AND DISPARITIES IN THIS GROUP
BUT I JUST WANT TO POINT OUT
THAT WE'RE TALKING ABOUT CANCER
DISPARITIES ACROSS A LOT OF
DIFFERENT POPULATION GROUPS AND
TO KEEP THIS IN MIND AS WE DO
OUR STUDIES AND MOVE FORWARD.
AND SO WHEN WE THINK ABOUT WHAT
IS DRIVING THESE CANCER
DISPARITIES IT'S VERY MULTI
LEVEL.
THERE'S SOCIO, PSYCHOSOCIAL AS
WELL AS ENVIRONMENTAL WHICH IS
WHAT WE'RE ALL TALKING ABOUT
TODAY.
WITHIN THAT CONTEXT WE'RE ALSO
THINKING ABOUT STRUCTURAL
INEQUITIES AND INJUSTICES,
RACISM, DISCRIMINATION AND
SEGREGATION.
ALL THESE THINGS KIND MUCH COME
TOGETHER TO UNFORTUNATELY IMPACT
WHETHER PEOPLE CAN GET CANCER
CARE, WHEN ARE THEY DIAGNOSED,
ARE THEY AT HIGHER RISK FOR
DEVELOPING THESE CANCERS AND
OTHER ADVERSE HEALTH OUTCOMES.
SO THERE WAS A VERY ELEGANT
STUDY THAT CAME OUT LOOKING AT
ASSOCIATIONS BETWEEN EDC
EXPOSURES AND PREVIOUS CANCER
DIAGNOSIS.
THIS GROUP WENT IN AND LOOKED AT
THE NHANES DATA WHICH WE HEARD A
LOT ABOUT IN THE PREVIOUS DAY.
I PULLED OUT A COUPLE EXAMPLES.
THIS IS FOR PHENOLS INCLUDING
BPA WHICH I TALKED ABOUT ON THE
PREVIOUS SLIDE AND PARABENS AND
IF WE LOOK AT DIFFERENT CANCERS
IN MEN, WE CAN SEE THAT THERE'S
VARIABILITY IN TERMS OF THE
ASSOCIATION BETWEEN THE
EXPOSURES IN PREVIOUS CANCER
DIAGNOSIS WITH SOME MAYBE A
LITTLE BIT OF INCREASED HIGHER
RISK FOR SOME OF THESE -- THIS
IS METHYL PARABEN AND PURPLE
PARABEN FOR PROSTATE CANCER AND
A SIMILAR STORY IN WOMEN FOR THE
PHENOLS AND PARABENS WHERE IT'S
DEPENDENT ON FOR BREAST CANCER
FOR EXAMPLE ALL REPRODUCTIVE
CANCERS AND OVARIAN CANCER THESE
CHEMICALS ARE ASSOCIATED WITH
HIRE CHANCE OF PREVIOUS CANCER
DIAGNOSIS HIGHER CHANCE OF
PREVIOUS CANCER AND THERE'S NOT
A LOT OF STUDIES FOR THIS AND
THEY LOOKED AT WHETHER WE CAN
SUBCLASSIFY AND SEE IF THERE'S A
DIFFERENCE IN THESE ASSOCIATIONS
BASED ON RACE AND ETHNICITY.
HERE I'M SHOWING ON THIS PANEL
THE RESULTS FOR THE FINALLIES
AND PAYER WEN -- PARABENS FOR
MEXICAN WOMEN VERSUS WHITE WOMEN
AND THERE'S NOT DIFFERENTIAL
ASSOCIATIONS BUT FOR BOTH WHITE
AND MEXICAN AMERICAN WOMEN BPA
IS ASSOCIATED WITH PREVIOUS
CANCER DIAGNOSIS FOR OVARIAN
CANCER, FOR EXAMPLE.
I THINK THIS STUDY AND WE CAN
SEE FOR BREAST CANCER BOTH WHITE
WOMEN AND MEXICAN AMERICAN WOMEN
THESE CHEMICALS ARE ASSOCIATED
WITH A HIGHER RISK OF PREVIOUS
CANCER DIAGNOSIS.
WHEN WE LOOK AT OTHER HISPANIC
AND WHITE WOMEN WE SEE KIND OF A
SIMILAR STORY WHERE IT'S
DEPENDENT ON THE CHEMICAL AND
DEPENDENT ON THE CANCER BUT FOR
EXAMPLE IF I HIGHLIGHT HERE FOR
BP3 FOR BREAST CANCER AND OTHER
HISPANIC WOMEN THERE'S A HIGHER
RATE OF PREVIOUS CANCER FOR
OTHER HISPANIC WOMEN WITH BP3.
THE CAVEAT WITH THIS STUDY IS
THIS IS WE'RE LOOKING AT
PREVIOUS CANCER DIAGNOSIS AND
THE LEVELS OF THE CHEMICALS THAT
WERE THE SNAPSHOT TAKEN WHEN THE
H HANES SURVEY WAS DONE.
SO THERE'S MORE WORK TO BE DONE
IN THIS AREA BUT IF YOU'RE
INTERESTED LOOK AT TO THE PAPER
BECAUSE THEY ALSO LOOKED AT
PHTHALATES AND OTHER CHEMICALS
AND THERE WAS OTHER DATA I
DIDN'T PULL OUT FOR TIME.
WE KIND OF ALREADY HAVE SEEN A
VERSION OF THIS HOW THEY ACT AND
HOW THEY POTENTIALLY DRIVE THE
CANCER DISPARITIES SO ONE WAY WE
STUDY THIS THOUGH WE HAVE TALKED
ABOUT HOW REDUCTIONIST IT CAN BE
AND ONE WAY WE STUDIED THIS IN
THE LAB BECAUSE WE CAN'T GIVE
PEOPLE THE CHEMICALS AND FIGURE
OUT HOW THEY WORK IN TERMS OF
CANCER DEVELOP
THE AND PROGRESSION AND USE IN
VITRO MODELS.
WE DID A SCREEN WITH THE NCI6
PANEL OF CELLS.
THIS IS A PANEL OF 60 CHEMICALS
AND LOOKED AT CELL VIABILITY.
THIS IS A HEAT MAP I PULLED OUT
THE BREAST CANCER CELLS.
THOSE THAT GET MORE YELLOW ARE
WHERE WE SEE THE INCREASED
GROWTH OF THE BREAST CANCER
CELLS.
FIVE OF THE SIX CANCER CELL
LINES ARE EUROPEAN HISTORY AND
NOT GOOD NEWS AND MOST ARE
EUROPE.
IT'S OF A CAVEAT OF THE STUDY
AND OF PREVIOUS STUDIES MOVING
FORWARD WE'LL NEED TO TAKE THIS
INTO ACCOUNT.
SO THERE MAY BE AN ASSOCIATION
WITH THE EXPOSURES AND CAN
REDUCING EXPOSURES REDUCE THE
RISK OF THESE CANCERS.
SOMETHING PEOPLE ARE STARTING TO
TALK ABOUT IS DO ECDs INTERFERE
WITH THERAPIES BECAUSE HORMONE
RESPONSIVE CANCERS THESE
THERAPIES ARE HORMONE RELATED
AND WE CAN HAVE AN INTERFERENCE
WITH THE THERAPIES AND SOMETHING
THAT I DIDN'T GET TO TALK ABOUT
BUT WE KNOW AND HAVE HEARD ECDs
ARE ALSO OBESOGENIC AND DIABETES
AND OBESITY ARE RISK FACTORS FOR
CANCER AND CANCER DISPARITY AND
SOMETHING IMPORTANT WE'VE BEEN
TALKING ABOUT THE GAP IN
RESEARCH INCLUSIVITY AND IT'S A
MAJOR DISPARITY IN UNDERSTANDING
THE LIRNGZ.
WITH THAT I'D LIKE TO THANK MY
COLLABORATORS AND FUNDING
SOURCES.
THANK YOU VERY MUCH FOR YOUR
ATTENTION.
>> NEXT UP WE'LL HAVE
DR. LEONARDO TRASANDE.
>> THANK YOU FOR THE
OPPORTUNITY.
SORRY I CAN'T BE WITH YOU.
IT'S MY SON'S 8th GRADE
GRADUATION TODAY SO I HAVE TO BE
A PARENT FIRST THAN IN PERSON.
BUT IT'S BEEN A WONDERFUL TWO
DAYS THUS FAR AND I'M DELIGHTED
TO BE PART OF THIS.
SO IF WE CAN GO TO THE NEXT
SLIDE, I'LL PROVIDE THE ADULT
SUMMARY BEFORE WE GO IN.
MANY OF YOU HAVE ALREADY BETTER
THAN I EXPLAINED THE IMPACT OF
ENDOCRINE DISRUPTING CHEMICALS
ON DISEASE ACROSS THE LIFE SPAN.
I'LL HAVE A SUBPAR COMPONENT AND
PLASTICS ARE A SUBSTANTIAL
DRIVER OF EDC RELATED DISEASE
AND DISABILITY.
THAT'S VERY RECENT WORK WE'VE
DESCRIBED.
AND WE KNOW AS LINDSEY EXPLAINED
IT'S A STARK AND DIFFICULTY
REALITY AND MORE IMPORTANT TO
ADDRESS WE KNOW DISPROPORTIONATE
EXPOSURES TO ECDs ARE WIDELY
EXPERIENCED AND THE DISEASE AND
BURDEN DISPROPORTIONATELY BORN
BY SUBPOPULATIONS.
WE NEED TO DEVELOP AND SCALE
INTERVENTIONS FOR THOSE WHO
SUFFER THE MOST.
THE NEXT COUPLE OF SLIDES ARE
PROBABLY A REVIEW.
THE SCIENCE AT THIS POINT IS
WELL ESTABLISHED AND MAINSTREAM
AND VIGOROUS AND WAS THE
ENDOCRINE DISRUPTING DECLARATION
AND WAS A LABORATORY AND BASIC
SCIENCE SET OF DISCOVERIES AND
FURTHER ELABORATED BY THE REPORT
DOCUMENTING A GLOBAL PUBLIC
HEALTH CONCERN OF ECDs IN 2012.
AND THE DRUMBEAT HAS CONTINUED.
THE ENDOCRINE SOCIETY HAD A
STATEMENT WITH REFERENCES
PARTICULARLY EVIDENCE FROM HUMAN
STUDIES ON THE LOWER LEFT YOU
SEE GUIDANCE FOR PATIENTS OR
PREGNANT PEOPLE IDENTIFYING
STEPS TO REDUCE EXPOSURE.
I'M PROUD TO SAY THE AMERICAN
ACADEMY OF PEDIATRICS HAD AN
ARTICLE FOR THE ADDITIVE TO
FOODS AND NEED TO BE ADDRESSED
THROUGH PUBLIC POLICY.
THAT THE THE MOST POTENT OBESITY
AND DIABETES PREVENTION PATHWAY
IN THEIR EYES.
THEN THE COMMUNITY DISCUSSION
REALLY DROVE THIS HOME AND THE
NATIONAL ACADEMY OF SCIENCES AND
THE FOLLOW-UP CDC REPORT
DOCUMENTING HEALTH CARE PROVIDER
STEPS TO ADDRESS PFAS ARE
LANDMARK WHEN YOU THINK ABOUT
THE REALITY THE LAST CHEMICAL
THAT WAS ROUTINELY SUGGESTED FOR
CLINICAL TESTING WAS LEAD NEARLY
40 OR SO YEARS AGO.
SO, DOCUMENT THE DISEASE BURDEN
THAT WE KNOW DUE TO ECDs THAT
AFFECT ALL OF US.
BASED ON AN INDIVIDUALS OF STUDY
FROM 2015 SOMEWHAT DATED NOW BUT
WERE THE BEST CRITERIA FOR
EVALUATING THE EVIDENCE USING
THE INTERGOVERNMENTAL PANEL ON
CLIMATE CHANGE TO REDUCE BURDEN
AND ECONOMIC COST BASED ON
DEGREE OF UNCERTAINTY.
WHAT WE FIRST FOUND IN EUROPE
WERE COST OF ECDs ANNUALLY OF
160 BILLION EURO, 1.2% OF THE
GROSS DOMESTIC PRODUCT AND IT
WAS ONLY BASED ON FEWER THAN 5%
OF THE EDCs STUDIES AND THIS IS
A SEVERE UNDER ESTIMATE AND YET
1% OF THE GROSS DOMESTIC
PRODUCT.
THE U.S. COST HIGHER.
BECAUSE POLICIES PREDICT
EXPOSURE.
EXPOSURE CONTRIBUTE TO DISEASE
AND DISEASE ULTIMATELY AFFECTS
US ALL.
THE REASON THE COSTS IN THE
U.S. ARE HIGHER IS THE LEGACY OF
THE CALIFORNIA LAW THAT REQUIRE
FLAME RETARDANTS BE ADDED TO
EVERY PIECE OF POLY URETHANE
FOAM IN FURNITURE FOR MANY YEARS
AND THAT ONLY STOPPED IN 2013.
EUROPE ALREADY BANNED PBDEs BY
THEN BUT THE REVERBERATION IN
THE U.S. FOR GENERATION WAS IN
THE FORM OF $240 BILLION OF LOST
EXPECT PRODUCTIVITY DUE TO FLAME
RETARDANTS ALONE AND MORE THAN
$160 BILLION EXPLAINED IN
EUROPE.
THE GOOD NEWS, THERE CAN BE GOOD
NEWS, IS GOOD POLICIES LIKE THE
FOOD POLICY PROTECTION ACT ADDED
AN ADDITIONAL SAFETY FACTOR FOR
KIDS RESULTING IN LOW ORGANO
PHOSPHATES BECAUSE OF THE POLICY
PREVENTION AND PROACTIVE ACTION.
.
THE SLIDE HAS CHANGED BUT WE
SUBSEQUENTLY LOOKED AT P FOS
ACROSS THE 13 CONDITIONS THAT
RUN CRADLE TO GRAVE FROM
INFECTIOUS TO CHRONIC DISEASE
AND THE COSTS ARE IN THE $5
BILLION DOLLARS.
WITH THIS AUDIENCE AND THE OTHER
PANELISTS I DON'T HAVE TO GO
INTO AS MUCH DETAIL IN
DOCUMENTING THE DISPARITIES IN
THE ECDs EXPOSURE.
AND SUFFICE TO SAY WE'VE HAD
MULTIPLE STUDIES DOCUMENT THE
DIFFERENCES AND PATHWAYS IN EDC
EXPOSURE THAT CONTRIBUTE TO
DOCUMENTED DIFFERENCES IN LEVEL
OF DISEASE AND BURDEN AND
DISABILITY I'LL TALK ABOUT IN
THE NEXT SLIDE.
YOU'LL REMEMBER IN THAT SLIDE
THAT THE DISEASE BURDEN OF $340
BILLION IN THE U.S. WAS LARGELY
DRIVEN BY NEUROCOGNITIVE
CONSEQUENCES AND DRIVEN BY FLAME
RETARDANT CONSEQUENCES.
WITH FOLLOW-UP WORK WE LOOKED
MORE CAREFULLY FOLLOWING ON
NHANES DATA ON ALL CHEMICALS WE
STUDIED IN THE PREVIOUS ANALYSES
AND WHAT THE BURDEN WAS BY SUB
POPULATION AND RACIAL ETHNIC
SUBGROUP.
AND THE FINDINGS ARE DISTURBING.
YOU CAN SEE IN THE SECOND COLUMN
THE PROPORTION OF THE POPULATION
THAT ALIGNS WITH EACH RACIAL
ETHNIC GROUP IN THE U.S. AT THE
TIME.
AND YOU CAN SEE IN BOLD THE
DISPARITIES BROUGHT HOME.
SO NON-HISPANIC BLACKS COMPRISED
OF 14.7% OF THE U.S. POPULATION
AT THE TIME WE STUDIED THIS.
YET THEY SUFFER 17% AND IF YOU
USE SENSITIVITY ANALYSES TO
MODIFY THE ASSUMPTION THE TRUE
PERCENTAGE MAY BE A LITTLE LOWER
16%.
IT DOESN'T SEEM LIKE A LOT BUT
ACROSS THE U.S. POPULATION
THAT'S A BIG CHANGE IN DISEASE
BURDEN AND CAUSES OF PROPORTION
OF THE POPULATION.
THEN WHEN YOU LOOK AT ORGAN JOE
FOSS -- ORGAN JOE FOSS -- --
ORGANOPHOSPHATE EXPOSURE AND
NON-HISPANIC BLACK AND MEXICAN
AMERICANS CONTINUE TO BEAR THEIR
BURDEN BUT YOU SEE NON-HISPANIC
WHITES SUFFER A LOWER BURDEN.
LESS THAN THE MAJORITY.
DESPITE 54% OF THE POPULATION AT
THE TIME WAS NOT HISPANIC.
>> TWO MINUTES.
>> NO PROBLEM.
WITH OBESITY DISPARITIES WE SEE
EVEN MORE STARK CONSEQUENCES
WHEN YOU LOOK AT LEGACY
PESTICIDES SUCH AS DDT WITH
CONTRIBUTIONS OF CHILDHOOD
OVERWEIGHT AND DIABETES.
MUCH HIGHER AS DESCRIBED.
LET'S GO THROUGH QUICKLY BECAUSE
I'VE HAD THE BENEFIT OF THE NEXT
SLIDE, PLEASE, OF OTHERS
DESCRIBING INTERVENTION BUT THIS
SLIDE BRINGS IT FURTHER HOME.
YOU CAN SEE NON-HISPANIC WHITES
COMPRISE ROUGHLY 66% OF THE
POPULATION YET ONLY PAY 52% OF
THE FAIR WHEN OUT COMES TO
DISEASE BURDEN COSTS.
YOU CAN SEE NEARLY EVERY OTHER
GROUP SUFFERS A DISPROPORTIONATE
BAUE
BURDEN.
WE NEED TO ARTICULATE SAFE AND
SIMPLE STEPS TO POPULATIONS TO
MITIGATE EXPOSURES.
WITH I KNOW EXPOSURE CAN BE
PREVENTED IN HIGH-INCOME AS WELL
AS LOW-INCOME POPULATIONS AND
POLICY ACTIONS THAT ALSO REDUCE
THE EXPOSURES DISPROPORTIONATELY
BENEFITS SUBPOPULATIONS.
THE SAME IS TRUE FOR BISPHENOL
AND PHTHALATE EXPOSURES.
THEY'VE BEEN PREVENTED IN
HIGH-INCOME POPULATIONS AS WELL
AS LOW.
THE NATURE OF THE INTERVENTION
MAY DIFFER BUT WE NEED TARGETED
INTERVENTIONS.
THE HOUSEHOLD ENVIRONMENT IS
IMPORTANT TOO.
PROBABLY NOT AS GOING TO BE AS
EASY TO INCOME IN LOW-INCOME
POPULATIONS BUT REINFORCES THE
POLICY THAT POLICY EXPOSURE CAN
PRODUCE SUBSTANTIAL DECREASES IN
THE FLAME RETARDANTS AND THE
PFAS.
WITH THAT I'LL EMPHASIZE WE'VE
DOCUMENTED THE EXPOSURE TO THE
VDCs IS ANYWHERE FROM 70 TO 100%
PLASTIC AND THE PROPORTION OF
EDC RELATED DISEASE BURDEN THAT
IS DUE TO PLASTIC IS IN THAT
SAME RANGE WITH THE DISPARITIES
FOLLOWING THE SAME DRUMBEAT.
SO WE NEED TO PARTICULARLY FOCUS
AS WE THINK ABOUT A GLOBAL
PLASTICS TREATY AND OTHER STEPS
TO REDUCE THESE CHEMICAL
EXPOSURES ABOUT THE PRIMARY
SOURCES AND FOCUS ON THOSE
PREVENTION STEPS AS WELL.
THANK YOU FOR THE OPPORTUNITY.
>> SHOULD I BEGIN?
>> YES.
THANK YOU.
>> HOLD ON, SORRY.
>> DR. TRASSANDE I NEED YOU TO
STOP MOVING THE MOUSE FOR A
SECOND.
>> I CAN'T MUTE.
THAT'S WHAT CAN'T DO.
OKAY.
YOU CAN MUTE NOW.
>> OKAY.
SEEMS LIKE -- SO SHOULD I BEGIN?
YES?
>> YES, THANKS.
>> I'M DR. ZOTA FROM COLUMBIA
UNIVERSITY.
WHAT I'M GOING TO FOCUS MY TALK
ON IS THE ROLE OF SOCIAL AND
STRUCTURAL DETERMINATES IN
DRIVING INEQUITIES IN EDC
EXPOSURES AND POTENTIAL
INTERVENTIONS AND I KIND MUCH
CALL THIS LINE OF WORK THE
ENVIRONMENTAL INJUSTICE AND
BEAUTY AND I'LL BE DEFINING THAT
LATER.
MY TALK IS GOING TO BE FOCUSSED
ON THE BEAUTY CARE PRODUCTS IN
INDUSTRY.
I THINK WE'VE HAD MANY TALKS
THAT HAVE HIGHLIGHTED OUR
LARGELY UNREGULATED INDUSTRY OF
COSMETICS, BEAUTY PRODUCTS,
PERSONAL CARE PRODUCTS CONTAIN
MULTIPLE ENDOCRINE DISRUPTING
CHEMICALS THAT CAN HARM HEALTH
AND WE MENTIONED SOME ALREADY.
THESE LOVELY GRAPHICS ARE
AVAILABLE TO ALL OF YOU FROM THE
CAMPAIGN FOR SAFE COSMETICS THE
BCPP SAFER BLACK BEAUTY
CAMPAIGN.
WE TALKED ABOUT PARABENS AND
PFAS AND UC FILTERS.
THESE ARE IN PRODUCTS WE USE
EVERY DAY THAT CAN GET INTO OUR
BODIES AND IMPACT HEALTH ACROSS
THE LIFE COURSE.
THE EVIDENCE IS ALSO BUILDING
AROUND THE LIFE COURSE IMPACTS
OF PERSONAL CARE PRODUCTS
PARTICULARLY ON WOMEN'S HEALTH
OUTCOMES.
SO THIS IS NOT EASY RESEARCH TO
DO AND THE METHODS ON HOW TO
QUANTIFY THESE RISK ARE
ADVANCING YEARLY BUT WE HAVE
EVIDENCE ON EARLY MENARCHE TO
GIN
GI
GINECOLOGIC OUTCOME AND THE
HEALTH EVIDENCE IS BUILDING.
THE WORK OF MY COLLEAGUES AND I
SHOW THE RISK IS NOT THE SAME
FOR ALL POPULATIONS.
BLACK AND LATINX POPULATIONS IN
THE U.S. USE MORE PRODUCTS
ACROSS MULTIPLE CATEGORIES AND
MORE TOXIC PRODUCTS ACROSS
MULTIPLE CATEGORIES.
WE LOOKED AT HAIR PRODUCT USE,
SKIN LIGHTENING CREAMS, COSM
COSMETICS AS WELL AS FRAGRANCE
PRODUCTS BEING A CATCH-ALL TERM
THAT CAN HAVE MANY CHEMICALS
OFTEN YOU HAVE NO IDEA WHAT'S IN
IT AND PARTICULARLY FRAGRANCED
VAGINAL AND INTIMATE CARE
PRODUCTS.
WE KNOW THESE DISPARITY ARE
DRIVING THE DISPARITIES IN THE
LEVELS OF CHEMICALS IN OUR
BODIES.
MY TEAM PUBLISHED A STUDY WHERE
WE LAID THIS OUT PIECE BY PIECE
USING NHANES DATA AND PRODUCTS
USED AROUND OURSELF YOU'LL
REPRODUCTIVE ORGANS FOR DECADES
AND THERE WERE RACIAL ETHNIC
DIFFERENCES IN THE PRODUCTS
BEING USED ESPECIALLY THOSE
OFTEN USED TO CONTROL ODOR,
ALT
ALTER SCENT WERE MORE LIKELY TO
BE USED BY BLACK WOMEN THAN
WHITE WOMEN AND FOUND VAGINAL
DOUCHING IN PARTICULAR WAS
ASSOCIATED WITH ONE PHTHALATE IN
A DOSE RESPONSE WAY SO WOMEN WHO
DOUCHED FREQUENTLY HAD 150%
HIGHER LEVELS THAN THOSE WHO DID
NOT DOUCHE AND IT EXPLAINS THE
BLACK-WHITE DIFFERENCE IN
PHTHALATES.
WHEN I DID THIS WE GOT A LOT OF
PRESS BUT THE REPORTERS WERE
ALMOST VILIFYING THE USERS,
WOMEN WHO DOUCHE AND SAYING
WELL, THIS PRACTICE IS
DISCOURAGED BY THE OB-GYN
COMMUNITY AND WHY ARE WOMEN
DOING THIS BUT THERE'S A LONG
SOCIAL CONTEXT ON WHAT ARE
BEAUTY NORMS AND ADAPTIVE
BEHAVIORS THAT PEOPLE USE TO
COMPLY WITH THE BEAUTY FORMS.
I THOUGHT THAT WAS ABSENT IN ANY
BODY OF LITERATURE.
SO I STARTED FIRST WRITING ABOUT
THIS IDEA OF ENVIRONMENTAL
INJUSTICE OF BEAUTY AND
REFRAMING A DISPARITY IN PRODUCT
USE AND ASSOCIATED HEALTH
OUTCOMES AS AN ENVIRONMENTAL
HEALTH JUSTICE CONCERN.
I FIRST WROTE THIS IN 2009 BUT
TOOK A WHILE TO COME TO THE
LITERATURE.
I TEAMED UP WITH A SOCIAL
SCIENTIST AND WE PUBLISHED IT
EIGHT OR NINE YEARS LATER AND TO
REFLECT ON HOW FAR WE'VE COME, I
REMEMBER WHEN WE WERE TRYING TO
PUBLISH THIS WE WENT TO ONE OF
THE LARGE ENVIRONMENTAL HEALTH
JOURNALS TO SEE IF THEY WERE
INTERESTED IN AND THAT I DIDN'T
THINK THIS WAS AN ENVIRONMENTAL
HEALTH ISSUE.
IT'S A BIG DEAL THAT NOW WE'RE
HAVING CONFERENCES LIKE THIS.
THE REASON WE DEVELOPED THE
FRAMEWORK IS WE THINK PRODUCT
USE DEPENDS ON THE INDIVIDUAL
AND THERE'S FACTORS HOW WOMEN
THINK ABOUT BEAUTY WAS IT'S A
GENDER FORM OF POWER AND THE
PRODUCTS THEY USE, WE KNOW THERE
ARE LOTS OF SOCIAL ECONOMIC AND
HISTORICAL FACTORS THAT
INFLUENCE WHAT WE FIND
BEAUTIFUL.
AND THESE FACTORS AND PRESSURES
ARE NOT THE SAME FOR ALL WOMEN
BUT VARY ACCORDING TO ONE'S
SOCIAL POSITION.
SO FOR EXAMPLE GLOBALLY,
WHITENESS AND WHITE FEMININITY
ARE THE BEAUTY A DEALS AT THE
TOP OF OUR BEAUTY HIERARCHY AND
THE CLOSER YOU ARE TO THOSE
BEAUTY NORMS THE MORE SOCIAL
ECONOMIC OPPORTUNITIES YOU'LL BE
AFFORD AND THEY'RE ENFORCED
THROUGH ADVERTISING AND POLICIES
IN THE WORKPLACE AND SCHOOLS AND
PEER PRESSURE AND CULTURAL
TRADITION.
WOMEN OF COLOR ARE INHERENTLY
OUTSIDE THE BEAUTY FORMS AND
THEY OFTEN EXPERIENCE
SYNERGISTIC FORMS OF
DISCRIMINATION AT THE
INTERSECTION THE RACISM, SEXISM
AND CLASSISM LEADING TO USE OF
MORE PRODUCTS AS AN ADAPTIVE
RESPONSE.
WE CREATED THIS FRAMEWORK TO
HELP UNDERSTAND HOW THESE
FACTORS ARE INTERCONNECTED.
AND SO MY GROUP AND MY
COLLEAGUES WE'VE DEVELOPED A
RESEARCH AGENDA THAT'S BEEN
INFORMED BY THE THEORY OF
CHANGE.
IF WE'RE GOING TO ADDRESS THESE
DISPARITIES WE NEED TO THINK OF
INTERVENTIONS ON MULTIPLE
LEVELS.
SO SOME OF THESE WERE MENTIONED
AS BEHAVIORAL INTERVENTIONS.
IN MY OPINION THAT ALONE WON'T
SOLVE THE PROBLEM.
WE NEED POLICY CHANGE, LAWS THAT
ARE GOING TO REGULATE CHEMICALS
MORE EFFECTIVELY AND NEED
CHAMPIONS IN THE PRIVATE SECTOR
WHO ARE WILLING TO MAKE CLEANER
AND SAFER PRODUCTS AS PART OF
THEIR BRAND IDENTITY AND THE
ELEPHANT IN THE ROOM IS
ADDRESSING SOCIAL NORMS.
AS LONG AS STRESSORS LIKE HAIR
DISCRIMINATION EXIST PEOPLE BE
PUSHED TO USE THEM.
I'LL TALK ABOUT THE RESEARCH
WE'VE DONE AROUND THIS TO
IDENTIFY THE LINKAGES AS WELL AS
THINK ABOUT INTERVENTIONS.
OFTEN IN COLLABORATION WITH
COMMUNITY GROUPS.
I'M HERE IN NORTHERN MANHATTAN
WE COLLABORATE WITH WE ACT FOR
ENVIRONMENTAL JUSTICE ONE OF THE
LONGEST STANDING ENVIRONMENTAL
JUSTICE ORGANIZATIONS THAT ARE
FOCUSSED ON EMPOWERING AND
ORGANIZING LOW-INCOME PEOPLE OF
COLOR.
NAY HAVE A BEAUTY INSIGHT-OUT
CAMPAIGN AND HAVE LONG FOCUSSED
ON TOXICS.
THE GOAL IS TO RAISE AWARENESS
ABOUT TOXIC BEAUTY PRODUCTS IN
ORDER TO PROTECT CONSUMERS AND
WI AC COMMUNITIES BECAUSE
NORTHERN COMMUNITY AND THE BRONX
HAVE SO MANY BEAUTY SUPPLY
STORES.
WHEN THEY DEVELOPED THE CAMPAIGN
THEY RECOGNIZED THERE WAS NO
DATA ON PRODUCT USE AND DRIVERS
OF PRODUCT USE IN THEIR
COMMUNITIES.
SO WE PARTNERED TOGETHER --
>> TWO MINUTES.
>> OKAY.
WE DECIDED TO FOCUS ON TWO
STRESSORS.
ONE ON NATURAL-HAIR
DISCRIMINATION AND DID A SURVEY
AND FOUND CHEMICAL STRAIGHTENER
USE IS DECLINING BUT STILL
PREVALENT IN BLACK COMMUNITIES
AND IN TERMS OF SOCIAL
DETERMINATES WE FOUND
RESPONDENTS THROUGH PEERS OR
FAMILY MEMBERS EXPRESSED
PREFERENCE FOR STRAIGHT HAIR
WERE MORE LIKELY TO USE CHEMICAL
STRAIGHTENERS IN THEIR LIFE
TIMES AND PEOPLE WHO THOUGHT
OTHERS THOUGHT STRAIGHT HAIR WAS
ASSOCIATED WITH BEAUTY BEING
MORE PROFESSIONAL AND YOUNGER
AND WEALTHIER WERE MORE LIKELY
TO USE STRAIGHTENERS IN THEIR
LIFE TIME.
OCCIDENTAL COLLEGE IS WORKING
WITH A POPULATION AND THEY'RE
STARTING TO DO COMMUNITY-LEVEL
INTERVENTIONS AN USING A
SMARTPHONE APP TO COLLECT DATA
AMONG BLACK AND LATINA WOMEN AND
UNDERSTAND THE COMPLEXITY OF
PRODUCT USE.
FOR EXAMPLE, IN TERMS OF NEW
CHEMICALS WE'RE FOCUSSING ON ONE
FORMALDEHYDE RELEASES AND IS A
FOCUS OF FDA.
THEY'VE BEEN PRIMARILY FOCUSSED
ON HAIR PRODUCTS.
WE'RE FINDING 6% TO 8% OF ALL
PERSONAL CARE PRODUCTS LIST
FORMALDEHYDE OR RELEASERS AND
TWO-THIRDS USE PRODUCTS WITH
FORMALDEHYDE RELEASERS INCLUDING
FACE CREAMS AND INCREASE
PRODUCTS.
AND BIOLOGICAL MECHANISMS ARE
NOT WELL UNDERSTOOD FOR HOW
THESE PRODUCTS IMPACT HEALTH.
SO WE ARE ACTUALLY -- THIS SLIDE
DIDN'T TRANSLATE WELL BUT
BEGINNING A CASE CROSSOVER STUDY
WHICH WILL INFORM INTERVENTIONS
WITH THE FOCUS ON UNDERSTANDING
BIOLOGICAL PROCESSES.
HERE WE'RE GOING TO BE
RECRUITING WOMEN WHO ALREADY
RELAX THEIR HAIR AND HAVE THEM
GO IN ONE SALON DO A HAIR
RELAXER TREATMENT AND
CHEMICAL-FREE TREATMENT AND THEN
GO BACK TO A CHEMICAL TREATMENT
AND WE'LL COLLECT 12 URINE
SAMPLES TO CHARACTERIZE
METABOLOMIC SIGNATURES IN URINE
SPECIFIC TO EACH SALON
TREATMENT.
BECAUSE WE'LL BE IN A CONTROLLED
SETTING WE'LL BE ABLE TO MATCH
THE METABOLOMIC PROFILE TO THE
CHEMICAL PROFILES OF ALL THE
PRODUCTS USED IN THE SALON WHICH
WE'RE GETTING TARGETED AND
NON-TARGETED TESTING FOR THE
METABOLOMICS AND WE'LL DO
QUALITATIVE WORK WHILE WE DO THE
STUDY TO UNDERSTAND WHAT WOMEN'S
EXPERIENCES WERE WITH THE
CHEMICAL-FREE SILK PRESSED
TREATMENT.
SO WITH THAT, I JUST WANT TO
THANK MY TEAM AND I'LL END
THERE.
THANK YOU.
>> GOOD MORNING AND THREW --
THANK YOU TO THE WORKSHOP
ORGANIZERS.
I'LL TALK ABOUT EDC WORKPLACE
EXPOSURE AS A DRIVER TO HEALTH
DISPARITIES AS WELL AS AN
OPPORTUNITY FOR PUBLIC HEALTH
ACTION TO MITIGATE HEALTH
INEQUITIES.
SO WE KNOW SEVERAL FACTORS CAN
CONTRIBUTE TO AN INDIVIDUAL'S
VULNERABILITY WHEN IT COMES TO
ENVIRONMENTAL EXPOSURES.
THESE INCLUDE SUSCEPTIBILITY AND
PRECONCEPTION, PRENATAL AND
CHILDHOOD PERIOD AND PREEXISTING
CONDITIONS AND GENETICS IN
ADDITION TO ACCESS TO HEALTH
CARE, HEALTH THE FOODS AND
PRODUCT AS WELL AS AN
INDIVIDUAL'S ABILITY TO
ANTICIPATE AND RECOGNIZE OR
RECOUP FROM EXPOSURES.
WE ALSO KNOW WHERE WE LIVE AND
WORK CAN HAVE AN IMPACT ON OUR
HEALTH.
IT'S WIDELY RECOGNIZED THAT
HIGHER ENVIRONMENTAL EXPOSURES
HAVE BEEN DOCUMENTED IN
LOWER-INCOME AND COMMUNES OF
COLOR LARGELY DUE TO PRACTICES
ROOTED IN STRUCTURAL RACISM SUCH
AS REDLINING AND IT'S OFTEN
THESE INDIVIDUALS WHO HOLD MORE
HAZARDOUS JOBS.
ONE THING OFTEN IGNORED IS THAT
WORK IS AN IMPORTANT SOCIAL
DETERMINATE OF HEALTH OFTEN
NEGLECTED WHEN WE TALK ABOUT
PUBLIC HEALTH RESEARCH AND
INTERVENTIONS.
IN FACT THE WORKPLACE CAN
INCREASE A PERSON'S
VULNERABILITIES THAT CAN LEAD TO
HEALTH INEQUITIES.
RESEARCH SHOWS THE WORKPLACE CAN
ACCOUNT FOR 30% TO 55%
INEQUITIES AND THOUGH THE
WORKPLACE IS AN EXCELLENT AVENUE
FOR INTERVENTIONS.
I WANT TO TALK ABOUT RESEARCH ON
HAIR DRESSERS OF COLOR WHO ARE A
VULNERABLE EXPERIENCE
EXPERIENCING EDC EXPOSURE
DISPARITIES AND A POTENTIALLY
HIGHER RISK OF HEALTH INEQUITIES
DUE TO THESE EXPOSURES.
SO A LITTLE BIT ABOUT WHAT LED
TO THIS WORK.
WE KNOW AS OTHERS HAVE SHOWN
THAT WOMEN HAVE A HIGHER BODY
BURDEN WHEN WE'RE TALKING ABOUT
EDCs PRESENT IN PERSONAL CARE
PRODUCTS COMPARED TO FEMALES AND
FOR WOMEN IT'S BLACK AND LA
TEENA WHO HAVE A HIGHER BODY
BURDEN.
THIS -- LATINA AND DUE TO
SOCIAL-CULTURAL DIFFERENCES IN
PRODUCT USE AND SPECIFIC
PRODUCTS MARKETED TO THIS
POPULATION AS WELL AS ED
FREQUENCY OF USE AND VARIETY OF
DIFFERENT PRODUCTS, INFLUENCED
BY A SOCIETAL PRESSURES AND
SOCIETAL CULTURAL NORMS TO FIT
INTO AN BEAUTY STANDARD.
WE KNOW WOMEN IN GENERAL IN THE
U.S. POPULATION WOMEN OF COLOR
HAVE A HIGHER BURDEN OF ECDs BUT
WHAT ABOUT WOMEN WHO USE THEM AS
PART OF THEIR JOBS WHICH LED US
TO STUDY HAIR DRESSERS IN THE
U.S. THERE'S OVER 700,000 HAIR
ADDRESSERS AND IT'S A LARGELY
FEMALE WORKFORCE.
THE AVERAGE AGE IS 38.
WHICH MEANS THEY'RE WOMEN OF
REPRODUCTIVE AGE AND IT POSES A
WOMEN'S AND CHILDREN'S HEALTH
RISK.
IT'S A POPULATION EXPERIENCING
BOTH CHEMICAL AND NON-CHEMICAL
STRESSORS OUTSIDE THE WORKPLACE
AS WELL.
THEY ALSO FACE BARRIERS IN
ACCESSING SAVING RESOURCE AND
UNAWARE OFTEN OF WORKPLACE
HAZARDS.
SO PRIOR TO THIS WORK AND STILL
THERE'S VERY FEW STUDY WHERE WE
TALK ABOUT SALON SPACES
PARTICULARLY IN THE UNITED
STATES.
IN ADDITION, FINDINGS FROM
EPIDEMIOLOGIC STUDIES ARE
INCONCLUSIVE.
MOST ARE DONE IN EUROPE AND RELY
ON JOB TITLE TO ASSESS EXPOSURE.
SO THERE'S LITTLE INFORMATION ON
CHEMICAL EXPOSURE ON THE
SITTINGS AND DATA TO WOMEN
SERVING A RACIALLY ETHNIC
DIVERSE POPULATION IS CURRENTLY
LACKING AND PRODUCTS TARGETED TO
BLACK WOMEN WHICH INCLUDE MANY
TOXIC CHEMICALS.
I WANT TO BRIEFLY ACKNOWLEDGE MY
COMMUNITY PARTNER AND PRIOR
PILOT STUDY PARTICIPANT KARINA
RANDOLPH A SALON OWNER.
YOU'LL SEE HER IN A LOT OF
PICTURES.
TO BEGIN ADDRESSING SOME GAPS WE
STARTED PILOT STUDIES.
FOR SELECT INDOOR AIR RESULTS
INDOOR ORGANIC VOLATILE
COMPOUNDS MEDIUM IS TWO TO 75
TIMES HIGHER IN SALONS AND
OFFICE SPACED AND PM
CONCENTRATIONS WERE HIGHER IN
SALONS SERVING LATINA AND BLACK
CLIENTELE VERSUS SHOWS SERVING
JUST BLACK WOMEN.
WE ALSO CONDUCTED BIO MONITORING
AND TOOK URINE SAMPLES AT THE
END OF THE WORK SHIFT TO ASSESS
EXPOSURE FOR THE WORKDAY AND FOR
HERE WE SEE EACH REPRESENT
DIFFERENT BIOMARKERS FOR
DIFFERENT ECDs AND THE BLUE
REPRESENTS OFFICE WORKERS AND
RED IS HAIR DRESSERS.
AND WE'RE SEEING THAT ACROSS THE
BOARD WE'RE SEEING STATISTICALLY
SIGNIFICANTLY HIGHER
CONCENTRATIONS OF THE VOCs IN
THE SAMPLE SIZE AND SAW
DIFFERENCES AMONG HAIR DRESSERS
BASED ON CLIENTELE.
WE SAW THAT HAIR DRESSERS
WORKING IN BLACK SALONS WHO
HAPPEN TO BE BLACK FEMALE
HAIRSTYLISTS HAD HIGHER
CONCENTRATIONS OF VOCs COMPARED
TO THOSE SERVING IN LATINO AND
BLACK CLIENTELE.
FOR PHTHALATES WE SAW HIGHER
CONCENTRATIONS OBSERVED AMONG
HAIR DRESSERS COMPARED TO OFFICE
WORKERS.
FOR EXAMPLE, GEOMETRIC
CONCENTRATIONS FOR MEP WERE TEN
TIMES HIGHER AND COMPARED TO
WOMEN IN THE GENERAL POPULATION
OF THE SAME AGE RANGE WE'RE
SEEING MEDIAN CONCENTRATIONS
WERE HIGHER THAN THE 75% AMONG
WOMEN IN THE U.S.
AND COMPARED TO OTHER STUDIES
AND PUBLISHED LITERATURE MEDIUM
CONCENTRATIONS WERE UP TO 41
TIMES HIGHER THEN THE LEVELS
LINKED WITH PREMATURE OVARIAN
FAILURE.
MEP IS A BIOMARKER OF DET
COMPARED IN SOME STUDIYS TO --
STUDIES ASSOCIATED WITH PRETERM
BIRTH AND PREGNANCY
COMPLICATIONS AMONG OTHERS.
WHAT YOU SEE IS DIFFERENT VOCs
FOR WHICH WE MEASURED BIOMARKERS
IN URINE AND ON THE Y AXIS WE
HAVE DIFFERENT SERVICES OR
WORKPLACE CHARACTERISTS AND THE
PLUS INDICATES IF YOU USED A
PARTICULAR AUSE OF A PRODUCT YOU
HAD HIGHER VOCs.
THERE'S BEEN A BIG PUSH FOR
GOING NATURAL AND NOT RELAXING
YOUR HAIR OR NOT TEXTURIZING
YOUR HAIR.
BECAUSE IT'S BELIEVED IT'S MUCH
SAFER OR TOXIC FREE OR CHEMICAL
FREE TO GET NATURAL HAIR
SERVICES AND THERE'S STILL
CHEMICALS BEING USED AND WE DID
FIND FOR THOSE HAIR DRESSERS
REPORTING PROVIDING THE SERVICES
WE'RE STILL FINDING HIGH
CHEMICAL EXPOSURES.
WE ALSO ASKED A DETAILED HEALTH
HISTORY.
WE LOOKED AT THE PREVALENCE OF
ASTHMA AMONG U.S. ADULTS 8.4 AND
U.S. BLACKS IS 10.4 AND UP OUR
STUDY WE HAD A PREVALENCE OF
17.4% IN HAIR DRESSERS AND 75%
OF THE HAIR DRESSERS THAT WE
INTERVIEWED HAD BEEN DIAGNOSED
AT SOME POINT DURING EMPLOYMENT
AND WE'RE HOPING TO LOOK AT THIS
FURTHER WITH A GRANT WE JUST
GOT.
WE LOOKED AT GYNECOLOGIC
CONDITIONS AND ADVERSE PREGNANCY
CONDITIONS ON BIRTH OUTCOMES.
THE BLUE BARS OR TOP BARS
REPRESENT HAIR DRESSER AND THE
GREEN ARE OFFICE WORKERS AND
RACIALLY AND ETHNICALLY SIMILAR
COMPARISON GROUPS.
FOR EXAMPLE WE FOUND THAT FOR
MENSTRUAL CYCLE ABNORMALITIES
WAS ALMOST DOUBLE THE PREVALENCE
REPORTED IN OFFICE WORKERS AND
SO MENSTRUAL CYCLE ABNORMALITIES
ARE IMPORTANT FOR FROM THE
STANDPOINT OF FERTILITY AND
LINKED TO PREMATURE MORTALITY
AND INCREASED RISK OF CARDIO
METABOLIC DISEASES AS WELL AS
DIFFERENT OUTCOME PREGNANCY,
PREECLAMPSIA AND DIFFICULTY
CONCEIVING AND FOUND A HIGHER
PREVALENCE IN OUR SMALL SAMPLE
OF HAIR DRESSERS.
IN WORKING WITH THE EDC AND
DISPARITIES THERE'S CULTURAL
CONSIDERATIONS ARE PARAMOUNT
WHEN CON CAN DU-- CONDUCTING T
WORK AND INCENTIVES HAVE TO BE
GIVEN TO YOUR COMMUNITY AND
DOESN'T HAVE TO JUST BE
MONETARY.
YOU CAN ARM YOUR COMMUNITY WITH
RESOURCES.
WE HAVE TO THINK ABOUT HOW TO
INFORM SUSTAINABLE INTERVENTIONS
LIKE OTHER COLLEAGUES MENTIONED.
IT'S ESSENTIAL TO BUILD TRUST TO
START IMPACTING BEHAVIORS AND
STUDY TEAM MEMBERS SHOULD HAVE
REPRESENTATION FROM THE TARGET
POPULATION.
AND I KNOW DR. ZOTA ALSO
MENTIONED THIS SO I'M GLAD WHEN
I HEARD HER SAY THIS BUT THE
ELEPHANT IN THE ROOM IS UNTIL WE
BEGIN ADDRESSING SYSTEMIC AND
STRUCTURAL ISSUES WE'LL CONTINUE
TO SEE HEALTH INEQUITIES WITH
THE MOST VULNERABLE SUFFERING
THE BURDEN.
WE CAN'T WORK IN SILOS.
IT WILL TAKE A VILLAGE AND ALL
STAKEHOLDERS TO ENSURE
EVERYONE'S RIGHT TO HEALTH
EQUITY AND NOT ONLY ACADEMICS
BUT COMMUNITY AND POLICY MAKERS
AND ADVOCACY GROUPS AS WELL AS
PRODUCT MANUFACTURERS AND
INDUSTRY.
WITH THAT I WANT TO ACKNOWLEDGE
MY RESEARCH TEAM, STUDY
PARTICIPANTS, STUDENTS AND TO
THANK THE AUD YEPS FOR BEING
HERE TODAY.
THANK YOU.
-- AUDIENCE FOR BEING HERE
TODAY.
THANK YOU.
>> THANK YOU.
WE HAVE ENOUGH TIME FOR
QUESTIONS.
I SAW A FEW PEOPLE TAKING
PICTURES.
HOT OF PEOPLE JOTTING DOWN
NOTES.
SO ANY QUESTIONS ON THE FLOOR ?
>> I'M AT NCCIH.
I KNOW YOU'RE PRESSED FOR TIME
BUT I SAW ONE LINE ALL NEGATIVES
ON THE BOTTOM OF THAT COMPLEX
SCREEN ABOUT WEARING MASKS.
I'M CURIOUS WHAT KIND OF MANAGES
AND DID YOU REALLY SOO THAT MUCH
OF A REDUCTION OF EXPOSURE FOR
PEOPLE WEARING MASKS?
>> THANK YOU.
THE QUESTION WAS RECALL --
THAT'S A GREAT QUESTION.
THIS STUDY HAPPENED BEFORE
COVID.
WE NEED TO LOOK AT THIS FURTHER
BECAUSE IT WAS A PILOT STUDY.
WE WERE SEEING WHAT WORKED AND
WHAT DIDN'T AND THAT WAS A
CONCERN WHERE WE DIDN'T REALLY
GET INTO WHAT TYPE OF MASK THEY
WERE WEARING.
WE JUST ASKED DO YOU WEAR ANY
TYPE OF MASK WHEN YOU'RE
CONDUCTING DIFFERENT TYPES OF
SERVICES.
WE NEED TO LOOK AT THAT WE NEED
TO LOOK AT THAT FURTHER.
>> I KNOW IN MANY NAIL SALONS
WHERE THEY HAVE EXPOSURES TO
ECDs EVEN BEFORE COVID THEY'D
WEAR MASKS BECAUSE THE FUMES ARE
SO STRONG AND TO SEE THERE MAY
BE PROTECTIVE BENEFIT FROM MASKS
BUT DID YOU CAPTURE INFORMATION
ON VENTILATION OR GLOVES?
I KNOW SOMETIMES WHEN PEOPLE ARE
HANDLING THE NO-LYE BASE
RELAXERS THEY'LL HAVE TO WEAR
GLOVES BECAUSE IT CAN BURN THEIR
FINGERS.
>> WE DIDN'T FIND DIFFERENT
GLOVE USE FOR THE DIFFERENT
CHEMICALS WE MEASURED AND THE
OTHER QUESTION WAS ABOUT
VENTILATION.
WE LOOKED AT VENTILATION BUT
THOUGH WE HAVE MONITORED 23 TO
30 WORKERS DEPENDING ON THE
PILOT STUDY WAS SIX SALONS.
TO US IT'S NOT ENOUGH SAMPLE
SIZE BUT KNOW VENTILATION IS NOT
SUFFICIENT AND OFTEN TIMES THEY
DON'T HAVE A LOT OF CONTROL OVER
THIS.
>> HI, MY NAME IS AMY.
MY QUESTION IS ABOUT TOXIC
CLEANING AND BEAUTY PRODUCTS AND
I WORK WITH FARM WORKING WOMEN
WHO BUY MOST THEIR PRODUCTS FROM
THE 99 CENT STORE AND A LOT OF
THOSE PRODUCTS ARE HARMFUL.
THEY'RE NOT USUALLY NATURAL,
ORGANIC AND PART OF THE REASON
THEY PURCHASE THESE PRODUCTS IS
PROXIMITY AND PRICE.
I'M CURIOUS WHAT RECOMMENDATIONS
YOU HAVE FOR COMMUNITIES WHO
LIVE IN ISOLATED AREAS AND WHAT
IS MAYBE MOST ACCESSIBLE AND
WHAT TYPES OF CHANGES CAN THEY
MAKE THAT IS AFFORDABLE AND IN
REACH OR IF SOMEONE ELSE WANTS
TO ANSWER.
>> ANYONE CAN JUMP IN.
>> I THINK YOU BRING UP A REALLY
GOOD POINT ABOUT ACCESSIBILITY
BOTH IN TERMS OF PRICE AS WELL
AS JUST GEOGRAPHIC ACCESS.
I THINK WHEN WE TALK ABOUT
INTERVENTIONS IN THE SPACE, I
THINK AN INDIVIDUAL CAN DO ONLY
SO MUCH AND THERE ARE MULTIPLE
EFFORTS BY THE NGO COMMUNITY TO
WORK DIRECTLY WITH BUSINESSES ON
THEIR CHEMICAL POLICY FOR
STORES.
SO FOR EXAMPLE THERE'S AN EFFORT
CALLED MIND THE STORE WHERE THEY
WORK WITH RETAILERS AND THEY'VE
HAD A LOT OF SUCCESS.
THEY GOT METHYLENE CHLORIDE -- I
THINK IT WAS THAT, OUT OF HOME
DEPOT AND OTHER STORES LIKE
THAT.
AND THEY'VE AFFECTED WHAT IS
SOLD.
THEY'VE TRIED ENGAGING DOLLAR
STORES BUT THERE'S LESS
RECEPTIVITY AND THAT'S WHERE
PUBLISH PRESSURE AND MEDIA
ATTENTION IN THE ISSUES CAN HELP
CREATE A FEEDBACK LOOP TO PUT
PRESSURE ON THE STORES.
BECAUSE WE CAN TELL YOU THINGS
LIKE MAYBE THEY CAN MAKE THEIR
OWN PRODUCTS BUT THE REALITY IS
WITH THIS ISSUE INDIVIDUALS HAVE
POWER TO A CERTAIN AMOUNT BUT WE
HAVE TO IMPACT WHAT'S AVAILABLE
AT THE STORE LEVEL AND WHAT'S
GOING ON WITH POLICY TOO BECAUSE
WE CAN'T.
SHOP OUR WAY OUT OF THE PROBLEM.
>> THANK YOU.
I HAD ONE QUESTION FOR THE
ENTIRE PANEL AND AN EMERGING
TOPIC.
THERE'S A RECENT DATA AND BIRTH
DEFECTS AND OTHER THINGS, HARM
THINGS THAT ARE COMING WITH ECDs
AND THEY WERE LOOKING AT THE
PAPER LOOKED AT PSYCHOSOCIAL
FACTORS.
MORE NON-CHEMICAL STRESSORS IN
CONJUNCTION WITH THE CHEMICAL
STRESSORS AND HOW THAT WAS
PLAYING A ROLE IN HARM AS WELL
AS BEING SEEN IN POPULATIONS
THAT EXPERIENCE HEALTH
DISPARITIES.
SO I'M CURIOUS FOR PEOPLE WHO
ARE INVESTIGATING THIS FIELD OF
WORK IN YOUR FIELD OF WORK, ARE
THERE OTHER NON-CHEMICAL
STRESSORS THAT YOU ARE
ACCOUNTING FOR AND SHOULD THERE
BE OTHER MEASUREMENTS WHEN
COLLECTING THE DATA ON THE ECDs?
WAS MY QUESTION CLEAR?
>> I THINK THERE'S SOME DATA
AROUND SYNERGISTIC IMPACTS OF
ECDs AND STRESS.
PARTICULARLY FOR THE PRENATAL
PERIOD.
WHEN I THINK ABOUT STRESS I
THINKS IT'S JUST AS COMPLICATED
AS TRYING TO MEASURE
ENVIRONMENTAL CHEMICALS.
SO THERE'S SO MANY DIFFERENT
FORMS OF STRESS AND YOU HAVE TO
THINK ABOUT ARE YOU MORE
INTERESTED IN ACUTE STRESS OR
MORE INTERESTED IN CHRONIC
STRESS.
AND SO I THINK THE MEASUREMENT
OF WHAT TYPE OF STRESS YOU WANT
TO MEASURE DEPENDS ON THE B
BIOLOGICAL PATHWAYS YOU THINK
MAY BE IMPACTED AS WELL AS THE
HEALTH OUTCOMES OF
CONSIDERATION.
I KNOW ONE PARTICULAR FORM OF
STRESS THAT MY GROUP IS THINKING
MORE ABOUT AS WE THINK ABOUT HOW
TO BRING INTERSECTIONALITY INTO
THIS WORK AND THINKING ABOUT
MULTIPLE FORMS OF MARGI
MARGINALIZATION AND HOW THEY MAY
SYNERGISTICALLY IMPACT IS
GENDERED RACISM AND THINKING
MORE HOW TO CAPTURE
SOCIAL-STRUCTURAL IMPACTS OF
INTERSECTIONAL IDENTITY.
THAT'S ONE FOR EXAMPLE THAT I
THINK IS LESS USED IN THIS SPACE
THAT WE'RE USING QUALITATIVE
DATA AS WELL AS SURVEY
MEASUREMENTS BUT I'LL LET OTHERS
JUMP IN HERE.
ANY OF THE OTHER PANELISTS HAVE
ANYTHING TO ADD?
S
>> A LOT OF US THINK OF
OXIDATIVE STRESS AND DIETARY
BIOMARKERS AND VARIOUS FORMS OF
STRESS HORMONE.
>> ANY OTHER COMMENTS ON THAT?
OKAY.
DR. QUIROS-ALCALA LIKES YOU'RE
POISED TO SAY SOMETHING?
OKAY, WELL, THANK YOU THAT WAS
AN EXCELLENT SESSION.
THANK YOU, EVERYONE.
SO KNOW WE'RE GOING TO MOVE ON
TO OUR LAST SESSION BEFORE LUNCH
MODERATED FROM DR. LAVERNE BROWN
FROM THE OFFICE OF DIETARY
SUPPLEMENTS.
AND PLEASE FEEL FREE TO SIT UP
HERE AS WELL AS LILLY MARCELIN.
DR. BROWN, THANK YOU.
>> GOOD MORNING, EVERYONE.
LET ME STOP AND SAY THIS HAS
BEEN A FANTASTICING W IING --
FANTASTIC WORKSHOP AND THANK YOU
FOR TO SEKAI FOR THE WORKSHOP
BECAUSE I'VE LEARNED SO MUCH.
MY NAME IS LAVERNE BROWN I LEAD
THE RESILIENCE AND HEALTH
STUDIES PROGRAM AT THE NIH
OFFICE OF DIETARY SUPPLEMENTS
AND LEAD THE NIH RESEARCH
WORKING GROUP.
BEFORE I INTRODUCE OUR ESTEEMED
PANELISTS FOR THE SESSION, I'D
LIKE TO FIRST PROVIDE A LITTLE
BIT OF AN OVERVIEW OF WHY WE
FELT IT WAS IMPORTANT TO HAVE A
SESSION DEDICATED SPECIFICALLY
TO RESILIENCE AGAINST EDC
ASSOCIATED DISEASES.
NOW THE NIH RESEARCH RESILIENCE
WORKING GROUP DEFINES RESILIENCE
AS THE CAPACITY TO RESIST, ADAPT
TO, RECOVER OR GROW FROM A
CHALLENGE FOR STRESSOR.
OUR UNDERSTANDING IS THAT
RESILIENCE OUTCOMES CAN BE
ATTRIBUTED TO PATHWAYS THAT ARE
UNIQUE AND UNRELATED TO ANY
DISEASE PATHWAY SUCH THAT
STUDIES OR PROGRAMS OR EVEN DATA
SOURCES INTENTIONAL ABOUT
CAPTURING RESILIENCE OUTCOMES
MAY EXPAND OUR UNDERSTANDING OF
HOW BEST TO PROMOTE FAVORABLE
HEALTH OUTCOMES UPON EXPOSURE TO
OR DARE I SAY DESPITE EXPOSURE
TO STRESSORS LIKE ECDs.
YOU IN OTHER WORDS AS WE
CONTINUE TO PREVENT, WE WORK TO
MITIGATE EXPOSURES TO ECDs THE
NIH RESILIENCE WORKING GROUP
BELIEVES IT'S ALSO IMPORTANT AT
THE SAME TIME CONSIDER HOW BEST
TO STRENGTHEN OUR SYSTEMS TO
BETTER RESPOND TO THOSE
EXPOSURES.
WE MIGHT BE ABLE TO DO THAT BY
IDENTIFYING AND ENHANCING
PROTECTIVE FACTORS THAT PROMOTE
RESILIENT OUTCOMES.
SO AS YOU'LL SEE FROM OUR
PANELISTS WHO REPRESENT THIS
VERY DIVERSE EXPECTS AND
EXPERTISE FROM THE RESILIENCE
SESSION TODAY, RESILIENCE
OUTCOMES CAN BE EXPLORED ACROSS
MULTIPLE DOMAINS.
WE CAN EXPLORE RESILIENCE
THROUGH THE LENS OF A COMMUNITY,
ENVIRONMENT, PSYCHOLOGICAL
RESILIENCE, PHYSIOLOGICAL
RESILIENCE, GENETICS OR EVEN AT
THE MOLECULAR OR CELLULAR LEVEL.
WITH THAT I'D LIKE TO WELCOME
OUR PANELISTS FOR THE SESSION.
EACH WILL BRIEFLY INTRODUCE THE
WORK THEY'RE DOING RELEVANT TO
THE SESSION AND FOLLOWING THE
BRIEF INTRODUCTORY PRESENTATIONS
THE PANELISTS WILL JOIN TOGETHER FOR PANEL DISCUSSION.
>> GOOD MORNING, EVERYONE.
I'M VERY HAPPY TO BE HERE.
THE CONFERENCE HAS BEEN
WONDERFUL.
MY NAME IS LILLIAN MARCELLIN AND
A STARTED AN ORGANIZATION 12
YEARS AGO.
AS YOU READ OUR MISSION
STATEMENT, I'D LIKE TO SHARE
WITH YOU THAT EVERY TIME I MEET
WITH OUR BOARD MEMBERS WE ALWAYS
TAKE THE TIME TO READ OUT LOUD
THE MISSION STATEMENT.
THE REASON IS I BELIEVE THE
MISSION STATEMENT SUCH AS OURS
COMES WITH ACCOUNTABILITY AND
RESPONSIBILITY TO OUR
COMMUNITIES, TO THE WOMEN THAT
WE WORK WITH.
SO ALSO THE MULTIPLE OPPRESSIONS
THAT SHOW IN MULTIPLE FORMS FOR
US IN THE BLACK COMMUNITY.
ONE SUCH OPPRESSION IS
ENVIRONMENTAL INJUSTICE.
SO THROUGH OR WORK AT THE
RESILIENT SISTERHOOD PROJECT.
I HAVE TO KEEP ADJUSTING THE
MIC.
CAN YOU HEAR ME WELL?
GOOD.
THROUGH OUR WORK RSP SHORT SHORE
THE RESILIENT SISTERHOOD
PROJECT, WE STRIVE TO
HISTORICALLY ACKNOWLEDGE AND TO
CONTEXTUALIZE EXPOSURE TO
ENVIRONMENTAL TOXIN IN THE BLACK
COMMUNITY FROM PERSONAL PRODUCT
AND SO MUCH MORE.
WITH THE WORK WE DO WE FOCUS ON
DISEASES OF REPRODUCTIVE SYSTEM
THAT DISPROPORTIONATELY AFFECT
WOMEN OF AFRICAN DESCENT AND
FIBROIDS.
I THINK YESTERDAY SOMEBODY ASKED
A QUESTION ABOUT BLACK WOMEN AND
FIBROIDS AND THE STATISTICS
ABOUT HOW MANY BLACK WOMEN ARE
AFFECTED BY FIBROIDS.
THE ANSWER IS 70% TO 80% OF
BLACK WOMEN EITHER HAVE OR WILL
HAVE FOLLICULAR FIBROIDS ACC
ACCORDING TO THE CDC.
THEY'RE NOT DISPROPORTIONATELY
ED BY ENDOMETRIOSIS BUT DO END
UP WITH HIGH RATES OF
ENDOMETRIOSIS AND WOMEN WITH
FIBROIDS AND SORRY FOR THE TYPO.
AND MANY ARE AFFECTED BY
FIBROIDS AND ENDOMETRIOSIS AND
PCO AND FERTILITY AND EARLY
PUBERTY AND MENOPAUSE WHICH ALSO
AFFECT YOUNG BLACK GIRLS.
ISSUES OF MENOPAUSE ALSO
REPRODUCTIVE HEALTH CONDITIONS
WE TALK ABOUT AND ALSO IN TERMS
OF HOW EXPOSURE TO ECDs
CONTRIBUTE TO MAKE THE
EXPERIENCES THEIR WOMEN TO BE
MORE CHALLENGING AND ONE PANEL
TALKED ABOUT THE IMPORTANCE OF
LOOKING AT ECDs THROUGH
REPRODUCTIVE HEALTH ACROSS THE
LIFE SPAN.
AND YOU CAN'T EMPOWER PEOPLE OR
FULLY ENGAGE WITH PEOPLE WITHOUT
ROOM BRINGING THE NECESSARY
KNOWLEDGE.
SO KNOWLEDGE GAPS AROUND FIRST
OF ALL TO START OUT WITH MANY OF
THE DISEASES IS OMITTED.
MANY TIMES I'LL TALK TO SOMEONE
DIAGNOSED WITH FIBROIDS AND
THEY'LL SAY I HAVE FIBROIDS I'M
LIKE OH, WOW.
TELL ME MORE, WHERE ARE THE
FIBROIDS LOCATED AND I'LL GET
THIS BLANK STARE.
OF COURSE IT'S NOT THE FAULT OF
THAT PATIENT FOR NOT KNOWING
WHERE THE FIBROIDS ARE LOCATED.
SO NOT ONLY THEY DON'T HAVE THE
BASIC KNOWLEDGE OF THE ILLNESS
AFFECTING THEM BUT YOU CAN
IMAGINE THE LACK OF KNOWLEDGE
THEY WOULD HAVE WHEN IT COMES TO
THINKING ABOUT PERHAPS HOW
EXPOSURE TO ECDs MAY BE A
CONTRIBUTING FACTOR TO THEIR
DEALING WITH SOME THINGS LIKE
FIBROIDS.
SO EDUCATION INTERVENTION ALSO
IS SOMETHING THAT'S CRUCIAL FOR
THE WORK THAT WE DO.
AND CAN YOU HEAR ME?
BUT ALSO WITH HEALTH
PRACTITIONERS.
SO WE DO A LOT OF WORK IN
COLLABORATION WITH MANY OF OUR
COMMUNITY PARTNERS AND ONE SUCH
COLLABORATION IS WITH A RESEARCH
PROJECT WHERE WE WANTED TO
ENGAGE WITH BLACK WOMEN IN OUR
COMMUNITY.
AND TO ASSESS WHAT KIND OF
PRODUCTS WE ARE USING, HOW OFTEN
WE WERE USING THEM AND SO THESE
ARE THE DIFFERENT STEPS THAT WE
TOOK BUT WHEN WE SET OUT TO TALK
ABOUT TO DO THAT RESEARCH, WE
WERE NOT THINKING ABOUT USING
SOCIAL MEDIA AT ALL.
BUT THIS RESEARCH SHOWS THE
IMPORTANCE OF ENGAGING DIRECTLY
WITH PEOPLE WHO ARE MOSTLY
IMPACTED BY HEALTH AND THE MOST
IMPACT WILL BY THE HEALTH ISSUES
AND IT WAS TRUE, ONCE WE RECORD
THE THIS IT WAS AN A
CONVERSATION ABOUT THE PRODUCTS
THEY WERE USING.
WE FOUND THAT MANY OF THEM WERE
USING PRODUCTS THAT WERE FROM
SOCIAL MEDIA INFLUENCERS AND
THAT LED US TO REDIRECT AND
RE-THINK HOW WE WERE GOING TO
PLAN THE RESEARCH WHICH TURNED
OUT TO BE EXTREMELY SUCCESSFUL
AND WITHIN ONE YEAR USING AND
ENDED UP HAVING SOCIAL MEDIA
INFLUENCERS AND WE TRAINED THEM
AND THEY HAD TO AGREE TO AT
LEAST PARTICIPATE IN TWO
WORKSHOPS BECAUSE WE WANTED TO
BE UNDERSTOOD AND WERE AWARE AND
HAD CONTROL OVER THE MEDIA
CONTENT THEY WERE DELIVERING TO
MAKE SURE THE INFORMATION THEY
WERE COMMUNICATING WITH THE
AUDIENCE WE WERE TRYING TO
TARGET WAS AN IMPORTANT MESSAGE
RELEVANT TO ECDs.
OF COURSE EVEN THE IMPORTANCE OF
RESILIENCE THOUGH I COULD HAVE
DONE WORKSHOPS FOR BLACK PEOPLE
BUT THAT'S A DIFFERENT TOPIC FOR
ANOTHER TIME BUT -- AT THE
BEGINNING OF THE CONFERENCE
SEKAI MENTIONED THE IMPORTANCE
OF HOW PEOPLE TALK A LITTLE BIT
ABOUT AVOIDANCE WHEN IT COMES TO
ECDs AND SAID SOMETHING
IMPORTANT WHICH IS WHAT IS NEXT
TO IMPOSSIBLE AND I THINK WE PUT
A LOT OF BURDEN ON THE
COMMUNITIES THAT WE ARE TRYING
TO SERVE.
SO I THINK IT'S IMPORTANT -- I
THINK FOR US WE ARE REQUIRED.
I UNWORKING WITH COMMUNITY -- IN
WORKING WITH THE COMMUNITY AND
THINK OF THE PARADIGM SHIFT TO
THE BURDEN IS NOT THOSE IN THE
COMMUNITY BUT MOST IMPACTED IN
ORDER TO MITIGATE THEIR EXPOSURE
TO ENVIRONMENTAL STRESSORS.
AND ALONG WITH THE ENVIRONMENTAL
STRESSORS IT'S IMPORTANT FOR US
TO THINK ABOUT THE STRESSORS OF
RACISM WHICH IS IT'S OWN
TOXICITY IN THE LIVES OF MANY
WOMEN DEALING WITH REPRODUCTIVE
HEALTH ISSUES.
IN RESILIENCE I BELIEVE I
STARTED THE PROJECT I THOUGHT
ABOUT THE WORK AND RESILIENCE
HAS POTENTIAL AND WITH THAT
COMBS RESPONSIBILITY.
WE BELIEVE IN GOING FORWARD.
AND NOT BACKWARD AND ALL THE
RESEARCH THAT WE'RE DOING
DEMONSTRATE THAT.
SOME STEPS ARE SLOWER THAN
OTHERS.
I'M GRATEFUL FOR DOING THE WORK
WE DO AND TRYING TO WILL
UNDERSTAND THE REALITY AND
CHALLENGES ARE QUITE FIERCE.
THANK YOU SO MUCH.
>> HI, EVERYONE.
I WANT TO TALK TO YOU FROM THE
CONTEXT OF ENVIRONMENTAL STRESS
FACING OUR COMMUNITIES AND HOW
DO WE ADDRESS THAT ESPECIALLY IN
THE CONTEXT OF CLIMATE CHANGE.
AND SO AND SO AND SO YOU'LL TALK
ABOUT PSYCHOLOGICAL RESILIENCE.
WE HAVEN'T SPECIFICALLY LOOKED
AT ECDs BUT WHEN WE LOOK AT
CLIMATE-RELATED DISASTERS THEN
THEN ECDs COME UP FROM THE KINDS
OF DISASTERS THAT TAKE PLACE
LIKE WILDFIRES OR FLOODS THAT
CAN BE ASSOCIATED WITH RELEASE
OF ECDs.
JUST AS AN INTRODUCTION, I LEAD
THE NEAT LABS AT UC SAN DIEGO.
I'M AN ASSOCIATE PROFESSOR IN
THE DEPARTMENT OF PSYCHIATRY AND
CO-LEAD THE CLIMATE CHANGE AND
MENTAL HEALTH INITIATIVE.
SO I'LL TALK MORE ON THE MENTAL
HEALTH AND NEUROLOGICAL HEALTH
PERSPECTIVES AND THE
PSYCHOLOGICAL ASPECTS OF
RESILIENCE.
MY WORK IN THE LAST FIVE YEARS
HAS LOOKED AT STUDYING
RESILIENCE IN THE CONTEXT OF
CLIMATE CHANGE IMPACT ON MENTAL
HEALTH AND BRAIN HEALTH WITHIN
OUR IMPACTED AND VULNERABLE
COMMUNITIES.
SO A RESILIENCE RESEARCH STUDY
WAS EMBEDDED IN THE CONTEXT OF
THE WILDFIRES THAT ARE HAPPENING
IN CALIFORNIA ESPECIALLY IN
VULNERABLE COMMUNITIES THAT LIVE
AT THE WILD LAND URBAN
INTERFACES.
THESE ARE WHERE THE FOREST MEETS
THE RESIDENTIAL AREAS WE FIND
CHRONIC EFFECTS ON MENTAL HEALTH
SYMPTOMS FOUND AND WE SEE
CHRONIC EFFECTS THAT ARE IN THE
DOMAINS OF POSTTRAUMATIC STRESS
DISORDER AND ANXIETY.
THESE ARE INDIVIDUALS PRIMARILY
EXPOSED TO THE FIRED AND PEOPLE
DIRECTLY EXPOSED FOLLOWED BY
THOSE INDIRECTLY EXPOSED AND
INDIVIDUALS IN THE SAME
COMMUNITIES WHERE THE FIRES TOOK
PLACE BUT THEY WEREN'T
PERSONALLY IMPACTED BY THEM.
THEY DID NOT SUFFER PERSONAL
DAMAGE IN TERMS OF INJURY OR
DEATH OR PROPERTY LOSS IN ANY
WAY.
IT'S INTERESTING TO SEE MENTAL
HEALTH IS IMPACTED IS COMMUNITY
IS AFFECTED.
WHEN WE THINK OF MENTAL HEALTH,
THE AFFECTS ARE LONG LASTING IN
THAT WE SEE THESE AFFECTS EVEN
SIX MONTHS TO A YEAR AFTER THE
DISASTER'S TAKEN PLACE WHICH IS
AFTER THE SMOKE-RELATED EFFECTS
HAVE SUBSIDED.
HOW DOES THE SMOKE-RELATED
EFFECTS INTERACT WITH THE TRAUMA
PATHWAYS AND STRESS PATHWAYS TO
BRING ABOUT THE LONG-TERM
EFFECTS IS AN AREA OF INTEREST
FOR US TO STUDY.
ALONG SIDE POSTTRAUMATIC STRESS
DISORDER WE SEE HIGHER
PREVALENCE OF DEPRESSION AND
ANXIETY WHICH IS 1.5 TO 2X
RELATIVE TO POPULATIONS NOT
EXPOSED TO THESE STRESSORS.
IN THIS REGARD CLIMATE CHANGE
RELATED DISASTERS ARE A HUGE
STRESSOR ON OUR SYSTEMS.
AND WHEN WE THINK OF RESILIENCE
IN THE CONTEXT OF CLIMATE CHANGE
WE LOOKED AT A POPULATION OF
1,000 PEOPLE STUDYING HERE AND
NOT JUST LOOKED AT THE
DEMOGRAPHIC FACTORS BUT OTHER
PSYCHOLOGICAL RESILIENCE
FACTORS.
AND WHAT EXACTLY IS PROTECTING
PEOPLE FROM DEVELOPING THESE
MENTAL HEALTH SIGNS.
AND SO IF YOU LOOK AT THE
FACTORS IN GREEN IN EACH CASE
THESE ARE THE FACTORS THAT
PROTECT FROM PTSD OR DEPRESSION
OR ANXIETY IN A SIGNIFICANT WAY.
WE FOUND AGE BRINGS A SENSE OF
PSYCHOLOGICAL WISDOM THAT
PROTECTS FROM DEVELOPING OVER
ALL SEVERE SYMPTOMS.
WE ALSO FOUND RESILIENCE WHICH
WERE MEASURED USING THE BRIEF
RESILIENCE SCALE AND THAT LOOK
AT THE ABILITY TO BOUNCE BACK
FROM STRESSORS THE QUESTION IS
FOCUSSED ON THE ABILITY TO
BOUNCE BACK FROM STRESSORS.
IF ONE HAD GREATER PERSONAL
RESILIENT BELIEFS THEY WERE
PROTECTIVE AGAINST THE
DEVELOPMENT OF THE SYMPTOMS.
IN TERMS OF DEPRESSION AND
ANXIETY, IT WAS ALSO IMPORTANT
TO HAVE SKILLS IN THE DOMAIN OF
EXERCISE AND AS WELL AS
MINDFULNESS AND SLEEP WAS
IMPORTANT AND HAVING LESSER
SLEEP DISTURBANCES WAS IMPORTANT
AS WELL.
WE CAN SEE HAVING PROPER
LIFESTYLE FACTORS IN PLACE SUCH
AS EXERCISE AROUND MINDFULNESS
AND SLEEP AND PERSONAL
RESILIENCE BELIEFS ALL COME
TOGETHER TO FORM PROTECTION
AGAINST MENTAL HEALTH SYSTEMS WE
SEE IN THE CONTEXT OF CLIMATE
CHANGE AGGREGATED DISASTERS.
>> ONE MINUTE, JYOTI.
>> SURE.
THAT WAS OBSERVATIONAL WORK AND
NATURE-BASED INTERVENTIONS THAT
DEVELOPED ECO MINDFULNESS.
THAT'S DONE IN THE CONTEXT
BECAUSE INDIVIDUALS DEVELOPED A
POOR OR CONNECTION WITH NATURE
WHERE THEY'VE LOST THEIR ABILITY
TO CONNECT WITH NATURE IN AI
POSITIVE WAY BECAUSE OF THE
APOCALYPTIC NATURE OF WHAT
THEY'VE WITNESSED AND
REEXPERIENCE NATURE IN A MORE
POSITIVE WAY AGAIN AND
PROTECTIVE COMMUNITY-LED
INTERVENTIONS WE'RE PARTNERING
ON THAT WE'RE MEASURING EFFECTS
OBJECTIVELY AND BRAIN FUNCTION
AND COGNITIVE SYMPTOMS TO SEE
HOW ECO MINDFULNESS TOOLS CAN
HELP WITH THE RESILIENCE
BUILDING IN THESE IMPACTED
COMMUNITIES.
OVER ALL OUR OBSERVATIONAL WORK
HAS ALSO SHOWN INDIVIDUALS WITH
STRONGER TIES TO COMMUNITIES AND
FAMILY TIES AND COMMUNITY TIES
WITH OTHERS WITHIN THEIR
COMMUNITY ARE ALSO PROTECTED
FROM THE MENTAL HEALTH OUTCOMES
IN DEVELOP IS -- DEVELOPING
PTSD IN THE CONTEXT OF CLIMATE
CHANGE.
THANK YOU.
>> THANK YOU.
>> I'M FROM EAST CAROLINA
UNIVERSITY.
I'M KAREN LITWA.
I'D LIKE TO THANK LAVERNE FOR
THE INVITATION TO TALK ABOUT
RESILIENCE FROM A MOLECULAR
PERSPECTIVE AND WOULD LIKE TO
THANK THE FUNDERS OF THE
RESEARCH.
THIS PROJECT WAS INITIATED
THROUGH FUNDING FROM THE NORTH
CAROLINA STATE UNIVERSITY CENTER
FOR HUMAN HEALTH AND THE
ENVIRONMENT AND SINCE FUNDED BY
THE OFFICE OF DIETARY
SUPPLEMENTS AND NCCIH.
WE'RE INTERESTED IN WHETHER THE
PHYTO CHEMICAL CAN PROTECT
DEVELOPING BRAINS FROM A
CHEMICAL DISRUPTION.
HOW CAN WE PROTECT AGAINST THE
CHEMICALS AROUND US?
THIS SPROUT CONTAINS
SULFORAPHANE AND WHEN IT ENACTS
WITH THE ENZYME AROUND THIS
OCCURS WHEN THE PLANT IS
INJURED.
SO WE SEE THE LEVELS OF THE
SULFORAPHANE ARE HIGHEST IN THIS
LITTLE DEVELOPING SPROUT WHEN IT
NEEDS TO BE PROTECTED FROM
INJURY IN ORDER TO FULLY DEVELOP
INTO A PLANT.
SO WE WANTED TO KNOW WHETHER WE
COULD USE THIS SULFORAPHANE TO
ALSO PROTECT THE DEVELOPING
NEURAL CIRCUITS OF OUR BRAIN IN
PREVENT NEURAL DEVELOPMENTAL
DISORDERS.
THE BASIC IDEA IS YOU CAN BE
EXPOSED TO PHARMACEUTICAL DRUG
AND FOR EXAMPLE SPOEMOKING AND
ENVIRONMENTAL SUCH AS PESTICIDE
EXPOSURE AND FACTORY POLLUTANTS
CAN ALL IMPACT THE FETUS DURING
THE SENSITIVE PERIOD WHEN YOU'RE
BUILDING THE FOUNDATIONS OF THE
BODY.
AND WE'RE PARTICULARLY
INTERESTED IN THE DEVELOPMENT OF
THE BRAIN THAT LAYS THE
FOUNDATION FOR LATER BEHAVIORS.
SO WE WANTED TO UNDERSTAND
WHETHER WE COULD USE
SULFORAPHANE TO PREVENT ADVERSE
OUTCOMES RELATED TO CHEMICAL
EXPOSURES AND LEADING TO THE
NORMAL DEVELOPMENT OF THE BRAIN
IN NORMAL BEHAVIORAL OUTCOMES.
I DO WANT TO MENTION THESE
STUDIES ARE BEING PERFORMED IN
COLLABORATION WITH DR. McCOY AT
FLORIDA ATLANTIC.
I'M GOING TO PRESENT ON THE
STUDIES IN MY LAB AND DR. McCOY
IS DOING RESEARCH ON BEHAVIORAL
OUTCOMES IN A MOUSE MODEL
SYSTEM.
SO OUR MODEL HAVE TINY ORGANOIDS
THAT MIMIC THE DEVELOPING CORTEX
OF THE BRAIN.
AND THIS IS ESTABLISHED IN
HUMANS EPIDEMIOLOGICALLY AS WELL
AS IN MOUSE MODELS LEADS TO
AUTISM LIKE BEHAVIOR.
THE INTERVENTION IN THIS CASE IS
USING SULFORAPHANE WHICH IS A
PHYTO CHEMICAL ABUNDANT IN THE
SPROUT OF CRUCIFEROUS VEGETABLES
SUCH AS BROCCOLI AND EXAMINED
SEVERAL OUTCOMES RELATED TO THE
INTERVENTION WHETHER WE CAN
REDUCE STRESS CAUSED BY VALPROIC
ACID OR AND HAVE NORMAL
DEVELOPMENT OF SYNAPSES IN THE
BRAIN AS WELL AS NORMAL SYNAPTIC
FUNCTION.
ACTION POTENTIAL FORMATION
WITHIN THE NEURAL CIRCUITS.
COMMUNICATION AGAIN THE NEURONS
AND WE ALSO EXAMINED THE
TRANSCRIPTIONAL SIGNATURES
ASSOCIATED WITH THIS
INTERVENTION.
JUST TO GIVE YOU INSIGHT INTO
HOW SULFORAPHANE WORKS.
AT A MOLECULAR LEVEL,
SULFORAPHANE IS A SMALL
MOLECULE.
IT'S LIPOPHILIC AND INTERACT
WITH THE LIGASE.
IT CAN INTERACT WITH KEAP1
HOLDING ON TO THE TRANSCRIPTION
FACTOR NRF2 AND DEGRADING THE
FACTOR AND WHEN SULFORAPHANE IT
BIND ALLOWING NRF2 TO BECOME
PHOSPHORYLATED AND ENTER INTO
THE NUCLEUS LEADING TO THE UP
REGULATION OF ANTIOXIDANT AND
PHASE 2 DETOX FACE ENZYMES.
AND WE CAN UPREGULATE THE
EXPRESSION OF ANTIOXIDANT GENE
PRODUCTS LEADING TO NORMAL
SYNAPTIC DEVELOPMENT AND
FUNCTION IN THE DEVELOPING
BRAIN.
AND THERE'S RESULTS CURRENTLY
UNDER REVIEW FOR PUBLICATION.
MY STUDENTS CURRENTLY ADDRESS
REVIEWER COMMENTS.
AND THERE'S A NERVOUS SYSTEM TO
THE LEVEL AND UNDER
PHYSIOLOGICAL CONDITIONS BETWEEN
SPECIES AND ANTIOXIDANTS.
YOU HAVE THE NORMAL DEVELOPMENT
OF THE SYNAPTIC CONNECTIONS AND
NORMAL SIGNALLING BETWEEN THEM
AND WHEN YOU INTRODUCE BPA YOU
SOO THE INCREASE IN CELLULAR
OXIDATIVE STRESS.
WE ACTUALLY SAW A REDUCTION IN
THE FORMATION OF SYNAPSES
BETWEEN NEURONS AND WE SAW SOME
DISRUPTION TO NEURAL ACTIVITY
THAT WAS RELATED TO THE LEVEL OF
NEURONAL ACTIVITY.
AND WE ALSO SAW SIGNATURES, GENE
SIGNATURE CHANGES THAT WERE
SIMILAR TO THOSE IN INDIVIDUALS
WITH AUTISM SPECTRUM DISORDERS.
HOWEVER, WHEN WE ADDED
SULFORAPHANE EITHER PRIOR TO BPA
EXPOSURE OR IN ADDITION TO BPA
EXPOSURE, WE WERE ABLE TO
RECOVER THAT NEURAL FUNCTION.
WE SAW THE OXIDATIVE PHYSIOLOGY
RESTORATION AND NORMAL FORMATION
OF THE SYNAPSES WAS RESTORED AS
WELL AS THEIR FUNCTION AND WE
SAW SOME CHANGES IN GENE
EXPRESSION AND CHANGES RELATED
TO SYNAPTIC STABILITY AND
MITOCHONDRIAL FUNCTION WE'RE
FOLLOWING UP ON AND I SHOULD
MENTION THAT THESE WERE RESULTS
WERE PRIMARILY SEEN WITH A VERY
LOW DOSE OF OUR SULFORAPHANE
INTERVENTION.
AND SO WHILE OUR STUDY EXAMINED
USING THIS MODEL WE WANT TO
EXTEND TO ENDOCRINE DISRUPTING
CHEMICALS AND WAY IN THE TO
HIGHLIGHT WORK DONE BY MY
COLLABORATOR AND THE ABILITY TO
PREVENT HYPOSPADIAS IN A MOUSE
MODEL.
I'M THERE AND THANK YOU FOR YOUR
ATTENTION.
>> I THINK WE HAVE A MINUTE OR
TWO FOR QUESTIONS AND I THINK
I'LL TAKE THE MODERATOR'S
PREROGATIVE AND ASK THE FIRST
QUESTION.
WE WANTED THE SESSION TO FOCUS
ON RESILIENCE BUT WE COULDN'T
TALK ABOUT RESILIENCE WITHOUT
ALSO FIRST TALKING ABOUT THE
RISK AND THE PROBLEMS WE'RE
FACING WITH ECDs.
YOU HEARD ABOUT THE PROBLEMS
WITH ECDs SO I WANTED TO GIVE MY
PANELISTS AN OPPORTUNITY TO
ADDRESS QUESTIONS RELATED
DIRECTLY TO RESILIENCE.
SO I'LL JUST PICK THE QUESTION.
YOU'D LIKE TO SHARE MORE DETAILS
ON SPECIFIC EXAMPLES OF
RESILIENCE MODELS IN YOUR LAB OR
IN THE COMMUNITY AND PROGRAMS OR
EVEN IN YOUR DATA COLLECTION.
MODELS THAT HAVE ALREADY WORKED
THAT MIGHT ADDRESS EDC EXPOSURE
OR SIMILAR TOXICANTS.
DO ANY MIND SHARING THERE?
>> I THINK MARK HAD TO STEP OFF.
WOULD YOU LIKE TO SHARE
ADDITIONAL DETAILS ON SPECIFIC
EXAMPLES OF RESILIENCE MODELS
THAT HAVE WORKED TO ADDRESS
EITHER EDC EXPOSURE OR SIMILAR
TOXICANTS IN YOUR RESEARCH OR
PROGRAMS.
>> IT'S HOW WE DEFINE A
HEALTHIHEALTHY
SYSTEM.
THERE ARE POTENTIAL BIOMARKERS
WE CAN USE OXIDATIVE STRESS
BEING ONE AND METABOLIC
SIGNATURES THAT REALLY ARE
INDICATIVE OF HIGHLY FUNCTIONING
SYSTEM AND USE THE METRICS TO
DEFINE INTERVENTIONS THAT ARE
PROMOTING THOSE HEALTHY
SIGNATURES.
AND I WANT TO POINT OUT I DON'T
WANT TO DEMONIZE THE SPECIES
BECAUSE IF WE USED TOO MUCH
SULFORAPHANE IT ALSO WAS NOT
PROTECTIVE.
IT'S FINDING A BALANCE BETWEEN
THE PATHWAYS THAT ALLOW US TO
FUNCTION WITHIN AN OPTIMAL
RANGE.
>> THANK YOU, KAREN.
DID YOU WANT TO ADD, LILLY?
>> I THINK ABOUT THE FIRST
RESEARCH AND THE RESULTS THAT
LED US TO DO ANOTHER RESEARCH
WITH A YOUNGER -- I FORGOT TO
MENTION THE FIRST 25 WOMEN THAT
ACQUITTED WERE BETWEEN THE AGES
OF I THINK 22 TO 45.
BUT WE ALSO THOUGHT IT WOULD BE
IMPORTANT TO SEE WHAT THE
PATTERNS OF USAGE OF PRODUCTS
AND THE FREQUENCY AND ALSO COULD
IT BE THE SAME PATTERNS OF
FOLLOWING THE RECOMMENDATIONS OF
SOCIAL MEDIA INFLUENCES FROM
YOUNGER GROUPS SO WE DECIDED TO
DO ANOTHER RESEARCH WITH YOUNG
GIRLS BETWEEN THE AGES OF 15 TO
21 JUST TO ALSO SEE THE IMPACT
OF JUST BEING INFLUENCED BY
SOCIAL MEDIA INFLUENCERS
RECOMMENDING ALL KINDS OF
PRODUCTS THAT LIVE WITH ECDs.
>> THANK YOU.
SO IT SOUNDS LIKE WHAT I'M
HEARING IS THERE'S A SOCIAL
ASPECT TO PROMOTING RESILIENCE.
I'M HEARING FROM KAREN THERE'S
EVEN A MOLECULAR ASPECT.
DID YOU WANT TO ADD TO THIS
CONVERSATION?
>> AND THERE'S CO-PANELISTS ON
THE SPECIFIC AS SPEPECTS BUT THS
BIOLOGICAL MARKERS TRACKED IN
COMMUNITIES IN TERMS OF
COGNITIVE AND NEURAL FUNCTIONS
THAT CAN CHANGE IN THE CONTEXT
OF BUILDING RESILIENCE TO
ENVIRONMENTAL STRESSORS.
>> WE ALSO HAVE A QUESTION FROM
DR. LANGEVINE.
>> CAN YOU HEAR ME?
I HAD A QUESTION -- WELL
STARTING WITH THE WHAT WAS
PRESENTED WITH THE AFFECT OF THE
SULFORAPHANE AT A LOW DOSE.
AND THE CONCEPT OF FOREMESIS AND
A LOWER DOSE VERSUS HIGHER DOSE
BEING TOXIC AND A GENERALIZED
CONCEPT AND SOMETIMES THE
COMPOUNDS COULD BE STRESSORS IN
AND OF THEMSELVES, SMALL
STRESSORS AT LOW DOSE BUT THEN
STIMULATE AN ADAPTIVE RESPONSE
THAT COULD BE BENEFICIAL AND
CONFIRM RESILIENCE.
HAVE YOU LOOKED AT THOSE
MECHANISMS IN YOUR WORK?
>> WE DIDN'T REALLY LOOK TOO
MUCH AT WHAT WAS HAPPENING AND I
DO THINK IT MAY BE A CASE WHERE
THAT INTERVENTION IS GOING TO BE
CONTEXT DEPENDENT ON LEVEL OF
EXPOSURE AS TO WHETHER IT'S
BENEFICIAL OR NOT.
WE DID SEE SIGNATURES RELATED
MORE TO THIS INTEGRATED STRESS
RESPONSE WE FELT LIKE IN THE
PRESENCE OF BPA SULFORAPHANE
WHERE THE CELLS SEEM TO BE
BASICALLY ENTERING A STATE THAT
ALLOW THEM TO HAVE STABILITY IN
THE PRESENCE OF THIS STRESSOR
RATHER THAN SHIFTING TO AN
APOPTOTIC MECHANISM.
SO YOU SEE MORE PHOSPHORYLATION
OF THIS TRANSLATIONAL MACHINERY
LIKE EIF2A SO AT TO THE
TRANSCRIPTIONAL WE SAW SOME OF
THOSE PATHWAYS WERE STARTING TO
BE ENGAGED.
GIVING THE CELL SPACE TO STILL
EXIST DESPITE THE STRESSOR BEING
PRESENT AND CONTINUE TO THRIVE
WHEN THE STRESSOR IS GONE.
>> THAT IS SUPER INTERESTING.
I THINK YOUR MODEL MIGHT BE A
GOOD ONE FOR STUDYING THIS
PARTICULAR COMPOUND BUT ALSO
PERHAPS A MORE GENERAL
APPLICATION OF THE IDEAL.
>> THANK YOU.
WE'RE ALSO EXAMINING OTHER
COMPOUNDS SUCH AS CANNABIDIOLS.
>> THANK YOU.
>> WE HAVE ANOTHER QUESTION FROM
THE ZOOM PLATFORM.
THIS IS FOR JYOTI.
DR. MISHRA CAN YOU TALK MORE
ABOUT THE YOUR MINDFULNESS-BASED
PROGRAMS AND WHAT ARE LESSONS
LEARNED TO INFORM FUTURE
RESEARCH IN THE EDC SPACE
DIRECTLY INFORMED AND DELIVERED
BY PEOPLE WHO NEED THESE
INTERVENTIONS THE MOST?
>> THANK YOU FOR THE QUESTION.
COMMUNITY PARTNERSHIPS ARE VERY
IMPORTANT TO US.
THESE ARE PARTNERSHIPS WHERE WE
STRIVE FOR EQUAL POWER IN
RELATIONSHIPS AND THE COMMUNITY
LEADERS ARE THE ONES WHO DECIDE
WHAT CAN BE FEASIBLY IMPLEMENTED
IN THESE COMMUNITIES.
WHAT KIND OF PROGRAMS THE
DURATION OF THE PROGRAMS AND
WHERE WE COME IN IS MOSTLY IN
HELPING WITH THE SCIENTIFIC
DESIGN AND STRUCTURE MAKING SURE
THAT THERE ARE CONTROLS IN
PLACE, MAKING SURE THERE'S
ADEQUATE ASSESSMENTS THAT ARE
BOTH ADDRESSING SUBJECTIVE AS
WELL AS OBJECTIVE ASPECTS OF
RESILIENCE AND OBJECTIVE ASPECTS
COME IN FROM COGNITIVE AND
NEURAL MEASURES.
AND WE RESPECT THAT OUR
COMMUNITY PARTNERS WANT TO LEARN
ABOUT THESE KINDS OF
MEASUREMENTS AS WELL SO WE TRY
TO MAKE THINGS USER FRIENDLY SO
THEY CAN LEARN TO ADMINISTER
THESE ASSESSMENTS ON THEIR OWN
AND SO THAT IT DOESN'T FEEL LIKE
WE'RE COMING IN FROM OUTSIDE TO
INTERVENE WITHIN THE COMMUNITY.
FOR LONG-TERM SUSTAINABILITY
IT'S IMPORTANT THAT COMMUNITY
MEMBERS THEMSELVES TAKE THE
ASSESSMENTS AND INTERVENTIONS ON
THEIR OWN AND GROW THEM AND
SCALE THEM ON THEIR OWN WITH
HEALTH.
AND WE'RE PROUD THAT WE'VE GREEN
BEYOND STATES SO WE CAN DO THIS
WORK IN CALIFORNIA AND IN
HAWAI'I WHERE THEY WERE RECENTLY
HIT BY THE WILDFIRES AS WELL.
IT'S ABSOLUTELY COMMUNITY LED
AND WE'RE MOSTLY THE HELPERS IN
THE SCIENTIFIC EFFORT.
SO IT'S IMPORTANT TO RESPECT THE
COMMUNITY PARTNERS.
WHEN WE WANT TO EXPAND TO NEW
COMMUNITIES, FINDING NEW
COMMUNITY PARTNERS IS THE FIRST
THING WE DO.
PEOPLE WHO FEEL THAT THEY CAN
HAVE A STRONG FOOTPRINT TO
COALESCE COMMUNITY MEMBERS INTO
NEW INTERVENTIONS.
AND WE'VE BEEN FORTUNATE WITHIN
THE VULNERABLE COMMUNITIES ECO
MINDFULNESS HAS GROWN AS A NEW
INTERVENTION APPROACH THAT IS
REALLY HELPING THE MENTAL HEALTH
OF THE PEOPLE THAT ARE IMPACTED
BY THESE DISASTERS.
>> GREAT, THANK YOU, JYOTI.
I WANT TO THANK MY PANELISTS
AGAIN AND TURN THE WORKSHOP BACK
TO SEKAI.
>> THANK YOU, DR. BROWN AND
PANELISTS.
LET'S GIVE THEM A ROUND OF
APPLAUSE.
VERY GREAT.
WE'LL BREAK FOR LUNCH NOW
EVERYONE AND PLEASE COME BACK AT
1:00 P.M. EASTERN TIME.
THANK YOU.
MY NAME IS OMOWUNMI OSINUBI FOR
THE INJURY STUDY CENTER.
WE'RE GOING TO BE TALKING ABOUT
MILITARY OCCUPATION AND
ENVIRONMENTAL EXPOSURES TO ECDs
AND HOI DO WE ACTUALLY ADDRESS
THOSE CONCERNS.
YOU HAVE MY BIO ALREADY AND MY
PRESENTATION IS ON MILITARY
SERVICE MEMBERS WHO HAVE SERVED
VALIANTLY AND SOME ARE ALSO PAID
THE ULTIMATE SACRIFICE.
WE LEARN FROM THEM AND
EVERYTHING THAT WE DO.
WE'RE NATIONAL HEALTH OUTCOME
MILITARY EXPOSURES WAR RELATED
ILLNESS AND INJURY STUDY CENTER
AND THE FIRST ONE WAS
ESTABLISHED IN NEW JERSEY WHICH
IS WHERE I'M FROM.
THERE'S A COUPLE OTHER WRIISCs
AND ONE CLOSE TO YOU HERE.
WITH LOOK AT EXPOSURES IN THE
MILITARY SERVICE AND CLINICAL
CARE AND RESEARCH AND EDUCATION.
WE OFFER A VARIETY OF SERVICES
CONSULTING OF MEDICAL RECORDS
AND INTERDISCIPLINARY OVER DAYS
AND GIVE ROAD MAPS HOW TO
IMPROVE THEIR HEALTH AND WE HAVE
EXPOSURE ASSESSMENTS.
ONE OF THE THING THAT'S BEEN
COMMON IN THE PRESENTATION
LISTENING TO PRESENTERS LIKE
LAURENE TALKED ABOUT, PROVIDERS
NOT UNDERSTANDING THE EXPOSURES
AND FARM WORKERS GO TO THE E.R.
OR PRIMARY CARE PROVIDER AND WE
HELP PROVIDERS AND OTHER PEOPLE
UNDERSTAND HOW TO TAKE AN
EXPOSURE HISTORY AND HOW TO MAKE
THAT CONNECTION BETWEEN EXPOSURE
AND DISEASE WHICH IS DESPERATELY
NEEDED.
THAT THE THE FOCUS OF MY
PRESENTATION TODAY.
WHAT MILITARY AND ENVIRONMENTAL
EXPOSURES ARE LIKE.
AND THOSE WERE MENTIONED AROUND
WE'LL LOOK AT ENDOCRINE
DISRUPTORS RELATED TO MILITARY
SERVICE AND P-U-R-E AND PATTERNS
AND U UNDERSTAND EXPOSURE AND R
IS REMOVAL AND REDUCE EXPOSURES
AND E IS EFFECTIVE
COMMUNICATION.
IF YOU REMEMBER THE ACRONYM,
PURE, YOU'RE IN A GOOD PLACE TO
START WITH YOUR PATIENTS.
WE HAVE VETERANS IN THE UNITED
STATES AND THE MAJORITY OF
VETERANS GET THEIR CARE FROM THE
COMMUNITY.
AM I TOO FAST?
OKAY, I'LL SLOW.
ALMOST HALF THE VETERANS WE SEE
IN THE V.A. HAVE CONCERNS ABOUT
THEIR EXPOSURES.
SO IT'S REALLY IMPORTANT FOR US
AS A COMMUNITY OF PROVIDERS AND
SCIENTISTS TO HAVE AN
UNDERSTANDING OF WHAT THE
EXPOSURES ARE AND HOW THEY MIGHT
IMPACT --
[SPANISH]
AND WE LOOK WHETHER IT'S WORK IN
THE COMMUNITY AFTER THEY JOINED
THE MILITARY SERVICE OR WORK
THEY DID IN THE COMMUNITY WHILE
THEY WERE IN THE MILITARY
SERVICE WHILE WE GO.
BEAR THAT IN MIND AND WHILE WE
THINK OF AND THEY COME WITH
EXPOSURES AND IF THEY DEPLOY
SERVICES FOR COMBAT, WHAT WERE
THE EXPOSURES?
WE'RE LOOKING AT EXPOSURES FROM
AGE MULTITUDE OF ASPECTS TO MAKE
SENSE OF THE EXPOSURES AND SEE
IF ANY OF THOSE ARE MORE THAN
ONE ARE LINKED TO THEIR HEALTH
CONDITIONS.
LET'S TALK ABOUT GARRISON
EXPOSURES.
THERE'S 800 MILITARY BASES AND
COMPRISED 1% OF THE LAND MASS OF
THE UNITED STATES AND MANY OF
THESE MILITARY BASES AT LEAST
150 OF THEM ARE LISTED IN THE
EPA IMPERATIVE SITE AND HAVE
SIGNIFICANT CONTAMINATION.
MANY OF THOSE CONTAMINANTS ARE
ECDs.
THE QUESTION IS DOES THE VETERAN
HAVE DIRECT CONTACT WITH THE EDC
FOUND IN THE ENVIRONMENT OR FROM
THE WATER ON THE BASE.
HAVE THAT IN THE BACK OF YOUR
MIND AIR FORCE BASES ARE A
SIGNIFICANT SOURCE OF
CONTAMINATION FOR PFAS FOR THE
LOCAL ENVIRONMENT.
MANY HAS BEEN IN THE NEWS MORE
RECENTLY AND AS A MATTER OF FACT
THE U.S. MILITARY A CONCERN IF
THEY WERE TO BAN PFAS IT MAY
AFFECT NATIONAL SECURITY BECAUSE
IN A LOT OF THE COMPONENTS AND
MATERIALS THEY USE HAVE THIS
FOREVER CHEMICALS AS PART OF THE
COMPONENT SO WE HAVE TO STRIKE A
BALANCE BETWEEN SECURITY AS WELL
AS INDIVIDUAL HEALTH AND
WELL-BEING.
SO, WE HAVE BEEN IN CONFLICT A
NUMBER OF YEARS IN THE UNITED
STATES.
WHICH CONFLICT HAS THE MOST
INFAMOUS ECDs?
MILITARY CONFLICTS OVERSEES MAY
EXPOSE TO CHEMICALS IN SERVING
IN COMBAT.
HOW DO WE USE THE EXPOSURES AND
OCCUPATIONAL MEDICINE WE LIKE TO
GROUP THINGS.
THE PHYSICAL AND PSYCHOLOGICAL
EXPOSURES.
WHEN SOMEBODY IS EXPOSED TO
BLASTS IT DOES SOMETHING TO THE
BRAIN AND THE ADRENAL AND HI
HYPOTHALAMIC ACCESS AND THERE'S
PSYCHOLOGICAL STRESSORS.
MILITARY SEXUAL TRAUMA, ALL OF
THOSE PER TURN THE HPA AXIS.
LAY ON THAT CHEMICAL EXPOSURES.
THE SOLVENTS, THE PAINT, THE
PESTICIDES, CHEMICAL WEAPONS.
WHAT ARE THEY CONCERNED ABOUT?
SARIN.
IT'S AN ORGANOPHOSPHATE.
THAT'S AN ENDOCRINE DISRUPTOR IF
IT DOESN'T KILL YOU.
THE PROPHYLACTIC MEASURES ARE
COMPOUNDS THERE'S PESTICIDES AND
THEY ARE USE PESTICIDE ON THEIR
SKIN AND UNIFORM AND OF COURSE
BIOLOGICAL EXPOSURES AND OTHER
COMPONENTS CAN DISRUPT THE
ENDOCRINE EXPOSURE AND MAYBE
THEY WERE EXPOSED TO ONE
CONTAMINANT IN THE COMMUNITY AND
THESE VETERANS HAVE A MULTITUDE
OF EXPOSURES PERTURBING THEIR
ENDOCRINE SYSTEMS AND OTHERS AS
WELL.
WHY DID THIS GET IN THEIR BODY?
THE MAIN WAY IS INHALATION OF
THE DUST AND VAPORS AND SOME IS
THROUGH FOOD.
PLASTIC WRAPS AND THE WATER IN
THE BOTTLE THAT HAS SAT IN THE
HOT SUN IN THE DESERT, 130
DEGREES FOR WEEKS AND CONSUMED
GALLONS AND THERE'S LEECHES OF
PLASTICS AND WHAT IS APPLIED TO
THE SKIN IT'S HIGHLY UNLIKELY
YOU'LL GET ECDs THROUGH
INJECTIONS BUT OF COURSE THE IVY
FLUIDS SOME OF THE PLASTIC
LEECHES IN.
WHEN YOU THINK OF THE MULTIPLE
PATHWAYS IN WHICH THE DISRUPTORS
GET IN THE BODY THERE'S
PATHWAYS.
WHEN YOU DO AN EXPOSURE
ASSESSMENT THESE ARE THINGS YOU
INTO NEED TO ASK.
WHAT WAS EXPOSED?
THEIR PARENTS, SIBLINGS, WHO
SERVED WITH THEM?
WHEN DID THE EXPOSURE OCCUR?
WHERE WERE THEY WHEN THEY WERE
EXPOSED AND HOW DID IT GET IN
THEIR BODIES AND HOW WILL THE
EXPOSURE AFFECT THEM AND IT THIS
IS HOW TO TAKE AN EXPOSURE
HISTORY.
ENDOCRINE DISRUPTORS AND
REMEMBER MICRO PLASTICS TO ADD
TO EVERYTHING ELSE THAT CAN
HAPPEN AND OVERSEES.
AND WE NEED TO FIGURE OUT HOW TO
ADDRESS THIS.
SO YOU HAVE A 44-YEAR-OLD
VETERAN WHO SHOWS UP IN YOUR
CLINIC AND HAS CONCERN AND HAS
NEVER HAD LIVER PROBLEMS AND IS
NOW TIRED ALL THE TIME AND HAS
MEMORY ISSUES AND SIX MONTHS AGO
HAD AN NEPHRECTOMY AND THINKS HE
WAS POISONED BY THE MILITARY.
THAT'S A LOT.
IN HIS RECORDS HE HAS OBJECTIVE
FINDINGS TO SHOW HE HAS
NEUROPATHY AND MILD COGNITIVE
IMPAIRMENT ON NEUROPSYCHOLOGICAL
TESTING AND HIS COLITIS IS
COMPOUNDED BY THE COLONOSCOPY
AND HAS HYPERTHYROIDISM AND
METABOLIC SYNDROME AND HIS
NEPHRECTOMY AND IS ONLY 33 YEARS
OLD.
YOU CAN TAKE AN EXPOSURE HISTORY
AND THE INSTITUTES OF FUNCTIONAL
MEDICINE HAS GIVEN US A WAY TO
HAVE A TIME LINE OF THE EXPOSURE
AND SEE WHERE THE HEALTH
CONDITIONS LIE.
LET'S START ON THE LEFT SIDE THE
COLUMN THAT SAYS PREDISPOSING
FACTORS.
THESE ARE ANTECEDENTS AND HIS
FATHER IS A VETO -- VIETNAM
VETERAN AND HAS A PTSD AND
ALCOHOLISM AND NON-HODGKIN'S
LYMPHOMA.
ALL THE CONDITIONS EXCEPT FOR
THE ALCOHOLISM ASIDE ARE LINKED
TO MILITARY SERVICE IN VIETNAM.
SIBLINGS ARE HEALTHY.
HE WAS AT CAMP LEJEUNE AND THEY
HAD SOLVENTS SOME KNOWN TO BE
CARCINOGENICS AND HAD SOME
DEGREE OF POVERTY AND PARENTAL
ABUSE WITH PHYSICAL INJURIES AND
THINKING ABOUT HIS.
HPA AXIS ALREADY PRE-PROGRAMMED
FOR TRAUMA AND ESCAPED THAT
SITUATION TO GO TO THE MILITARY
AND TRAINED AT AN AIRCRAFT
MECHANIC AND STATIONED IN
MICHIGAN.
WHAT WAS WHERE HE WAS STATIONED?
THEY HAD CONTAMINANT IN THE
WATER SUPPLY AND APPP WAS
SOMETI
SOMETIMES DOUSED ON HIM AND
THERE WERE PETRO CHEMICALS AND
HAD TWO DEPLOYMENTS TO THE GULF
WAR AND ALL THOSE OTHER
EXPOSURES AS WELL.
WHEN HE CAME BACK FROM THE GULF
HE DEVELOPED NEUROPATHIC
SYMPTOMS AND HAD FATIGUE,
IRRITABLE BOWEL IN SYNDROMES AND
WENT TO WORK AS A CIVILIAN AT 40
AS A WELDER EXPOSED TO PETRO
CHEMICAL SOLVENTS AND FUMES.
NOW HE HAS ALL THESE CONDITIONS
SO HOW DO YOU THEN FIGURE OUT
WHAT EXPOSURE CAUSED WHAT
DISEASE?
AND WE KEEP THE CYCLE GOING AND
THE STANDARD AMERICAN DIET WITH
ONGOING HEALTH ISSUES AND
CIVILIAN EXPOSURES BUT HAS SOME
POSITIVE MEDIATORS WHEN WE THINK
ABOUT RESILIENCE IN TERMS OF
FAMILY AND ALL THAT.
I'M GOING TO MOVE FORWARD IN
TERMS OF THE PICTURES OF WHAT
SOME OF THE VETERANS HAVE
DESCRIBED AND WHEN YOU DO THE
RESEARCH WE KNOW, YES, THE WATER
WAS CONTAMINATED WITH PFAS.
WHAT HE WANTS TO KNOW IF IT
CAUSED HIS HEALTH ISSUES.
AND THE V.A. WOULD GRANT SERVICE
CONNECTION IF IT'S CONNECTED.
AS FAR AS HIS HEALTH ISSUES
LET'S TALK ABOUT HIS
HYPERCHOLESTEROLEMIA AND THYROID
FUNCTION AND URIC ACID AND
ULCERATIVE COLITIS AND KIDNEY
CANCER AND THEY'RE ALL
INDICATIVE OF EXPOSURE AND HE
WAS EXPOSED TO PETRO CHEMICALS
AND NEUROCOGNITIVE IMPAIRMENT,
PETRO CHEMICAL SOLVENTS CAN
CAUSE NEURAL -- NEUOPATHY --
NEUROPATHY AND KIDNEY CANCER AND
THE BOTTOM LINE IS THEY HAVE
CONTRIBUTED AT LEAST IN PART OR
IN WHOLE.
THEY DO NOT HAVE TO BE THE ONLY
CONTRIBUTING FACTOR.
BUT THEY ARE NOT THE ONLY
EXPOSURES.
WE CANNOT UNWIND THE CLOCK BUT
STILL LIVES IN THE WURTSMITH
BASE ENVIRONMENT AND STILL HAS
TO GET HIS WATER TEST AND MAY
HAVE TO DO REMEDIATION AND LOOK
AT WHAT FILTRATION HE'S WORKING
WITH AND HEAVY METALS.
YOU WANT TO MAKE SURE HE'S
PROTECTED AT THE WORK OR GETS
DIFFERENT WORK AND THE NEXT NING
I WANTED TO ADDRESS IN THE NEXT
COUPLE OF MINUTES IS AFFECTIVE
COMMUNICATION.
WE KNOW THAT 30% SAY THEIR
HEALTH IS WORSE AFTER JOINING
THE MILITARY.
REMEMBER THESE ARE THE FITTEST
OF THE FIT IN OUR POPULATION.
THEY JOINED THE MILITARY AND
THEY'RE HEALTH IS WORSE.
WE NEED TO PAY ATTENTION TO
WHAT'S GOING ON.
IN THE MEDICAL FIELD WE WANT TO
GIVE A MEDICAL DIAGNOSIS THE
NAME IT AND BLAME IT AND TAME IT
APPROACH IN TERMS OF TREATMENT
RECOMMENDATIONS.
VETERANS HAVE BELIEFS ABOUT
THEIR EXPOSURE AND INTERESTED IN
WHAT THEY CAN DO TO GET BETTER.
SOMETIMES IT CAN BE ATTENTION.
VETERANS GET THEIR SOURCES OF
INFORMATION FROM MANY AVENUES.
I THINK IT WAS LORRAINE IN THE
HIGH INFLAMMATION AND SHE CAN'T
BUY IT AND WENT ON SOCIAL MEDIA
AND TRUSTED HER COMMUNITY AND
PEERS AND VETERANS TRUST
VETERANS MORE THAN THE
GOVERNMENT.
HELLO, ANYONE LISTENING?
WHEN WE THINK OF COMMUNICATION
ARE YOU A TRUSTED SOURCE OF
INFORMATION FOR THE COMMUNITY
YOU'RE TRYING TO GET THE MESSAGE
ACROSS?
WE HAVE TO THINK ABOUT WHO
VETERANS TRUST OR WHO YOUR
COMMUNITY IS GOING TO TRUST TO
DELIVER THAT INFORMATION.
AND WHEN YOU TALK ABOUT PFAS OR
ECDs OR WHATEVER WE HAVE MEDICAL
TERMINOLOGY.
THEY CANNOT PROCESS ALL THAT
INFORMATION ALSO THERE'S DELAYS
IN THE RELEASE OF INFORMATION
AND THEY TALK ABOUT THE ADVISORY
LEVEL.
ARE THEY SUPPOSED TO BELIEVE YOU
WHEN THERE'S SO MANY CHANGES IN
WHAT YOU SAID?
SO AS COMMUNITIES OF SCIENTISTS
AND PROVIDERS WE HAVE TO THINK
OF ALL THE THINGS THAT ARE LIKE
INFORMATION BLOCKS.
THERE ARE MANY THINGS BUILT INTO
OUR WAY OF COMMUNICATION.
VERY QUICKLY, RISK PERCEPTION.
IF THE PERCEPTION OF THE RISK IS
HIGH AND THE TRUST IS LOW,
THEY'RE NOT GOING TO LISTEN TO
YOU.
WHAT MAKES RISK PERCEPTION HIGH?
IF THE EXPOSURE IS INVOLUNTARY
AND CONTROLLED BY OTHER PEOPLE
AND CAN CAUSE CANCER AND CAN
AFFECT CHILDREN, IT'S OF HUMAN
ORIGIN AND NOT WELL UNDERSTOOD,
THERE'S CA TAS -- ACAST TROPHY
YOU HAVE TO ADDRESS THE CONCERN
ON THE RISK.
WHAT MAKES YOU A TRUSTED AND
CREDIBLE SOURCE?
WE TALKED ABOUT P VALUES AND
CONFIDENCE INTERVALS.
THAT TECHNICAL COMPETENCE IS
ONLY 17% OF WHAT ACCOUNTS FOR
PERCEIVED TRUST AND CREDIBILITY.
MOST ARE SOFT SKILLS, EMPATHY,
CARING, COMMITMENT AND
DEDICATION, HONEST AND OPENNESS
ESTABLISHED FROM THE BEGINNING
OTHERWISE YOUR MESSAGE WON'T GET
THROUGH.
SO BASICALLY WHAT ARE THE
TECHNIQUES?
START BY OFFERING EMPATHY.
VALIDATE, REMEMBER WHEN REMEMBER
WHEN THEY WERE TALKING ABOUT THE
EXPERIENCE OF THE FARM WORKER
AND WHEN FIREFIGHTERS GO TO
PROVIDERS.
NOBODY'S VALIDATING THEIR
EXPOSURE CONCERN.
THEY'RE NOT LISTENED TO LET
ALONE VALIDATE AND HAVE TO
LISTEN AND ACTIVELY REFLECT BACK
AND YOU WANT TO MAKE SURE AS YOU
SOMEONE KATE -- COMMUNICATE AND
EXPRESS EMPATHY AND PROVIDE THEM
WITH NECESSARY INFORMATION AND
IT'S ONLY AFTER THAT YOU CAN
WITH RECOMMENDATIONS THEY CAN DO
ON THEIR OWN BECAUSE YOU'VE BEEN
ABLE
ABLE TO AND WHEN THERE'S
FOLLOW-UP PROMISED YOU NEED TO
FOLLOW-UP BECAUSE WE'RE IN
SERVICE RECOVERY MODE.
THANK YOU SO MUCH EVERYONE.
>> DOES ANYONE HAVE QUESTIONS
FOR DR. OMOWUNMI OSINUBI.
>> I WORK WITH THE JESSE BROWN
V.A. AS WELL AS USC.
IT'S NICE TO MEET YOU.
THE V.A. IS AN OUTSTANDING
EXAMPLE HOW THIS COULD BE DONE.
I COULD LOVE TO SEE THIS SORT OF
EDUCATION DONE IN OUR MEDICAL
STUDENTS AND MEDICAL SCHOOLS
ACROSS THE COUNTRY.
I'M WONDERING IF YOU DO
EDUCATION WITH THE MEDICAL
SCHOOL OR HOW THE V.A. COULD
POTENTIALLY GET MORE INVOLVED IN
MAKING OUR MEDICAL STUDENTS
SMARTER ABOUT ALL THE ISSUES.
>> ABSOLUTELY.
THANK YOU SO MUCH.
WE DO A LOT OF EDUCATION.
SO ALL PROVIDERS COMING INTO THE
V.A. NOW HAVE TO TAKE THE FIRST
MODULE ON EXPOSURES.
THAT IS NOW REQUIRED.
WE DO MONTHLY WEBINARS FROM THE
V.A. TMS WEBSITE AND SOMETHING
CALLED TRAIN.
TRAIN IS A WEBSITE AVAILABLE TO
PROVIDERS EVERYWHERE.
THAT'S ANOTHER WAY TO GET THE
INFORMATION ACROSS AND WE DO
ROTATIONS FOR MEDICAL STUDENTS
AS WELL.
SO IF WE HAVE RESIDENTS WHO WANT
TO ROTATE AND MEDICAL STUDENTS
WHO WANT TO ROTATE WITH US TO
SEE HOW THIS IS DONE, WE WELCOME
THAT AS WELL.
I'M HAPPY TO SHARE MY
INFORMATION WITH YOU AND HAPPY
TO SEND YOU INFORMATION ON THE
LINKS WHICH I PROBABLY SHOULD
HAVE PUT ON THIS ON WHERE TO GET
MORE TRAINING ON THIS BUT THANK
YOU, THAT'S A GREAT QUESTION.
THANK YOU.
AND IMPORTANT ONE.
THANK YOU SO MUCH.
>> I ALSO WANT TO SAY GREAT TALK
WITH LOTS OF INFORMATION.
I DON'T KNOW IF YOU'RE AWARE BUT
THE V.A. IS ORGANIZING TO HOLD A
MAJOR SYMPOSIUM THIS SUMMER TO
MAKE THE AGENT ORANGE BIO
SPECIMENS AND DATA AVAILABLE
AGAIN FOR RESEARCH.
BECAUSE WE CAN ASK QUESTIONS
TODAY WE COULDN'T ASK 20 OR 30
YEARS AGO.
>> THANK YOU FOR THAT COMMENT.
I HAVE TO SAY SOMETHING ABOUT
VIETNAM VETERANS BECAUSE IT'S A
SPECIAL POPULATION.
REMEMBER THE POLITICS GOING ON
WITH THAT WAR AT THE TIME THEY
FOUGHT THE WAR VALIANTLY AND
CAME BACK TO AN UNGRATEFUL
NATION.
THEY WERE CALLING THEM NAMES AND
ALL THAT AND WENT TO THE V.A.
AND WERE SHELLSHOCKED AND THE
V.A. WASN'T ACKNOWLEDGING THEIR
EXPOSURES.
THE VIETNAM VETERANS IN
PARTICULAR ARE ON THE BRUNT OF
THE EXPOSURES AND LACK OF
RECOGNITION OF WHAT THE
EXPOSURES DID TO THEM WHETHER
THEY WERE PHYSICAL OR
PSYCHOLOGICAL OR CHEMICAL
EXPOSURES.
FOR ANY VIETNAM VETERAN IN THE
ROOM OR LISTENING TO THIS,
AGAIN, APOLOGIES TO HOW WE'VE
TREATED YOU.
WE SHOULD NOT HAVE DONE THAT.
MANY VETERANS ARE STILL NOT
RECOGNIZED.
GULF WAR, THE MORE RECENT ONES
ARE STILL NOT RECOGNIZED BUT
IT'S NOT AS BAD AS IT WAS IN THE
VET NAM WAR ERA SO THREW -- SO
YOU THANK YOU FOR ACKNOWLEDGING
THAT.
>> I'M ASKING THIS QUESTION ON
BEHALF OF DR. ZLATNIK.
SHE SAID GREAT TALK ARE YOUR
GROUPS STUDYING PREGNANCY
OUTCOMES IN VETS OR THEIR
FAMILIES?
>> WE DON'T SEEK OUT PREGNANT
WOMEN BECAUSE IT'S NOT OUR AREA
OF SPECIALTY.
HAVING SAID THAT THE NATIONAL
ACADEMIES SCIENCES ENGINEERING
MEDICINE IN THEIR MOST RECENT
GULF WAR AND HEALTH LOOK AT THE
HEALTH EFFECTS OF THE CHEMICALS
BECAUSE THE DISCUSSION YESTERDAY
WAS WHAT HAPPENED TO YOUR
GRANDMOTHER MAY NOT AFFECT YOUR
MOTHER BUT MAY AFFECT THE
GRANDCHILD.
IT MAY SKIP A GENERATION.
SO THERE'S SOME DATA TO INDICATE
THAT SO THAT'S THE NEXT PART OF
THE RESEARCH IS TO LOOK AT THE
INTERGENERATIONAL HEALTH EFFECT.
AT THE RISK WE GENERALLY DON'T
SEE PREGNANT WOMEN.
THANK YOU.
>> I'M ASKING A QUESTION ON MY
BEHALF.
I HEARD YESTERDAY AND TODAY
ABOUT THE POTENTIAL POWER OF
TESTING TO EMPOWER PEOPLE TO
PROTECT THEIR OWN HEALTH AND
CHANGE THEIR BEHAVIOR.
I'M CURIOUS AT THE V.A. IF I WAS
A VETERAN AND THOUGHT I HAD BEEN
EXPOSED BUT HAD NO SYMPTOMS LIKE
YOU'RE CASE EXAMPLE HAD KIDNEY
CANCER, METABOLIC SYNDROME AND
FATTY LIVER, HAD SOME THINGS
THAT WERE CLEARLY ABNORMAL ON
TESTS BUT SAY I DIDN'T HAVE ANY
SYMPTOMS AND I STILL LOOKED
HEALTHY, WOULD THE V.A. IS IT
POSSIBLE TO GET THEIR LEVELS
TESTED FOR ECDs IF THEY'RE
ASYMPTOMATIC?
>> THAT'S A GREAT QUESTION.
AFTER THE NASEM REPORT CAME OUT,
I THINK IT WAS TWO YEARS AGO NOW
THEREABOUT AND IT'S THE FIRST
TIME WE CAN HAVE A CHEMICAL WE
WE CAN TEST FOR AFTER THE
EXPOSURE BECAUSE PFAS LASTS A
LONG TIME.
YOU CAN'T TEST FOR SOLVENTS THAT
HAPPENS 30 YEARS AGO.
YOU WON'T FIND IT IN THEIR
BLOODSTREAM.
SO THE V.A.'S LOOKING AT THAT
RIGHT NOW AS TO WHAT THEY'RE
GOING TO DO IN TERMS OF
RECOMMENDATION FER -- FOR
TESTING.
THE ONE VETERAN PART OF WHOM IS
REFLECTED IN THE CASE WAS HIGH
HELL AND HOLY WATER I WAS GOING
TO GET HIM TESTED AND HAD
ELEVATED LEVELS OF THE ONE FOUND
IN AFFF WAS TESTED AND HE WAS AN
INFLUENCER AND I THOUGHT IF WE
DON'T GET HIM TESTED, WE'LL HEAR
ABOUT IT SO IT'S COMING.
WE DON'T HAVE AN ANSWER YET.
WHAT WE'RE DOING WITH THE
VETERANS NOW IS THAT BECAUSE WE
CANNOT FIX JUST THE ONE PROBLEM,
WE'RE LOOKING AT A WHOLISTIC
APPROACH IN TERMS OF WHOLE
HEALTH FUNCTIONAL MEDICINE AND
WITH THAT WE'RE DOING FUNCTIONAL
MEDICINE TESTS WHERE WE'RE
LOOKING AT THE GENOMICS.
WE'RE LOOKING AT THE URINE FOR
THE HORMONES IF THERE'S
DYSREGULATION THERE AND LOOKING
AT THE GUT HEALTH.
WE'RE LOOKING AT THE GUT
MICROBIOME.
WE'RE LOOKING AT THE SLEEP AND
THEY'RE EXERCISE AND GIVE THEM
FITBITS.
WE'RE COLLATING THE INFORMATION
AND SAY WE KNOW YOU'VE BEEN
EXPOSED HAVE YOU ALL THESE
HEALTH ISSUES.
THERE'S NO PILL BUT HOWEVER,
THIS IS WHAT WE CAN DO.
WE CAN WORK ON NUTRITION AND
EXERCISE AND SLEEP.
THEN WE'LL USE THE DATA.
I SAY, LOOK, YOUR CHOLESTEROL IS
HIGH.
YOU DON'T DETOXIFY VERY WELL.
YOU NEED MORE BROCCOLI AND
BRUSSEL SPROUTS.
THAT WILL BEAT IT.
OKAY, THANK YOU VERY MUCH.
>> DON'T GO TOO FAR.
YOU CAN PLOP DOWN AT THE TABLE
IF YOU WANT.
OUR NEXT -- THAT WAS EXCELLENT.
OUR NEXT SESSION IS A PANEL OF
CLINICIANS LIKE DR. OMOWUNMI
OSINUBI AS WELL AS COMMUNITY
MEMBERS LIKE LAURENE ALLEN AND
AMY TAMAYO AND INVITE YOU TO
COME TO THE TABLE AND WE HAVE
PEOPLE ONLINE AS WELL.
DR. WENDY WEBER FROM NCCIH WILL
BE MODERATING THE SESSION.
>> THANK YOU.
WE'VE HAD FROM 250 AND LOTS OF
PEOPLE WATCHING ONLINE AND THANK
YOU FOR STICKING WITH US THROUGH
TO THE END.
AND AS I SAID WHAT OUR NEXT
PANEL IS ABOUT IS TALKING WITH
COMMUNITY MEMBERS AND
COMMISSIONS ON THE PANEL TO
REALLY THINK ABOUT HOW DOES ALL
OF WHAT WE'VE LEARNED AND HOW
DOES THEIR EXPERIENCE -- WHAT DO
WE NEED TO THINK ABOUT TO INFORM
THE FUTURE OF RESEARCH WE'RE
GOING TO BE DOING IN THIS FIELD
AND WE'RE HERE AT NIH AND
LISTENING AND WANT IT LEARN
WHAT'S NEEDED AND FROM YOUR
DIFFERENT PERSPECTIVES.
WE'LL START WITH PREVIOUS
INTRODUCTIONS FROM OUR PANELISTS
TO INTRODUCE THEMSELVES TO THE
GROUP AND IF YOU CAN JUST SHARE
INITIALLY THE PERSPECTIVE YOU
BRING AS A PANEL AND HAVE
QUESTION TO START AND BRIEFLY
SAY WHO THE DIFFERENT SPEAKERS
ARE AND WE'LL GO IN THAT ORDER
FOR PEOPLE TO SAY HELLO AND
INTRODUCE THEMSELVES.
SO JOINING VIRTUALLY WE HAVE
VIOLA WAGHIYI -- I BELIEVE I
SAID SAID THAT RIGHT FROM THE
ALASKA COMMUNITY ACTION ON
TOXICS.
SECOND UP WILL BE AMY TAMAYO WHO
IS JOINING US FROM THE ALIANZA
NATIONAL DE CAMPESINNAS AND
WE'LL HAVE LAURENE ALLEN ON THE
MERRIMACK CITIZENS FOR CLEAN
WATER AND MARYA ZLATNIK FROM THE
UNIVERSITY OF CALIFORNIA, SAN
FRANCISCO AND WE'LL HAVE SHEELA
SATHYANARAYANA FROM THE
UNIVERSITY OF WASHINGTON ALSO
FROM A CLINICIAN PERSPECTIVE AND
THEN OUR LAST SPEAKER OMOWUNMI
OSIN
OSINUBI AND SHE'S WITH US FROM
THE DEPARTMENT OF VETERANS
AFFAIRS.
VIOLA CAN I TURN THINGS TO YOU
TO START US OFF?
>> GOOD AFTERNOON.
MY NAME IS VIOLA THE DAUGHTER OF
MY GRANDFATHER AND GRANDMOTHER
IS FROM TRADITIONAL ISLAND AND
NATIVE VILLAGES AND TRIBAL
CITIZEN AND ENVIRONMENTAL HEALTH
AND JUSTICE DIRECTOR AT ALASKA
COMMUNITY ACTION ON TOXICS AND
WHITE HOUSE ENVIRONMENTAL
JUSTICE ADVISORY COUNCIL.
I'D LIKE TO THANK THE ORGANIZERS
AND NIH FOR THE OPPORTUNITY.
[NOT SPEAKING ENGLISH]
>> THANK YOU SO MUCH.
AMY.
>> GOOD AFTERNOON.
MY NAME IS AMY TAMAYO THE POLICY
DIRECTOR WITH THE NATIONAL
ALLIANCE OF FARM WORKER WOMEN.
A NATIONAL FARM WORKERS'
ORGANIZATION CREATED BY AND FOR
FARM WORKER WOMEN OR FARM WORKER
FAMILY AN WORK ON IMMIGRATION
RIGHTS AND PESTICIDES AND ENDING
VIOLENCE AGAINST WOMEN AND MADE
UP OF 50 MEMBER ORGANIZERS
ACROSS 20 DIFFERENT STATES.
>> LAURENE ALLEN MANY MERRIMACK
CITIZENS FOR CLEAN WATER AND HI
WORK ON ENGAGEMENT ADVOCATING
FOR PFAS IMPACTED COMMUNITY AND
WE'RE WORKING WITH 30 DIFFERENT
STATES AND PEOPLE WHO HAVE
STEPPED INTO THESE ROLES BECAUSE
WE NEEDED TO GET THE JOB DONE.
>> MARYA.
>> I'M MARYA ZLATNIK A MATERNAL
FETAL MEDICINE DOC IN SAN
FRANCISCO AND I'M PART OF WHAT
ASK CALLED THE PROGRAM AND
RESEARCH REPRODUCTIVE HEALTH AND
THE ENVIRONMENT AT UCSF AS WELL
AS THE REGION 9 STATE PEDIATRIC
ENVIRONMENTAL SPECIALTY UNIT.
AS A HIGH-RISK PREGNANCY
SPECIALIST WHO PROVIDES CLINICAL
CARE FOR PEOPLE PREGNANT,
LACTATING OR PLANNING PREGNANCY
AS WELL AS A PROFESSOR WHO
EDUCATES MEDICAL STUDENTS,
OB-GYN'S IN TRAINING AND IN
PRACTICE ABOUT THE HEALTH HARMS
OF ECDs AND OTHER ENVIRONMENTAL
EXPOSURES, I'M REALLY PLEASED TO
BE HERE AND THIS HAS BEEN SUCH
AN OUTSTANDING MEETING.
I'VE LEARNED SO MUCH.
THANK YOU.
>> ALL RIGHT.
AND WE JUST HEARD FROM OUR LAST
SPEAKER BUT DO YOU WANT TO IN
CASE ANYONE'S -- SORRY, SHEELA,
YOU'RE NEXT.
>> THANKS, MY NAME IS SHEELA
SATHYANARAYANA I'M A
PEDIATRICIAN AND PROFESSOR OF
PEDIATRICS AND ALSO ADJUNCT
PROFESSOR IN THE DEPARTMENT OF
ENVIRONMENTAL AND OCCUPATIONAL
HEALTH SCIENCES AT THE
UNIVERSITY OF WASHINGTON AND
SEATTLE CHILDREN'S RESEARCH
INSTITUTE.
AND I COME AS A CLINICIAN WHO
SPEAKS TO FAMILIES AND PATIENTS
AND WORKS WITH THE REGION 10
PEDIATRIC AND ENVIRONMENTAL
HEALTH SPECIALTY UNIT AND
RESEARCHER WHO FOCUSSED ON
ENDOCRINE DISRUPTOR CHEMICALS
AND I WANT TO THANK THE
ORGANIZERS TO PUT FORWARD SUCH A
FORWARD THINKING WORKSHOP
BRINGING THE ADVOCATES AND
RESEARCH COMMUNITY WHICH IS SO
IMPORTANT TO MOVING THIS FIELD
FORWARD.
>> GREAT, WE HEARD FROM ALASKA
SO I THINK THE INTRODUCTION WILL
WORK FOR US.
WHY DON'T WE START OFF AND ONE
OF THE QUESTIONS WE ASKED TO THE
PANEL WAS WHAT WOULD BE YOUR TOP
PRIORITIES?
MAYBE ONE TO TWO PRIORITIES IF
YOU COULD GET THIS RESEARCH
COMMUNITY THAT'S LISTENING TO DO
THE WORK THAT YOU WOULD LIKE TO
SEE DONE, WHAT WOULD BE THOSE
TOP PRIORITIES AND YOU CAN GO IN
ANY ORDER.
WHO WOULD LIKE TO GO FIRST?
>> SINCE I'M SITTING NEXT TO
YOU, I'LL GO FIRST.
A COUPLE THINGS.
HOW DO WE EDUCATE EFFECTIVELY
HEALTH CARE PROVIDERS SO OUR
PATIENTS AND MEMBERS OF OUR
COMMUNITIES DO NOT FEEL
DISMISSED WHEN THEY SHOW CONCERN
ABOUT ENVIRONMENTAL EXPOSURES?
MOST MEDICAL SCHOOL CURRICULUM
IS VERY WEAK WHEN IT COMES TO
EXPOSURES.
AND THEY BARELY ASK WHAT JOB YOU
DO LET ALONE ASK YOUR ZIP CODE.
THAT'S ONE THING.
THE OTHER AREA IS MANY PEOPLE DO
NOT HAVE A SINGLE EXPOSURE AND
THEY GENERALLY DO NOT HAVE A
SINGLE OUTCOME BUT OUR RESEARCH
AND FUNDING IS TYPICALLY GEARED
TOWARDS ONE EXPOSURE, ONE
OUTCOME.
THAT'S NOT WHAT LIFE IS ABOUT.
THE QUESTION IS HOW DO WE THINK
OF RESEARCH STUDY THAT LOOK AT
THE IMPACT OF MULTIPLE EXPOSURES
AND THERE'S AOUT COME AND HAVE
MULTI-DISCIPLINARY INTERVENTIONS
BECAUSE WHEN YOU HAVE A SERIES
OF HEALTH ISSUES IT'S NOT GOING
TO BE MEDICATION ALONE OR
SUPPLEMENTS ALONE.
YOU'LL HAVE TO BRING ALL THOSE
TOGETHER AND THE QUESTION IS HOW
DO WE DESIGN RESEARCH AND FUND
STUDIES SO WE'RE LOOKING AT
COMPREHENSIVE WHOLE HEALTH
APPROACH IN TERMS OF THE
INTERVENTION TO MAKE A
DIFFERENCE IN HOW PEOPLE ARE
FEELING?
>> I AGREE IT'S IMPORTANT AND
COMMUNITIES WHO ARE EXPOSED ARE
EXPOSED TO CLASSES OF CHEMICALS
AROUND MULTITUDE OF OTHER
TOXICANTS.
WE SHOULDN'T HAVE TO PROVE THE
HARM AND IT'S GEARED TO ONE
COMPOUND AT A TIME TO TAKE MY
LIFE TIME, MY CHILDREN'S LIFE
TIME AND FUTURE UNBORN
GRANDCHILDREN'S GRAND TIME,
ETCETERA.
IT'S NOT ACCESSIBLE.
WHILE THE WORK HERE WE TALKED
ABOUT HEALING.
HEALING IS RESILIENCE, HEALING
IS IMPORTANT, HEALING WILL MAKE
COMMUNITIES WHOLE, BEING
VALIDATED, ACTIVE LISTENING ALL
THE THINGS YOU TOUCHED ON BUT
WE'LL HAVE TO GET TO THE
RICHNESS OF THE DATA.
WHEN HAVE YOU AN EXPOSED
COMMUNITY YOU DON'T NEED TO WAIT
FOR THE PROOF FOR EVERY LITTLE
COMPOUND AND THEN WHAT'S THE
CURE SNOW OVERLAPS ARE THERE AND
IF WE GATHER THE HEALTH
INFORMATION AS THE MINNESUSCULE
SAMPLING I DID THERE'S A
RICHNESS OF DATA AS THE
BASELINE.
YOU KNOW THE EXPOSURE AND GATHER
THE HEALTH PROFILES AND
INFORMATION AND CAN TRACK THAT
OVER TIME FOR EXAMPLE TO SEE IF
WE STOP THE SOURCE OF WATER
CONTAMINATION FOR EXAMPLE DOES
THAT RESULT IN A DECREASE IN
CERTAIN MARKERS AND BLOOD WORK?
IT HAS FOR ME SOMEWHAT.
IT'S UP AND DONE BUT MAYBE AND
THEN WHAT?
WE CAN'T JUST WAIT AND SEE AND
SAY WE STOPPED THE SOURCE THE
POLICY AND REGULATION IS AN
ONGOING TO BATTLE PEOPLE ARE
WORKING ON YOU BUT PERHAPS WE
NEED TO STOP AND THINK HOW TO
WRAP AROUND HOW TO HELP PEOPLE
HEAL WITH BASIC THINGS WE KNOW
WORK FOR ENDOCRINE DISRUPTORS
ACROSS THE BOARD AND LOOKING AT
THE DATA HOW CAN WE GATHER TO
AND IT'S A RICHNESS OF
INFORMATION.
THEN YOU'LL REALLY SEE WHAT IS
OUT THERE AND WHAT IS HAPPENING
CAN FROM THE PANEL AND CLASS
ACKNOWLEDGEMENT.
THANK YOU.
>> ONE THING THAT'S STRUCK ME IS
THOSE WHO WORK IN THE FIELD ARE
CONSTANTLY THINKING HOW TO
INCORPORATE MORE INFORMATION IN
MEDICAL CARE AND TO PROVIDERS ON
FRONT LINES.
AND ONE THING THAT MAY BE GREAT
IS THE HEALTH CARE PROVIDERS
THAT WE DO HAVE HERE, I DO THINK
IT MIGHT BE NICE TO COMBINE AND
WRITE A LETTER TO ADVOCATE FOR
INCORPORATION OF ENVIRONMENTAL
COMPONENTS TO THE MEDICAL
CURRICULUM IS UNRELATED AND HARD
TO INTRODUCE NEW THINGS.
AND IN TERMS OF RESEARCH
PRIORITIES, I DO THINK THAT
THERE DOES NEED TO BE MORE FOCUS
ON INTERVENTION RESEARCH.
WHILE WE CAN CONTINUE TO LOOK AT
MULTIPLE EXPOSURES AND OUTCOMES,
I THINK WE DO HAVE ENOUGH
INFORMATION ON MANY CHEMICALS.
WHEN I STARTED 15 YEARS AGO WE
DIDN'T KNOW PHTHALATES WERE
GOING TO BE SIGNIFICANT AND
HARMFUL.
WE LEARNED SO MUCH IN THE PAST
DECADE ABOUT SO MANY CHEMICALS
AND OFTEN IT'S THE SAME LESSON
LEARNED YOU CAN TELL PEOPLE TO
HAVE A HEALTHY DIET, EXERCISE
REGULARLY AND ALL THE PIECES BUT
THE EVIDENCE BEHIND SOME OF
THOSE IS A LITTLE WEAK.
WHAT WE HEARD OVER THE PAST TWO
DAYS ARE THE POSITIVE
INTERVENTION STUDIES BUT FOR
EVERY POSITIVE INTERVENTION
STUDY THERE'S A NUL STUDY.
I HAVE HAD ONE OF THOSE AND I
KNOW MANY OTHERS HAVE SO WE NEED
MORE IN THAT REALM.
AND IN TERMS OF TRANSLATION WE
NEED A LITTLE BIT MORE FOCUS ON
INVOLVING COMMUNITY
ORGANIZATIONS AND CIRCULATING
EDUCATIONAL AWARENESS AND THAT
COMES WITH PARTNERING AT THAT
LOCAL LEVEL AND OFTEN THERE
ISN'T A FRAMEWORK FOR THAT.
COMMUNITY-BASED PARTICIPATORY
RESEARCH SEEMS TO BE SILOED AND
MAYBE IT COULD BE MORE
INTEGRATED ACROSS RESEARCH AND
CREATE MORE OF AN IMPACT OVER
ALL.
>> GREAT, THANK YOU.
VIE, I SEE YOUR HARD AS WELL.
>> YES, THANK YOU.
I COME FROM A COMMUNITY LOCATED
IN THE NORTH BERRING SEE BECAUSE
YOU HAVE OUR PROXIMITY TO RUSSIA
AND THEY ESTABLISHED TWO BASES
BECAUSE OF THE COLD WAR AND
WE'VE BEEN STRUGGLING TO HOLD
THEM ACCOUNTABLE SINCE THEN.
AND I STARTED THE WORK 21 YEARS
AGO AND IT'S SO PERSONAL BECAUSE
OF THE TWO FORMER DEFENSE SITES.
A FORMER HEALTH AID STARTED
NOTICING HIGH RATES OF CANCER,
LOW BIRTH WEIGHT BABIES,
MISCARRIAGES, STILLBIRTHS IN OUR
FAMILIES THAT LIVED, WORKED OR
CAMPED AT ONE OF THE FORMER
BASES.
AND SHE TRIED TO GET HELP FOR
OUR COMMUNITY FOR 20 YEARS AND
AS A RESPECTED HELD ELDER
COMMUNITY AND NOBODY TOOK HER
KNOWLEDGE AND OBSERVATIONS AND
HIGHLY TRAINED IN THE HEALTH
FIELD NOBODY TOOK HER
OBSERVATIONS AND WE'RE STILL
BEING DISCREDITED FOR THE HEALTH
HARMS WE'VE SEEN.
WHETHER AS THE COMMUNITY WITH
PESTIC
PESTICIDES, HEAVY METALS,
SOLVENTS, FUEL SPILLS, ASBESTOS,
MERCURY, MILITARY TOXIC.
THE BURDEN OF PROOF WAS PUT ON
MY PEOPLE.
THE MILITARY TURNED THEIR BACK
ON US.
NOW WE KNOW THE HEMISPHERIC SINK
THAT ARRIVE IN THE ARCTICS AND
FINDING THEM IN OUR FOOD FOR
EXCESS CANCER RISK AND BEING
RELEASED QUICKER AS THE
PERMAFROST MELT.
AND NOW WE KNOW THE ARCTIC OF
ALL THE OCEANS HAS THE MOST
CHEMICALS AND THERE'S 16,000
CHEMICALS IN THE PRODUCTION OF
PLASTICS BUT THEY'RE ABSORBING
EVEN MORE AS THEY'RE ARRIVING ON
OUR SHORES.
THERE'S AN ENVIRONMENTAL
VIOLENCE WHERE WE'RE BEING
CONTAMINATED WITHOUT OUR
CONSENT.
WE OFFER -- WE RECENTLY PRODUCED
OUR PROTECT OUR BREAST CANCER
PREVENTION TOOL KIT WE PRODUCED
RECOGNIZING THERE'S NOT ENOUGH
EDUCATION LIKE THE FIRST SPEAKER
SPOKE ABOUT HOW MEDICAL SCHOOLS
AND EDUCATION IS VERY WEAK.
WE PRODUCED THIS KNOWING NATIVE
ALASKAN WOMEN HAVE THE MOST
BREAST CANCER IN OUR STATE.
IT'S HOW TO PREVENT BREAST
CANCER.
WE OFFERED IT AT THE ANNUAL
COMMUNITY HEALTH DAY TRAINING
AND OFFERED GRAND ROUNDS.
ALSO OTHER TRAININGS WITH CMAs.
RECOGNIZING HOW IT'S IMPORTANT
WE EDUCATE THE HEALTH CARE
PROFESSIONALS BECAUSE IT'S NOT
IF GETTING CANCER BUT WHEN.
I'M A BREAST CANCER SURVIVOR.
I'VE HAD THREE MISS CHARGES AND
WE WERE A FAMILY OF EIGHT.
HALF OF US GOT CANCER AND MY
MOTHER GOT CANCER, DIABETES,
STROKES, DIABETES, MENTAL
HEATHER HARMS AND ON AND ON.
AND WE KNOW THAT THESE TOMMIC
EXPOSURES ARE
MULTI-GENERATIONAL.
WE OFFER EDUCATION AND EMPOWER
WOMEN TO ENVIRONMENTAL HEALTH
AND JUSTICE AND TO WORK
PROACTIVELY AND WORK WITH THEIR
TRIBE TO CONTACT THEIR
LEGISLATORS AND HOW TO TESTIFY
AND CONTACT THE LEGISLATORS.
SO IT'S IMPORTANT WE MAKE SURE
MEASURES ARE EN PLACE TO PROTECT
OUR MOST VULNERABLE.
OUR CHILDREN, WE'RE DOING
RESEARCH ON OUR CHILDREN LOOKING
AT ENDOCRINE DISRUPTOR CHEMICALS
LISTENING TO CONCERNS OF OUR
PARENTS AND GRANDPARENTS AND DUE
TO CONCERNS OF THE CHILDREN IN
MY COMMUNITY HAVE THE LOWEST
TEST SCORES.
HOW CAN WE PASS ON OUR
LANGUAGES?
OUR CREATION STORIES AND SONGS
AND DANCES.
OUR CULTURES AND TRADITIONS OUR
CHILDREN CAN'T LEARN?
IT'S IMPORTANT THAT HEALTH CARE
PROVIDERS AND GET EXTENSIVE
HEALTH HISTORY OF YOUR PATIENTS,
WHERE THEY MAY HAVE LIVED, WHERE
THERE'S ADJACENT TO EYE MILITARY
BASE ADJACENT OR IN CLOSE
PROXIMITY TO DEVELOPMENT WHETHER
IT'S FOSSIL FUEL, MINING AND
ALSO FOR COMMUNITIES LIKE MINE
TO SHARE THE KNOWLEDGE OF THEIR
HEALTH HISTORY TO MAKE SURE THEY
MAKE DECISIONS IN THEIR HEALTH
CARE.
THANK YOU VERY MUCH.
>> IT'S GREAT TO HEAR WHAT THE
OTHER PANELISTS ARE THINKING.
ONE OF THE THINGS THAT I WOULD
SUBJECT AS A WAY TO GET HEALTH
CARE PROVIDERS MORE WILLING TO
DISCUSS THESE ISSUES IS TO GIVE
HEALTH PROVIDERS TOOLS TO
ADDRESS THESE ISSUES.
I MAY NOT WANT TO ASK WHAT
SOMEBODY'S OCCUPATION IS IF I
CAN'T GIVE ADVICE.
IF SOMEONE TELLS ME THEY LIVE BY
A SUPER FUND THEY PROBABLY KNOW
THAT'S NOT THE HEALTHIEST PLACE
TO LIVE BUT WHERE THEY CAN
AFFORD OR WHERE THEY'RE FAMILY
LIVES.
I WOULD LOVE TO ENCOURAGE THE
NCCIH, THE NIEHS TO JOIN WITH
THE NICHD AND THINK OF FUTURE
LABORERS AS A HIGH RISK
PREGNANCY SPECIALIST BUT A RICH
AREA TO DO RCTs.
WE'VE HEARD OF AIR FILTRATION,
CHEMICALS IN PERSONAL CARE
PRODUCTS, POTENTIALLY WATER
FILTRATION, BASIC SUPPLEMENTS,
ARE THERE RCTs WHERE WE CAN TAKE
WOMEN AT RISK FOR PRE-TERM BIRTH
AND PROVIDE AN INTERVENTION AND
SEE IF THAT MAKES A DIFFERENCE
IN OUTCOMES?
IF PHYSICIANS KNOW I CAN PROVIDE
THIS INFORMATION AND IT'S
ASSOCIATED WITH A DECREASED RISK
OF PRETERM BIRTH I THINK YOU'LL
GET PHYSICIANS TALKING ABOUT
ENVIRONMENTAL EXPOSURES.
I THINK RCTs ARE THE PLACE WHERE
IT'S AT.
MAYBE IT COULD BE A BUNDLE OF
INTERVENTIONS AND DO COGNITIVE
WORK AND SCREENING FOR CHILDHOOD
EXPERIEN
EXPERIENCES LAKE THERE'S GOING
TO BE IN CLINICAL RESEARCH.
THOSE ARE SOME OF MY
SUGGESTIONS.
>> I WANTED TO ADD MORE TO THE
RECOMMENDATION SHEELA BRUTH UP
ABOUT PARTNERSHIPS BETWEEN
COMMUNITY ORGANIZATIONS AND NGOs
AND ACADEMIC INSTITUTIONS, WE
SEE A LOT OF AND DO AN INTERVIEW
TO HOW THINGS HAVE AFFECTED YOU.
AND PEOPLE ARE HESITANT TO
PARTICIPATE IN THE REPORTS
BECAUSE THEY'RE ALWAYS THINK IN
THE BACK OF THEIR MIND
ESPECIALLY IF THEY DON'T HAVE
IMMIGRATION STATUS HOW IS MY
PERSONAL INFORMATION BEING USED
OR IS MY EMPLOYER GOING TO FIND
OUT AND RETALIATE AGAINST ME.
BECAUSE OF THE REASONS AND
THERE'S A CULTURAL BARRIERS TOO.
WITH FARM WORKER WOMEN WE'RE
TAUGHT AT A YOUNG AGE TO NEVER
TALK ABOUT YOUR BODY OR SHOW
YOUR BODY TO ANYBODY EXCEPT YOUR
HUSBAND SO PEOPLE ARE HESITANT
TO BE FORTHCOMING ABOUT ANYTHING
RELATED TO REPRODUCTIVE HEALTH.
THERE'S ALWAYS THIS LEVEL OF
DISTRUST BETWEEN PEOPLE IN THE
COMMUNITY AND PEOPLE ENGAGING IN
THE RESEARCH.
IT'S IMPORTANT TO PARTNER WITH
THE GRASSROOTS ORGANIZATION WHO
HAVE RELATIONS WITH PEOPLE IN
THE TARGET COMMUNITY AND SOME
THINGS THAT HAVE HELPED MORE
PARTICIPATION FROM COMMUNITY
MEMBERS IS WE ALWAYS ASK IF,
WELL, WE NEED RESOURCES AND
FUNDING TO BE CONDUCTING
OUTREACH AND FACILITATING THE
SURVEYS IN SPANISH OR OTHER
INDIGENOUS LANGUAGES WE NEED TO
BE ABLE TO PAY STAFF TO DO THAT
AND ASK WE CAN GET FEEDBACK IN
THE DESIGN OF THE RESEARCH AND
THAT'S IMPORTANT BECAUSE AT
LEAST SPEAKING FROM MY
EXPERIENCE I SEE A LOT OF THE
COMMUNITY ORGANIZATIONS ARE
APPROACHED TOWARDS THE END IN
DEVELOPING THE SURVEY OR THE
QUESTIONNAIRE AND HELP US
DISTRIBUTE TO THE COMMUNITY.
AND WE SEE IT AND SEE THAT IT'S
IN SPANISH BUT YOU PLUGGED IT IN
GOOGLE TRANSLATE BUT MAYBE IT
DOESN'T TRANSLATE IN OUR
LANGUAGE AND SO CHANGING THE
LANGUAGE SO IT COLLOQUIALLY
MAKES SENSE SO PEOPLE CAN
RESPOND AND THERE ARE PEOPLE WHO
ARE ILLITERATE BUT ALLOW
RESPONSES TO BE, ORAL,
RECORDINGS AND SPEAK MESSAGES
AND WHAT'S APP AND USING IMAGES
AND VIDEOS IF PEOPLE ARE
UNCOMFORTABLE TALKING ABOUT
CERTAIN TOPICS AND ALLOWING FOR
AN OPPORTUNITY TO LEARN FROM THE
ORGANIZATIONS AND IF IT'S A
TOPIC WHERE SOMEONE CAN FEEL
LIKE THEY MAY BE RETRAUMATIZED
OR COMING IN MY COMMUNITY AND
EXTRACTING PERSONAL STORIES LIKE
YOU HEARD YESTERDAY, SOMETIMES
THEY FEEL LIKE WHAT ARE YOU
DOING ABOUT MY TRAUMA STORIES
AND JUST TALKING ABOUT IT BUT
NOT DOING ANYTHING TO HELP ME
BUT THAT'S WHERE YOU CAN BRIDGE
TRUST WITH THE COMMUNITY OH AND
IN NAVIGATING THE RELATIONSHIPS
WITH THE COMMUNITY AND
ORGANIZERS WE GET OUR MEMBERS TO
UNDERSTAND HOW IMPORTANT IT IS
TO CONTRIBUTE THEIR VOICES AND
STORIES IN THE WAY THEY CAN
WHETHER IT'S EVENTS LIKE THIS OR
WRITTEN TESTIMONY AND TRYING TO
PROVIDE COMMENTS TO REGULATORY
SESSIONS AND INFORM OF A FUNDING
OPPORTUNITY.
SOMETIMES WE NEED TECHNICAL
ASSISTANCE APPLYING TO GRANTS.
THAT'S COMPLICATED FOR US AND
OTHER BIGGER ORGANIZATIONS HAVE
A FULL-TIME GRANT WRITER WHO
UNDERSTANDS THAT LANGUAGE WE
DON'T.
ANYWAY YOU'RE ABLE TO PROVIDE
THE OPPORTUNITIES OR SUPPORT
SMALLER ORGANIZATIONS TO SHARE
STORIES OR ACCESS RESOURCES TO
GATHER THE DATA OURSELVES IS
SOMETHING THAT I THINK WOULD
REALLY HELP THAT GAP IN GETTING
COMMUNITY INPUT.
>> THAT'S GREAT.
YOU AND SHEELA FOLLOWED UP ON
WHAT MY NEXT QUESTION WAS GOING
TO BE.
IN PART OF THE WORK WE DO HERE
AT NCCIH AT NIH WE'RE DOING
SEVERAL SETS OF STUDIES IN
PARTNERSHIP WITH HEALTH CARE
SYSTEMS AROUND COMMUNITY
ORGANIZATIONS AND ONE THING WE
HEARD IS THE RESEARCHER HAS THE
QUESTION AND READY TO COME TO
YOU AND IMPLEMENT THE QUESTION
AND DO THE STUDY IN THE
COMMUNITY OR GROUP WE HAD CASES
WHERE AMAZING QUESTIONS CAME
FROM THE COMMUNITY ORGANIZATIONS
AND THEY HAVE FOUND A RESEARCH
PARTNER.
WHAT ADVICE DO YOU OR OTHERS
HAVE IN TERMS OF HOW ELSE WOULD
YOU GIVE ADVICE IN HOW TO
APPROACH THIS AND FOR THOSE IN
THE CLINICS WHAT IS YOUR ADVICE
FOR WANTING TO DO RESEARCH WITH
YOUR PATIENT POPULATIONS OR
TRYING TO RECRUIT FROM YOUR
CLINIC.
I'LL OPEN THAT UP.
>> I'LL TALK ABOUT THE CLINIC.
MY FIRST THING IS WANTING TO DO
RESEARCH.
YOU NEED TO SHADOW AND SEE WHAT
LIFE IS REALLY LIKE AND HEAR
FROM THE PATIENT DIRECTLY AND
UNDERSTAND THEIR LIVED
EXPERIENCE.
I ENCOURAGE THE RESEARCH IN
FLORIDA SERVED POPULATION TO BE
PART OF OUR CLINICAL PROCESS.
THEN YOU CAN LOOK AT YOUR
RESEARCH AND SEE HOW THAT
ADDRESSES THE MAIN ISSUES
VETERANS ARE DEALING WITH.
>> I THINK IT'S IMPORTANT WHEN
YOU'RE CONCEPTUALIZING TO REACH
OUT AND ENGAGE COMMUNITY GROUPS
FROM THE START AND INVOLVE THEM
IN THE PROCESS BEFORE
FORMULATING THE MAIN QUESTIONS
AND MAKING SURE THE THESIS IS
CORRECT AND INCLUDE THEM IN
DRAFT.
IT'S FUNNY.
I'M LEARNING THE TECHNOLOGICAL
SKILLS IN THE LAST YEARS I'VE
NEVER HAD AND ONE THAT
EMBARRASSES YOU LOOKING BACK
WORKING WITH AN ACADEMIC PARTNER
IN BOSTON AND WHEN IT KAMZ
CAME -- CAME TIME TO APPLY FOR
THE STUDY WHICH WE WERE DENIED
FOR AND I NEVER THOUGHT IT WOULD
BE ALLOWED BUT I'M USING THE
iPAD AND iPHONE AND GOING BACK
AND FORTH SO DON'T FORGET THE
TECHNOLOGY.
SOMETIMES PEOPLE ARE SCARED OF
IT AND DON'T ENGAGE AND THE
PEOPLE WHO ARE ENGAGING LIKE I
WAS, THEY'RE SENDING DRAFTS SO I
OPEN UP MY E-MAIL AND SEE A WORD
FILE IN THE DRAFT SO I READ IT
AND I'M ASKED TO GIVE INPUT.
I SAY HOW DO I GIVE INPUT IN
THIS.
I'LL PUTTING IT ON ONE DEVICE
READING IT AND ON THE OTHER
DEVICE I'M MAKING MY COMMENTS.
SO I SUBMIT MY COMMENTS AND THEY
SAY, GREAT, THANK YOU.
AND AFTER A FEW MONTHS AND MAYBE
45 TO 50 REVISIONS I HAPPEN TO
HAVE A LAPTOP OPEN FOR
TELEHEALTH REASONS AND I OPENED
THE LAPTOP IN WORD AND YOU ALL
USE COMPUTERS BUT YOU KNOW WHAT
HAPPENS IN WORD YOU SEE THE
TRACKING THING ON THE RIGHT, I
HAD NO IDEA THAT EXISTED.
PERFECTLY INTELLIGENT PERSON AND
THINK I'M COLLABORATING AND I
SEE EVERYBODY'S COMMENTS ARE
THERE AND IDENTIFIED AND I THINK
YOU ALL KNOW WHAT THAT LOOKS
LIKE.
I REACH BACK OUT TO THE TEAM AND
SAY, OH, MY GOSH, THREE MONTHS
IN I DIDN'T KNOW THIS WAS A
THING AND EXISTED.
I STUMBLED ON IT.
WHY DIDN'T YOU JUST TELL ME IF
TO OPEN THIS ON THE LAP TON AND
THEY SAID IT'S OKAY WE WROTE
WHAT YOU SAID AND INCORPORATED
IT.
NOT JUST THE CONTENT BUT MAKING
SURE YOU GIVE A LITTLE BIT OF A
PRIMMER ON BASIC DOs AND DON'Ts
BECAUSE I WAS A YELLOW PAD NOTE
TAKER FOR YEARS IN MY WORK.
DON'T OVERLOOK THOSE BASIC
THINGS IN PARTNERING FOR PEOPLE
WHO WILL BE SILENT OVER VARIOUS
THINGS LIKE ZOOM AND SOMEBODY
SELLS I'LL DROP THE LINK IN THE
CHAT.
TO THIS DAY I SAY TO MYSELF,
THERE IS THE DROPPED IN THE
CHAT.
I REALLY WANT TO LOOK AT IT BUT
IF I HIT THAT LINK WHAT WILL
HAPPEN TO THE ZOOM?
WILL IT BE GONE?
WILL I GET IT BACK AND NEVER DO
IT.
I CAN LAUGH AT MYSELF,
FORTUNATELY, BUT THERE'S SOME
BASIC THINGS ACADEMIC AND
SCIENCE FOLKS TAKE FOR GRANTED
IS A PRIMITIVE SKILL SET.
WE DO NOT HAVE THOSE SKILLS.
WE HAVE A LOT OF TO OFFER AS
COMMUNITY MEMBERS BUT PARTNERING
GOES BEYOND LISTENING AND
VALIDATING AND DRAFT REVISIONS.
BRINGING THE TECHNOLOGY IN.
THAT'S A FUNNY QUIP OVER ONE OF
THE THINGS I LEARNED ON THE WAY.
>> THAT'S GREAT.
>> SHEELA.
>> I GUESS ONE POINT I WANTED TO
MAKE WAS I HEARD FROM MANY
PEOPLE WHO HAVE TRAINEES, ONE OF
THE THINGS I TELL MY TEAM AND
TRY TO STAND BEHIND THE CALL OF
MY TRAINEES IS DON'T LET YOUR
RESEARCH DIE IN A JOURNAL.
I BELIEVE THAT.
JOURNALS ARE IMPORTANT AND HELP
WITH THE DISCOURSE BUT WHAT
HELPS IS EVERYONE IN CAN HEAR
THE RESULTS AND I ASK TRAINEES
WHAT DID YOU DO TO TRANSLATE THE
RESULTS?
SOME HAVE FOUND ORGANIZATIONS
AND DIFFERENT AUDIENCES AND A
K-12 SCHOLAR DID AN ARTICLE ON
ULTRA FINE EXPOSURE AND REACHED
OUT TO AN ORGANIZATION CONCERNED
ABOUT THE AIR FLIGHT PATH OVER
THEIR COMMUNITY WITH SIGNIFICANT
AIR POLLUTION AND COMMUNICATED
THAT HANDOUT TO THAT
ORGANIZATION.
I FEEL LIKE THERE ARE WAS WHERE
WE CAN USE WHAT WE HAVE AND
COMMUNE IT TO DIFFERENT PARTNERS
BUT A LOT OF IT IS ABOUT MAKING
THAT CONNECTION AND THAT RELATES
TO IN TERMS OF RESEARCH AND
IMPLEMENTATION SCIENCE HE'S
BECOME A MORE IMPORTANT PART OF
MEDICAL RESEARCH BUT I DON'T SEE
THE CONNECTIONS BETWEEN HHS AND
NIH IN PUTTING THOSE TOGETHER.
IN TERMS OF EFFORTS TO GET THE
WORD OUT TO WORK WITH COMMUNITY
HAD ORGANIZATIONS, TO WORK WITH
CLINICS, IT WOULD BE HELPFUL IF
THERE WAS A PARTNERSHIP TO
SUPPORT THOSE PIECES.
THAT'S THE KEY IS TO NOT STAY IN
SILOS AND CONNECT ACROSS THOSE
DOMAINS.
>> THANK YOU.
I SEE VIE AND MARYA.
VIE, I THINK YOU MUTED YOURSELF.
>> WE'RE A SMALL NON-PROFIT
WOMAN-LED ORGANIZATION AND THE
EXECUTIVE DIRECTOR RECOGNIZED
THE NEED AND ESTABLISHED A
COMMUNITY ON TOXICS WHEN SHE MET
ANNIE IN 1997.
A LOT OF TIME COMMUNITIES COME
TO US AS I MENTIONED INTO THEY
EXHAUSTED TRYING TO GET HELP FOR
THEMSELVES AND FAMILY AND
COMMUNITY OR REGION.
IT'S IMPORTANT THAT ON A
PARTICIPATORY RESEARCH PROJECT,
YOU PARTNER WITH THE LOCAL
LEADERSHIP.
YOU ESTABLISH A COMMUNITY WORK
GROUP MEMBER.
YOU HIRE AND TRAIN LOCAL PEOPLE
AND THEY COME UP WITH THEIR OWN
DESIGN OF THE RESEARCH FOR DATA
TO COLLECT TO MAKE THEIR OWN
INFORMED DECISIONS.
WE BELIEVE EVERYONE HAS A RIGHT
TO TOXIC FREE FOOD AND WATER AND
THE MAJORITY OF US ARE ALASKAN
WOMEN AND WE'VE BEEN FUNDED
SINCE 2000 FROM NIEHS AND NIH.
IT'S IMPORTANT COMMUNITIES ARE
INVOLVED AND COME UP WITH
RESEARCH QUESTIONS AND IN MY
COMMUNITY WE'RE CONFRONTED WITH
TOXICS AND MICROPLASTICS AND ON
AND ON.
NOW THE RESEARCH ON ENDOCRINE
DISRUPTING CHEMICALS KNOWING THE
FLAME RETARDANTS THAT ARRIVE
THROUGH AIR AND OCEAN CURRENT
AND HOW WE'RE BEING EXPOSED IN
OUR HOME AND THE LEGACY PFAS AND
HEAVY METALS INCLUDING MERCURY
AND I MENTIONED THE MILITARY
SITE AND IT'S IMPORTANT YOU TALK
AND FIND SOMEBODY IN THE
COMMUNITIES SO THAT THEY'RE
INVOLVED FROM THE BEGINNING.
THE DATA BELONGS TO THEM BUT MY
COMMUNITY THEY WANT US TO SHARE
THIS KNOWING WE'RE NOT THE ONLY
COMMUNITY IN THE NATION.
TO EDUCATE DECISION MAKERS ABOUT
PERSISTENT ORGANICS AND THE
STOCKHOLM TREATY THE LEGALLY
BINDING TREATY AND USE IS IT
EDUCATE DECISION MAKERS.
A LOT OF TIMES WE'RE NEVER AT
THE TABLE WHEN DECISIONS ARE
MADE FOR US MILES AND MILES AWAY
BUT ALSO THE COMMENT REGARDING
OUR HEALTH CARE.
WE NEED TO GIVE OUR FAMILY AND
OUR OWN INDIVIDUAL LIVED
EXPERIENCE CRADLE TO GRAVE TO
MAKE SURE HEALTH HARMS WE'RE
FACING.
WE HAVE SOME DATA SHOWING LOCAL
FORCES FROM THE COLD WAR ERA AND
WHAT PERSISTENT ORGANIC
POLLUTANTS.
IT'S SO IMPORTANT NOT ONLY DO WE
EDUCATE OUR PEOPLE BUT HEALTH
CARE PROVIDERS AND DECISION
MAKERS.
THANK YOU.
>> THANK YOU.
MARYA.
>> I DON'T KNOW IT WOULD BE THE
SAME MECHANISM IMPLEMENT IT BUT
THE EPA STARTED ENVIRONMENTAL
JUSTICE THRIVING COMMUNITY
ASSISTANCE CENTER IN EACH EPA
REGION INTENDED TO HELP
COMMUNITY GROUPS APPLY FOR
GRANTS AND HELP THESE GROUPS
WITH A LOT OF THE RESOURCES THEY
MAY NOT OTHERWISE HAVE IF THEY
HAD NOT APPLIED FOR GRANT AND
THINKING OF THE LANGUAGE OR HOW
TO DO MEASUREMENTS OR THAT KIND
OF THING.
AND I THINK THAT IS AN IDEA THAT
WOULD BE GREAT TO SPREAD TO THE
NIH SO THAT COMMUNITY GROUPS
WOULD HAVE ASSISTANCE IN
CONNECTING WITH AN ACADEMIC
CENTER OR WHATNOT AS A WAY TO
ADDRESS COMMUNITY GROUPS AND
CONCERNS PEOPLE HAVE OUTSIDE
ACADEMICS.
>> I THINK COMING BACK TO A
LITTLE BIT ABOUT HOW PEOPLE CAN
BE APPROACHED WITH RESEARCH
QUESTIONS I THINK IT'S IMPORTANT
TO KNOW WHAT THE TARGET
COMMUNITY DOESN'T KNOW OR WHAT
INFORMATION THEY HAVE ACCESS TO
BECAUSE AN EXAMPLE IS WE WERE
ASKED IF WE WANTED TO JOIN THE
LITIGATION AGAINST A PESTICIDE
AND THEY SENT US THE DOCUMENT
ASKING IF WE KNEW ANYBODY
EXPOSED TO GLYPHOSATE AND WHEN
WE ASKED AND THEY WERE LIKE,
WELL, WHAT IS GLYPHOSATE.
PEOPLE DIDN'T KNOW WE WERE
TALKING ABOUT ROUND UP WHICH
SOME PEOPLE KNOW WHAT ROUND UP
IS ONCE YOU TELL THEM.
IT'S USED ON BERRIES OR BROCCOLI
OR WHATEVER THE CROP IS.
WHEN WE FRAME IT THAT WAY, DID
YOU EVER WALK ON THE CROPS IN
THIS PERIOD OF I'M AND THEY SAY
YES LIKELY YOU WERE EXPOSED TO
GLOW -- GLYPHOSATE AND THERE'S
NO TEST TO SAY YOU'VE BEEN
EXPOSED TO THESE THINGS.
USING ROUND UP OR PESTICIDE
DIDN'T WORK FOR SOME PEOPLE AND
THEY SAID THEY WEREN'T EXPOSED
TO PESTICIDES AND THEY DIDN'T
KNOW THEY WERE EXPOSED AND WE
REMINDED THEM SAY THEY SAID
WORKED ON A FARM AND THEY SAID
OH THE FERTILIZER OH, MY BOSS
TOLD ME THIS MAKES IT GROW.
THE WORSE -- WORD PESTICIDE IS
NEW TO SOME PEOPLE AND SOME
PEOPLE WOULD HAVE MARK THEY
WEREN'T EXPOSED AND WOULD HAVE
MISSED A REGION IN STATES BEING
SURVEYED.
TO WHAT WAS SAID THE INFORMATION
HAS TO BE PRESENTED TO THE
SPECIFIC GROUPS YOU'LL BE
WORKING WITH.
WE
>> WE HAVE ABOUT 20 MORE MINUTES
AND FOLLOWING UP ON THE
CHALLENGES OF GETTING ACCURATE
INFORMATION FROM INDIVIDUALS
WHEN THEY MAY NOT KNOW THEY'RE
EXPOSURES OR USE THE SAME
TERMINOLOGY RESEARCHERS THE WAY
WE'RE ASKING THE QUESTIONS.
MAKES ME THINK A LITTLE BIT
ABOUT OTHER QUESTIONS THAT HAVE
COME UP AROUND TESTING AND HOW
GOOD OUR OUR TESTS, HOW MUCH OF
A SAMPLE DO YOU NEED, HOW CAN
THE SAMPLE BE STORED AND STILL
GET ACCURATE INFORMATION AND
LOTS OF QUESTIONS.
IN THINKING ABOUT ADVANCING THE
FIELD, WHAT DO WE MAYBE NEED IN
TERMS OF RESEARCH METHODS OR HOW
TO DO THIS BETTER TO BE ABLE TO
ADVANCE THIS KIND OF AREA OF
RESEARCH AND FOR OUR COMMUNITY
MEMBERS, WHAT DATA OR RESEARCH
DO YOU WISH YOU HAD?
IT WOULD BE REALLY NICE TO IF
THAT DATA EXISTED OR IF YOU KNEW
THE TEST OUT THIS WAS VALID AND
YOU COULD ACT UPON IT OR THAT
SORT OF THING?
I'M CURIOUS WHAT YOUR THOUGHTS
ARE.
>> I THINK RIGHT NOW WE HAVE A
HUGE DATA GAP SPECIFICALLY IN
PFAS WHERE THE TENSION IS ON
LEGACY AND C2 TO C6 EXPOSURE
EVERYWHERE SINCE 2015 AND THAT'S
A HUGE DATA GAP.
EVERYTHING OUT THERE IS LOOKING
AT MOSTLY LEGACY WITH A LITTLE
FAST FORWARD TO GEN X IS ONE BUT
IT'S SO IMPORTANT.
THERE'S ANOTHER PFAS I DON'T
KNOW WHO IS FAMILIAR WITH IT BUT
WE DID A SAMPLING ACROSS THE
NATION TO COMPARE THE OLEFINS
FOR COMMUNITIES THAT ALREADY
KNOW THEY HAVE PFAS AND I NOW AT
THAT POINT MY OUTSIDE STOP
WASN'T FILTERED AND KNEW WELLS
WERE CLOSED AND THOUGHT IT WILL
COME IN AT 13 AND CAME IN ABOUT
13 SO IT WAS A GOOD GUESS AND I
GET THE RESULTS BACK AND ON THE
FORM IS THIS PFPRA AND NORTH
CAROLINA I ASKED AND HE SAID WE
HAVE IT DOWN HERE AND I HAVEN'T
SEEN IT IN YOUR PUBLICATIONS.
IT'S NEW TO ME.
IT WAS 53 PARTS AT THAT POINT.
SO HERE WE ARE IN THE PROCESS OF
REMEDIATING WATER TO NON-DETECT.
EVERYBODY'S FEELING GOOD ABOUT
THIS.
I SEE THIS THING THAT VERY
LITTLE IS WRITTEN ABOUT.
IT'S FOUR TIMES THE CURRENT PFOA
LEVEL AT OUR BLENDED RATE AND
THAT'S A BLENDED RATE TOO AND
THINKING, OH, MY GOD, HOW DO WE
EVEN TELL MY COLLEAGUES AND
GROUP AND PEOPLE ABOUT THIS
BECAUSE I COULDN'T EVEN SPEAK
ABOUT IT FOR TWO DAYS TO THINK
THERE WAS EXPOSURE I DIDN'T KNOW
ABOUT THAT WAS FOUR TIMES PFOA
WAS STUNNING.
THAT IS A PCFAO SUBSTITUTE AND
WHY DON'T WE KNOW THAT AND WHY
ISN'T IT IN THE PANEL OF
TESTING?
BRING IT TO THE STATE'S
ATTENTION AND WELL, IS THERE
TEFLON TAPE -- NO, THERE ISN'T.
I KNOW WHAT'S IN MY HOUSE.
THERE'S OMISSIONS CONVENIENT FOR
THE CURRENT STREAM OF
MANUFACTURING GOING ON FOR SOME
TIME YET THAT'S WHAT'S COMING AT
US.
I KNOW IT'S DIFFICULT FOR
RESEARCHERS WHEN YOU THINK OF
THE DOLLAR AND THE BUDGET.
THERE'S SO MANY NEEDS ACROSS
THIS WORLD AND THIS NATION WHEN
YOU LOOK AT PERSISTENT CHEMICALS
LIKE PFAS VERSUS ENDOCRINE
DISRUPTORS WE LOOK AT AND SAY IF
YOU EDUCATE AND STOP EXPOSURE WE
SEE RESULTS IN URINE AND
SAMPLING.
THAT'S WONDERFUL.
BUT I DON'T KNOW IF WE DEAD KIT
MORE TO THE FULL STORY OF
PERSISTENT WILL THAT TRICKLE
DOWN AND HELP THE LOWER LINE
FRUIT THAN THE PIECES OF THE
BUDGET WE CAN HAVE WE HAVE TO
GET A TRUE PICTURE OF OUR AND
FOR YOU TO RECOGNIZE WITH THE
V.A., WHOEVER WE USE IF PEOPLE
USE AND QUEST HAS A NEW SYSTEM
THAT LOOKS WONDERFUL.
THE BLOOD TESTS WHEN YOU YOU GET
IT BACK MAKES SENSE.
CAN RIGHT IT AND INTERPRET IT
AND CALL THEM INSTEAD OF SAYING
WHAT DO I DO WITH THIS AND TAKES
THE NASEM AND APPLIES IT TO
SCREENING.
IT'S LIMITED TO SEVEN PFAS.
THAT'S IT.
WHATEVER YOU GET BACK IS GOING
TO BE AN INCOMPLETE PICTURE OF
YOUR OWN EXPOSURE.
THE HEAD OF THIS DIVISION OF
QUEST RAN HER OWN BLOOD THROUGH
AND CAME IN 13 PARTS AND SAID
I'M UNDER 20.
THAT'S A RELIEF BECAUSE I KNOW
IT'S EVERYWHERE AND I SAID
THERE'S SHORT CHAINS BASED ON
YOUR BLOOD PROFILE I'M WILLING
TO MAKE A GUESS AT WHAT THE
OTHER ONES ARE THAT IS NOT YOUR
EXPOSURE OR WHAT'S IN YOUR BODY.
SHE WAS SURPRISED BY THAT.
I DON'T KNOW IF THAT'S
INTENTIONAL AND DOD HAS BEEN
WORKING TO CONTROL THIS BECAUSE
IT'S BIG AND WHATEVER ELSE IS
OUT THERE FOR WHATEVER INTERESTS
ARE BEING PROTECTED BUT AND
EIGHT YEARS AGO YOU COULD GO TO
NMS LAB IN NEW JERSEY AND THE
WEST COAST IS VISTA AND THE EAST
COAST I THINK IS NMS, RIGHT?
AND EACH ONE HAS A DIFFERENT
PANEL BUT YOU CAN'T SHIP IT TO
CALIFORNIA BECAUSE YOU HAVE TO
FREEZE IT AND DRY ICE IT AND DRY
YOUR OWN BLOOD AND NO ONE HAS A
RELATIONSHIP WITH THAT LAB.
IT SHOULDN'T BE THAT DIFFICULT
TO HIDE AND IT'S NOT PARANOIA TO
SAY THERE'S MORE, THERE IS.
IF QUEST IS ROLLING OUT THIS
PHENOMENAL PRODUCT AND THEY'RE
EXCITED ABOUT IT AND I WAS ON A
CALL WITH THEM AND YET EIGHT
YEARS AGO I COULD GET A BIGGER
PANEL THAN THIS AND IF IT'S
GOING OUT TO THE NATION IT'S
PROBLEMATIC BECAUSE IT'S KEEPING
THE FOCUS ON LEGACY PFAS.
WE NEED TO DO SOMETHING ABOUT
THAT.
THE DATA GAPS IS WHERE WHERE HE
HAVE TO SCRUTINIZE.
THAT'S ONE OF MY ASKS WHAT'S OUT
IN THE MANUFACTURING STREAM
THAT'S BEEN OUT THERE WE HAVE
THAT INFORMING AND LOOK AT IT
HONESTLY AND TRANSPARENTLY
TOGETHER.
IT'S THE ONLY WAY FORWARD.
IT'S NOT SUSTAINABLE FOR HUMANS
FOR MANY REASONS.
>> THANK YOU.
IN TERMS OF TESTING THERE'S
COMMERCIAL LABS OUT THERE NOW
YOU CAN FROM A FINGER PRICK YOU
CAN COLLECT A BLOOD SAMPLE YOU
CAN SEND BACK TO THE LAB AND
GIVE YOU WHAT YOUR PROFILE MIGHT
LOOK LIKE.
THE USUAL PROBLEM WITH THAT IS
IT'S TYPICALLY NOT COVERED BY
INSURANCE SO PEOPLE HAVE TO PAY
OUT OF POCKET FOR THAT.
PART OF WHY WE'RE THINKING ABOUT
A HEALTH CARE SYSTEM AND HOW
PEOPLE TAKE CARE OF THEMSELVES.
MANY TIMES THE RESOURCES PEOPLE
CAN ACCESS COMMERCIALLY WOULD
NOT BE COVERED BY INSURANCE IF
YOU HAVE INSURANCE.
USUALLY SIGNIFICANT OUT OF
POCKET EXPENSE AND PEOPLE THAT
HAVE RESEARCH CONSTRAINTS IT'S A
CHALLENGE.
SAME WITH NUTRITIONAL
SUPPLEMENTS AND I'LL SEGUE INTO
WHAT YOU CAN DO.
EXPOSURES ARE IN THE PAST AND
THERE'S EXPOSURES AND YOU HAVE
HYPERTENSION, DIABETES, OBESITY,
HYPERTHYROIDISM, YOU'RE GOING TO
ALL THE SPECIALISTS AND AND
MULTIPLE MEDICATIONS AND NOT
BETTER WHAT ARE WE GOING TO DO?
THE HEALTH CARE SYSTEM CAN'T
KEEP GOING THIS WAY AND GO BACK
TO BASIC PRINCIPLES, LET'S LOOK
AT OUR LIFESTYLE AND
GASTROINTESTINAL TRACT AND LOOK
AT NUTRITION AND DIET.
THERE'S THINGS THAT CAN BE DONE
ON ALL THOSE LEVELS LOOKING AT
THE BASICS OF THE TREE OF LIFE,
SLEEP, DIET, EXERCISE, INTAKE
AND STRESS MANAGEMENT, SOCIAL
RELATIONSHIPS.
ALL THOSE THINGS FEED INTO
HEALTH.
THE QUESTION IS CAN WE BUILD A
COMMUNITY OF PEOPLE WHO HAVE
SIMILAR ILLNESSES OR EXPOSURES
AND THAT'S WHAT WE'RE DOING
WHILE THEY HAVE UNEXPLAINED
ILLN
ILLNESS WHEN WE'VE DONE WITH
COMPLEX ISSUES WE STARTED A
PILOT PROGRAM WITH INDIVIDUAL
COACHING AND FOCUS ON NUTRITION
AND FOOD AS MEDICINE,
UNDERSTANDING WHICH FOODS ARE
HELPING YOU AND LESS
INFLAMMATORY VERSUS THE ONES
THAT ARE INFLAMMATORY.
LOOKING AT SUPPLEMENTS THAT
SUPPORT GUT HEALTH AND PROVIDE
THEM WITH PROBIOTICS AND
NUTRITIONAL SUPPLEMENTS THAT
HELP HEALTH BECAUSE MANY HAVE
COGNITIVE DIFFICULTIES AND GIVE
THEM FITBIT WATCHES TO TRACK
THEIR ACTIVITY AND THE NEW
JERSEY WRIISC SERVICE IS IN 22
DIFFERENT STATES AND ALL DONE
VIRTUALLY.
WE DO MINDFULNESS AND YOGA AND
NOW VETERANS WHO COME THROUGH
ARE WORKING ALONGSIDE A HEALTH
COACH AND THEY'RE VETERANS SO
THERE'S A HEALING COMMUNITY THAT
HAS DEVELOPED.
AND THE VETERANS SUPPORT
THEMSELVES.
HOW DO YOU NAVIGATE WHEN YOU
HAVE A BAD DAY OF CHRONIC
FATIGUE AND FIBROMYALGIA AND
CAN'T DO WHAT THEY WANT TO DO
AND GIVE THEMSELVES TIPS.
IN THAT PROGRAM WE'RE SEEING
IMPROVEMENTS IN DEPRESSION AND
WE'RE SEEING IMPROVEMENTS IN
DEPRESSION AND ANXIETY AND
FUNCTIONAL MOVEMENT.
IT'S THINGS WE CAN DO TO SUPPORT
COMMUNITIES STRESS RELATED TO
EXPOSURES THAT ARE NOT NECESSARY
DIRECTED TO THE EXPOSURE PER SE.
I CAN'T TELL YOU I'LL GIVE YOU
SOMETHING TO REMOVE THE PFAS
FROM THE SYSTEM BUT CAN WE
CHANGE THE GUT HEALTH SO THAT
YOU'RE NOT LIKELY TO HAVE THAT
MUCH PERMEABILITY THAT FACTS
YOUR ENDOCRINE SYSTEM AND THEN
HAVE PROBLEMS WITH YOUR THYROID
BECAUSE OF THE INFLAMMATION IN
THE GUT.
IF WE CAN LOOK AT WHAT WE CAN
ADDRESS TO DO AND START WITH
THOSE THINGS AND THE MOMENT WE
CAN DO THAT THE BETTER.
>> I'LL INVITE OUR AUDIENCE TO
COME UP AND ASK QUESTIONS AS
WELL.
VIE, YOU HAVE YOUR HAND UP AS
WELL.
>> YES.
WE KNOW MY PEOPLE HAVE FOUR TO
TEN TIMES HIGHER PCs THAN THE
AVERAGE AMERICAN DUE TO THE COLD
WAR AREA AND FORMER MILITARY
BASES AND ALSO FROM THE
PERSISTENT ORGANIC POLLUTANTS
ENDING UP IN THEIR TRADITIONAL
FOODS, THE MARINE MAMMALS OUR
ELDERS CALL THE OCEAN OUR FARM
BUT OUR TRADITIONAL FOODS ARE SO
LOADED AT LEVELS WE SHOULD NOT
BE EATING THEM FOR EXCESS CANCER
RISK.
AND THEN KNOWING HOW THE
MICROPLASTICS ARE ENDING UP IN
THE TRADITIONAL FOODS, WALRUS
AND SEALS.
WE PRODUCED A REPORT THAT LINKS
WITH CLIMATE, CHEMICALS AND
PLASTICS AND TOXIC THREATS AND
THREATS TO INDIGENOUS LAND FROM
THE PETRO CHEMICAL INDUSTRY.
WE WERE AT THE PLASTICS TREATY
AND BROUGHT OUR INDIGENOUS
PEOPLES' DELEGATIONS.
RIGHT NOW IN THE REPORT IT
STATES SIX CHEMICALS AND THERE'S
16,000 CHEMICALS USED IN THE
PRODUCTION OF PLASTICS.
AND THEN WE ALSO HELPED WITH THE
PAPER, A BRIEF PAPER PROTECTING
THE DEVELOPING BRAINS OF
CHILDREN FROM THE HARMFUL
EFFECTS OF PLASTICS AND TOXIC
CHEMICALS IN PLASTICS FOR THE
PROJECT DANDER.
KNOWS WHO MAY NOT KNOW IT,
PROJECT TENDER, YOU CAN FIND THE
TWO REPORTS ON OUR WEBSITE,
WWW.INFO AT AK ACTION DOT ORG.
AND WE KNOW -- WE'VE DONE ENOUGH
RESEARCH FOR 22 YEARS.
NO THE TOXIC CHEMICALS WE'VE
BEEN EXPOSED TO AND ADDRESS THE
ENVIRONMENTAL VIOLENCE AND BEING
CONTAMINATED WITHOUT OUR
CONSENT.
OUR WOMB IS OUR CHILD FIRST
ENVIRONMENT AND THESE TOXIC
CHEMICALS CAN AAFFECT -- AFFECT
OUR ABILITY TO CONCEIVE AND
CARRY OUR CHILDREN AND HAVE A
HEALTHY BIRTH.
MENTAL HEALTH HARMS ARE SHOWN IN
OUR USE AND THERE'S MORE LINK TO
MENTAL HEALTH HARMS.
I APPRECIATE THE LAST SPEAKER.
I BELIEVE SHE'S WITH THE V.A.
AND THE HEALTH HARMS AND WHOLE
APPROACH AND IF THERE'S NO ICE
WE HAVE NO WAY TO KEEP FOOD IN
OUR FREEZER.
WE HAVE SUCH OF A CLIMATE CRISIS
WE'RE FACING AND I'D LIKE TO
REACH OUT TO HEALTH CARE
PROFESSIONALS IN THEIR ROOM.
I'M SORRY I WASN'T ABLE TO BE
HERE AND I GOT SICK YESTERDAY
BUT WE ARE PLANNING TO CONVENE A
CHILDREN'S ENVIRONMENTAL HEALTH
SUMMIT HERE IN ALASKA AFTER WE
GET DATA FROM OUR PROTECTING
FUTURE GENERATIONS PROJECT
LOOKING AT PCBs THOUGH THEY'VE
BEEN BANNED DECADES AGO AND THE
OTHER CHEMICAL OF CONCERN WE'RE
LOOKING AT THE IS FLAME
RETARDANTS TO BRING IN HEALTH
CARE PROFESSIONALS,
PEDIATRICIANS, DECISION MAKERS,
COMMUNITY PEOPLE.
OUR TRIBES, OUR HEALTH CARE
PROFESSIONALS, DEPARTMENT OF
HEALTH AND HUMAN SERVICES AND
INDIAN HEALTH SERVICE TO CONVENE
THIS HEALTH SUMMIT TO FIND WAYS
TO MAKE SURE MEASURES ARE IN
PLACE TO PROTECT OUR MOST
VULNERABLE, OUR CHILDREN.
WE ALSO WANT TO HAVE A HEALTH
CLINIC IN MY COMMUNITY AND
HOPING TO GET FUND IING AND WE
REACHED OUT TO ADMIRAL LAVIGNE
WITH THE DEPARTMENT OF HEALTH
AND HUMAN SERVICES.
WE NEED HELP.
WE HAVE SOUND DATA OF TOXIC
CHEMICAL EXPOSURES WHETHER FROM
LEGACY MILITARY TOXICS, POPS AND
ON AND ON.
THESE BURDENS WE DIDN'T CREATE
WE ARE FACING THE MOST HEALTH
HARMS BECAUSE OF WHERE WE LIVE.
I'M REACHING OUT TO THE HEALTH
CARE PROFESSIONALS IN THE ROOM
TO REACH OUT TO ME TO HELP OUR
COMMUNITY.
I CAN SHARE MY E-MAIL IN THE
CHAT.
THANK YOU.
I REALLY ADMIRE THE WOMAN THAT
TALKED ABOUT THE HOLISTIC HEATH
APPROACH.
WE HAVE SHORT SUMMERS AND
24-HOUR DAYLIGHT, SUPER PACKED
TRADITIONAL MEDICINE AND FIND A
WAY TO INTEGRATE WESTERN AND
TRADITIONAL MEDICINE TO ADDRESS
ALL THE ENVIRONMENTAL VIOLENCE
WE ARE BEING FACED.
THESE TOXIC CHEMICALS CAN MIMIC
HORMONES.
THEY CAN.
WE USE INNOVATIVE METHODS AND
75% OF THE REPRODUCTIVE SYSTEM
ARE STICKLE BACK AND THE MALE
FISH IS PRODUCING GLUE THE MALES
ARE MAKING EGGS AND WE'RE SEEING
MORE AND MORE GAY YOUNG WOMEN.
WE NEED HELP.
PLEASE HELP ME IF YOU'RE LOOKING
TO ADDRESS ENVIRONMENTAL RACISM
IN DISADVANTAGED COMMUNITY AND
THANK YOU FOR THE OPPORTUNITY.
>> THANK YOU.
WE HAVE A COUPLE MINUTES LEFT.
DID ANYBODY IN THE AUDIENCE HAVE
A QUESTION THEY WANTED TO ASK.
SHEELA I'LL TURN TO YOU FOR LAST
COMMENT AND I THINK WE MIGHT
MOVE ON TO WRAPPING UP.
>> THANKS.
I JUST WANTED TO MAKE THE
COMMENT BECAUSE THE QUESTION WAS
ABOUT TESTING.
I THINK WE REALLY NEED TO
CONSIDER PEOPLE'S LIVED
EXPERIENCE AND THE MENTAL HEALTH
BURDEN THAT COMES WITH LEARNING
ABOUT EXPOSURES LIKE THESE AND
THAT'S SOMETHING WE CERTAINLY
STRUGGLE WITH ON A HEALTH CARE
PROVIDER STANDPOINT.
SO WE CAN CERTAINLY TEST LOTS OF
PEOPLE BUT IT'S VERY EXPENSIVE
AND ONLY CERTAINLY POPULATIONS
HAVE ACCESS TO THOSE RESOURCES
AS HAS BEEN SAID.
WE STILL NEED THE SHUGSS.
-- THE SOLUTIONS AND THE
HOLISTIC CARE IS FANTASTIC.
I WHOLEHEARTEDLY SUPPORT THAT
BUT THERE STILL NEEDS TO BE MORE
EVIDENCE BEHIND THAT AND THERE'S
A LOT OF MORE TO BE DONE THERE.
SO I JUST WANTED TO MAKE THE
POINT THAT THOUGH I SUPPORT
TESTING I FEEL LIKE WE'VE PUT A
LOT OF EFFORT INTO TESTING AND
MAYBE THERE NEEDS TO BE MORE
RESOURCES ON THE BACK END OF
THAT.
>> I SEE APPLAUSE FROM YOUR
COLLEAGUE.
THAT'S A CHALLENGE IN THIS SPACE
AND WE TALKED ABOUT A LITTLE
BIT.
THERE'S PEOPLE OFFERING TESTS
AND WE DON'T YET KNOW THE
QUALITY OF THOSE TESTS.
AS WITH YOU MENTIONED YESTERDAY
WE BOTH DON'T WANT PEOPLE TO GET
FALSE POSITIVES TOE SAY THERE'S
SOMETHING BAD WHEN IT'S NOT TRUE
AND JUST AS BAD BEING TOLD TOLD
EVERYTHING'S FINE WHEN IN
REALITY YOU'RE NOT GETTING A
THOROUGH OR COMPREHENSIVE TEST.
THAT'S A NEED I HEARD THROUGHOUT
THE LAST COUPLE OF DAYS WAS HOW
DO WE -- I HAVE A COUPLE NOTES
THINKING HOW DO WE MEASURE THE
MULTITUDE OF EXPOSURES IN A WAY
THAT CAN BE DONE EFFICIENTLY AND
THAT IS COMPREHENSIVE AS ONE
ELEMENT.
HOW DO WE LOOK AT
MULTI-TREATMENTS AND BRIEFING
ALL THESE IMPLEMENTS IN
DIFFERENT WAYS.
SOME IS SYSTEM WIDE AND LOOKING
AT MULTI-LEVEL APPROACHES IN
TERMS OF EDUCATION OF PROVIDERS
AND EDUCATION OF THE COMMUNITY,
POLICY ISSUES TO ADDRESS
REGULATION AND OTHER ELEMENTS AT
THE CLINICIAN LEVEL IT'S THE
TREATMENT AND THE EDUCATION OF
THE INDIVIDUAL PATIENTS BUT THE
OTHER PIECE I HEARD IS HOW DO WE
MEASURE THE FACT THESE COMPOUNDS
HAVE MULTIPLE OUTCOMES AND LOOK
AT THE WHOLE PERSON AND THAT
DIFFERENT ELEMENT.
UP CLOSING AND WRAPPING UP FOR
THE SESSION I WILL POINT TO THE
FACT THAT THIS IS A VERY HIGH
PRIORITY FOR OUR DIRECTOR AND
WHAT WE'RE CALLING WHOLE PERSON
RESEARCH WE'RE WORKING CLOSELY
WITH THE V.A. AND WORK CLOSELY
WITH DR. KIGLER I CAN NEVER
REMEMBER HIS FULL TITLE BUT IT'S
CULTURAL TRANSFORMATION WHICH I
THINK IS AN AMAZING OFFICE NAME
WITHIN THE DEPARTMENT OF
VETERANS AFFAIRS.
THAT ROLLED OUT THE SYSTEM
CALLED WHOLE HEALTH ACROSS THE
V.A. IN DIFFERENT PLACES.
THEY'RE LOOKING AT IT TO PAIN.
I'M THRILLED TO HEAR IT'S BEING
LOOKED IN THE AREA OF EXPOSURES
TO DIFFERENT COMPOUNDS AND
TOXINS.
I THINK ONE OF THE THINGS WE'RE
DOING HERE AT NIH AND DR.
DR. LANGEVIN IS LEADING IS
WORKSHOPS AND DR. EDWARDS
MENTIONED HOW DO WE STUDY ALL AT
THIS ALL AT ONE.
THE EVERYWHERE ALL AT ONCE AND
THERE ARE METHODS.
HOW DO WE APPLY IT TO THE AREA
OF HEALTH AND STAY TUNED.
THERE'S MANY PARTNERS ACROSS THE
INSTITUTES AND CENTERS AND
OFFICES OF NIH BECAUSE THIS IS
RELEVANT TO ALL HONESTLY OF THE
INSTITUTES AND CENTERS AND
OFFICES HOW DO WE STUDY HEALTH
AS OUTCOME AND LOOK AT THE
COMPLEXITY.
WE'RE HOPING TO BRING EVERYBODY
TOGETHER AND TACKLE THAT AS A
THING WE'RE TRYING TO DO.
THANK YOU SO MUCH TO OUR
DIFFERENT PRESENTERS AND
PANELISTS FOR BRINGING YOUR
PERSPECTIVES AND AREAS OF
EXPERTISE.
I FEEL LIKE THERE'S A LOT OF FOR
US TO DO.
I'M GOING TO TURN IT OVER TO
SEKAI TO TELL US WHAT WE'RE
GOING TO DO TO MAKE THIS ALL
WORK.
>> THANK YOU.
THIS PANEL IS A PERFECT SEGUE
INTO OUR CLOSING SESSION.
YOU'VE MADE IT TO THE FINISH
LINE SO WE'RE JUST GOING TO WIND
DOWN NOW AND WE WANT TO TAKE
ADVANTAGE OF ALL OF YOU IN THE
ROOM AND ON THE ZOOM.
HOPEFULLY DR. ZLATNIK AND VIE
STAY ONLINE.
WE WANT TO TALK ABOUT WHAT IS
NEXT AND WHAT WE LEARNED OVER
THE LAST DAY AND A HALF IS A
LOT.
IT'S WHETTING OUR INTEREST.
WE LEARNED A LOT BUT IT'S
TEASERS AND HOW THEY IMPACT OUR
BODY AND THE CONSEQUENCES AND
THE COMMUNITIES ADD HIGHER RISK.
THERE ARE ALSO THINGS WE
POTENTIALLY CAN DO TO REDUCE OUR
RISK.
IT'S DIET AND PHYSICAL ACTIVITY
AND SLEEP AND SWEATING MORE
WHETHER YOU DO IT IN A SAUNA OR
EXERCISING AND SUPPORTING OUR
GUT MICROBIOME.
MAKING SURE WE DON'T HAVE
VITAMIN DEFICIENCIES AND GETTING
FLAVONOIDS AND MANAGING STRESS
AND BUILDING RESILIENCY.
YOU ARE AND WHETHER IT'S
OCCUPATIONAL EXPOSURE OR A
PRODUCT NOT LABELLED YOU MAY NOT
BE ABLE TO AVOID BUT DO YOUR
BEST AND KNOW IT WILL HELP IN
SOME FORM OR FASHION AND KNOW
THE INTERVENTIONS MAY BE HELPFUL
IN PEOPLE ALREADY EXPERIENCING
HIGH BURDEN OF DISEASE.
ANY CHANGE MAY MAKE AN IMPACT
DEALING WITH A HIGH ALLOSTATIC
LOAD OR BURDEN OF DISEASE.
THERE'S A LOT OF THAT REMAINS
UNCLEAR.
THESE ARE ADJUST SOME THINGS WE
CAME UP WITH.
THERE'S SO MANY ECDs.
16,000 CHEMICALS AND DIFFERENT
PLASTICS AND HOW MANY MORE ECDs
NOT TECHNICALLY PLASTIC.
WHICH ONES DO WE UNDERSTAND WELL
ENOUGH TO FOCUS ON?
DO WE NEED TO UNDERSTAND THEIR
CHEMISTRIES TO TRY TO TARGET
THEM FOR INTERVENTIONS?
MAYBE, MAYBE NOT.
WE HAVE PEDIATRICIANS AND
OB-GYN'S AND INTERNISTS AND
ENDOCRINOLOGISTS AND LAWYERS AND
PEOPLE FROM COMMUNITY-BASED
ORGANIZATIONS AND A LOT OF
RESEARCHERS.
AND EVERYONE'S GOING TO HAVE A
DIFFERENT OPINION, WHICH
POPULATION AND COMMUNITIES
SHOULD WE FOCUS ON?
I ASKED THE QUESTION YESTERDAY.
AND I HEARD CHILDBEARING WOMEN
AND WOMEN PREGNANT NEED TO TRY
TO PREVENT THE DOWN STREAM
EFFECTS AFTER BIRTH BUT SOME
PEOPLE MAY HAVE DIFFERENT
OPINIONS ABOUT THAT AROUND
THAT'S OKAY.
AND HOW DO YOU SAFELY CONDUCT
STUDIES IN SOME OF THESE
POPULATIONS IF YOU'RE DEALING
WITH PREGNANT WOMEN OR CHILDREN?
THAT COULD BE TRICKY.
ESPECIALLY IF YOU'RE DOING
INTERVENTIONS THAT MAY NOT HAVE
A LOT OF EVIDENCE BEHIND THEM.
AND WHAT DOES MEANINGFUL
IMPROVEMENT LOOK LIKE?
SO IS REDUCING BODY BURDEN
ENOUGH OR IS THE DAMAGE ALREADY
DONE?
YOU CAN CLEAR SOMETHING OUT OF
YOUR BODY BUT IF IT'S ALREADY
SET IN MOTION A LOT OF BAD
CHEMI
CHEMICAL REACTION AND ENDOCRINE
REACTION IS REMOVING IT FROM
YOUR BODY ENOUGH OR DOES IT HAVE
TO BE IN COMBINATION?
DO YOU HAVE TO HAVE IN ADDITION
TO REMOVING THE BODY BURDEN DO
SOMETHING ELSE TO NORMALIZE
FUNCTION AND SUPPORT AND BOOST
RESILIENCY?
WE HEARD PRE-ANIMAL MODEL
STUDIES ARE THEY RIFE FOR
TRANSLATION AND SOME
INTERVENTIONS SEEM HARMLESS BUT
WE KNOW SOMETIMES THINGS THAT
ARE IN ANIMAL MODELS DON'T
TRANSLATE ONE TO ONE WHEN YOU
DEAL WITH HUMANS.
WHAT'S READY FOR PRIME TIME IN
OUR BODIES?
GUIDED PATIENTS AN CLINICIANS WE
HEARD AND WE'LL ALL BE PATIENTS
AT SOME POINT IN TIME AND MANY
ARE ALREADY CLINICIANS.
SO HOW DO WE INFORM PEOPLE IN
WAYS THAT ARE USEFUL AND NOT
INACCURATE AND INAPPROPRIATE?
AND SOME OTHER QUESTIONS HERE.
WE WOULD LOVE THIS TO BE A FREE
FLOWING CONVERSATION.
PLEASE DON'T HESITATE TO JUMP UP
TO THE MICROPHONE.
LINDA BURMBAUM I KNEW IT.
LET'S FOCUS ON THE QUESTION AND
LET'S FOLK FOCUS ON THE
SCIENTIFIC STUDIES.
>> FIRST, THANKS FOR A GREAT
MEETING.
WHAT WAY IN THE TO SAY IS I GET
TIRED AS A TOXICOLOGIST OF
HEARING THE ATTACKS OF USE OF
ANIMAL MODELS BECAUSE YOU HAVE
TO USE THE RIGHT MODEL ON THE
QUESTION YOU'RE TRYING TO ASK
AND OFTEN PEOPLE DON'T USE THE
RIGHT MODELS BUT IN THE MAJORITY
OF CASES WHEN WE SEE SOMETHING
IN APPROPRIATE APPROPRIATE
MODELS OR MULTIPLE ANIMAL MODELS
IT'S LIKELY SOME PEOPLE ARE
GOING TO RESPOND THAT WAY SO I
WANTED TO MAKE THAT POINT.
>> I'M NOT ANTI-ANIMAL MODEL BY
ANY MEANS.
>> I DIDN'T SAY YOU WERE.
>> THERE ARE LIFESTYLE THINGS WE
THINK CAN WORK AGAINST A RANGE
OF ENDOCRINE DISRUPTORS AND THE
MODEL IS NICE AND I WOULD LOVE
TO SEE IT IMPLEMENTED IN ANOTHER
POPULATION IN AS A RANDOMIZED
CLINICAL TRIAL.
IT'S IN THE VETERANS COMMUNITY
AND THE VETERANS BECOME ME
HEALTH COACHES AND THE NEW
PATIENTS LISTEN TO THEIR FULLO
VETERANS WHO HAVE HAD THIS
POSITIVE EXPERIENCE AND I THINK
IN TERMS OF EVALUATING HOW
EFFECTIVE IT IS, WE TALKED ABOUT
THE KINDS OF AFFECT THAT
ENDOCRINE DISRUPTORS HAVE
THYROID FUNCTION, CARDIO
METABOLIC FUNCTION.
I THINK THERE'S A BUNCH OF
THINGS WE COULD TEST SCORE AT
BASELINE AND AFTER THIS
MULTI-MODAL INTERVENTION.
IF WE CAN DEMONSTRATE IT'S
EFFECTIVE IN AN RCT THEN
CLINICIANS ARE LIKELY TO ACCEPT
IT AS SOMETHING VALID.
>> WE SUBMITTED A RECENT GRANT
FOR A RANDOMIZED CONTROL TRIAL
TO DO THIS MULTI-FACETED
INTERVENTION AND THE CRITICISM
CAME BACK, WHAT IS THE MODEL?
ALL RIGHT, YOU FIXED THE GUT AND
FIXED THE NUTRITION AND EXERCISE
AND SLEEP AND IMPROVED THE
ABILITY TO MANAGE STRESS BUT
THEY WERE LOOKING FOR A MODEL.
WE'RE GOING TO RESUBMIT AND GIVE
A MODEL.
WHAT I'M SAYING IS THAT WHAT
HAPPENS IN REAL LIFE DOES NOT
NECESSARILY TRANSMIT WELL TO
RESEARCH CLAIMS.
AND YOU HAVE TO BE ABLE TO DO
THAT TRANSLATION BETWEEN WHAT
YOU'RE TRYING TO TO DO
CLINICALLY TO WHAT RESEARCHERS
WILL WANT TO LOOK AT AND SAY
YES, WE HAVE A MODEL THEY'RE
FOLLOWING.
THERE'S LESSONS TO BE LEARNED ON
BOTH SIDES OF THE AISLE OF
CLINICAL VERSUS RESEARCH IN
UNDERSTANDING ONE ANOTHER'S
LANGUAGES AND UNDERSTANDING WHAT
MAKES STATISTICAL SIGNIFICANCE
DOES NOT NECESSARY MAKE CLINICAL
IMPACT.
WE HAVE TO THINK OF WHAT MAKES
SENSE FOR THE PATIENT AND
VETERAN.
THAT'S AN OPPORTUNITY TO LEARN
HOW TO MOVE THE FIELD FORWARD.
THANK YOU.
>> I'D LIKE TO ADD COMMENTS.
OUR INSTITUTE'S BEEN STUDYING
ENDOCRINE DISRUPTORS FOR A LONG
TIME.
EIGHT YEARS AGO WE HAD A BIG
MEETING AT THE NIH CLINICAL
CENTER FOR THE 25th ANNIVERSARY
OF ENDOCRINE DISRUPTIONS AND
MANY WERE INVOLVED.
WE HAD A BIG GROUP OF TALKING
ENDOCRINE DISRUPTORS AND NOW HOW
THEY CAN AFFECT OUR BODY.
WE'VE KNOWN FOR DECADES.
WE KNOW WHAT MANY BIG ACTORS ARE
BUT IT'S DIFFICULT TO GO BEYOND
REDUCING EXPOSURES AND DOING AN
INTERVENTION OR TALKING ABOUT
MITIGATION AND REMEDIATION.
WHEN SEKAI CAME TO ME AND
STARTED TALKING ABOUT THE
MEETING AND POTENTIAL I HAVE TO
ADMIT WE WERE SKEPTICAL IN WHAT
WE KNOW NOW THAT TAKE US TO THE
NEXT STEP OF MEDIATION AND WHAT
ENDOCRINE DISRUPTORS DO WE KNOW
ENOUGH ABOUT WE CAN TARGET OR
FOR EXPOSURE.
I WAS HESITANT BUT ALSO ANXIOUS
TO LEARN WHAT WAS OUT THERE AND
IF WE WERE MISSING INFORMATION
AND WHO HAS DONE CLINICAL TRIALS
OR TRIED SOME SORT OF AND
REMEDIATION AND TRIALS UP
HUMANS.
I THINK WE LEARNED A LOT OVER
THE LAST FEW DAYS ABOUT
POTENTIAL BUT THERE'S STILL
QUESTIONS OUT THERE AND WE KNOW
WE NEED TO REDUCE EXPOSURE.
WE KNOW WHAT THE BAD CHEMICALS
ARE BY AND SHOULDN'T BE IN OUR
BODY BUT HOW IT'S PERCEIVED
BEYOND IS THE BIG QUESTION HERE.
>> THINK CHILDBEARING AND
PREGNANT PEOPLE ARE AN IMPORTANT
POPULATION TO STUDY BUT TO PUSH
BACK ON CONSIDERING PREGNANCY AS
AN VULNERABLE POPULATION WE KNOW
EXPOSURES CAN HAVE MAJOR
INTERGENERATIONAL EFFECTS BUT
WOMEN HAVE HISTORICALLY BEEN
UNDER STUDIED BY THE NIH BECAUSE
OF THESE CONCERNS ABOUT
VULNERABILITY AND LEADS TO AN
ABSENCE OF DATA AND CLINICIANS
ARE MAKING RECOMMENDATIONS
BIFFED ON GUESSES OR
EXTRAPOLATING FROM OTHER
POPULATIONS THAT MAY NOT BE
RELEVANT.
I THINK IF WE CONSIDER SOME OF
THE POTENTIAL ANINTERVENTIONS A
TALK ABOUT THE PESTICIDE
EXPOSURE AND DECREASING EXPOSURE
WHERE IT'S EDUCATIONAL OR PPE
IT'S HARD TO IMAGINE MAJOR HARMS
COMING FROM THAT AND THINK IT
WOULD BE BENEFICIAL OR AND I'M
BLANKING ON THE AUTHOR BUT THERE
A STUDY ON THE WATER FIT RATION
RATION SYSTEM IN A PFAS
COMMUNITY IN MINNESOTA AND
SHOWED BEFORE AROUND AFTER IN
THAT COMMUNITY AND AROUND THE
COMMUNITIES THE DECREASE IN
PRE-TERM BIRTH.
THERE'S INTERVENTIONS THAT ARE
UNLIKELY TO BE HARMFUL AND AS
LONG AS WE'RE AWARE OF THE
POTENTIAL RISK FOR UNINTENDED
HARMS AND STUDY THOSE THINGS, I
THINK IT IS SUPER IMPORTANT TO
STUDY THIS POPULATION.
THANK YOU.
>> I WOULD AGREE WITH YOU.
I DIDN'T MEAN TO COME ACROSS AS
SAYING PAUSE THESE ARE
VULNERABLE POPULATION WE
SHOULDN'T FOCUS ON THEM.
I KNOW SOMETIMES GETTING IRB
APPROVAL OR FOR POPULATIONS LIKE
PREGNANT WOMEN BECAUSE THEY
DON'T WANT TO PUT THEIR FETUS AT
RISK IS CHALLENGING YOU WOULD
KNOW BETTER THAN ANYONE THE
LIKELIHOOD OF PREGNANT WOMEN
WANTING TO PARTICIPATE IN
STUDIES.
AND FOR THINGS LIKE WATER
FILTRATION AND THEY WOULD
CONDITION EVEN HAVING BABIES AND
CURIOUS IF YOU THINK THE NATURAL
PRODUCTS AND THINGS WE'VE
DISCUSSED IF PREGNANT WOMEN OR
IRBs WOULD BE SUPPORTIVE.
>> I'D LOVE TO CHIME IN ON THAT.
I THINK AS LONG AS IN THE UNITED
STATES SUPPLEMENTS REMAIN
UNREGULATED IT'S HARDER TO SAY
IN THIS RESEARCH STUDY, THIS
PLANT DERIVED POLYPHENOL WAS AT
RISK OF THIS OR WHATEVER AND AS
THE LITTLE RESEMBLANCE TO WHAT
RESEARCHERS GOT.
THAT'S A CONCERN.
INITIALLY STUDIES ON THOSE KINDS
OF SUPPLEMENTS SHOULD BE ON
PEOPLE NOT ACTIVELY TRYING TO
REPRODUCE OR PREGNANT.
>> I REPRESENT THE OFFICE OF
DIETARY SUPPLEMENTS.
I DON'T KNOW HOW MUCH MY COMMENT
IS IN RESPONSE TO WHAT WAS JUST
SAID BUT I THINK THERE IS A
LITTLE BIT OF OVERLAP HERE.
WHAT WE'VE BEEN PUSHING WITH THE
RESILIENCE PROGRAM IS HOW BETTER
TO STUDY THINGS LIKE
INTERVENTIONS LIKE DIETARY
SUPPLEMENTS.
AS THE BEEN SO MUCH AT NIH WHERE
WE FOCUS ON THE DISEASE OR THE
RISK AND WE WANT TO MITIGATE OR
PREVENT THE RISK.
AND WE UNDERSTAND VERY CLEARLY
THE DISEASE PANEL WAY AND
UNDERSTAND VERY CLEARLY WHAT
DROVE US TO THE RISK.
BUT WE ARE THE NATIONAL
INSTITUTES OF HEALTH AND OUR
UNDERSTANDING OF HEALTH IS WHAT
THE THORN IN OUR SIDE.
WE THINK WITH THE RESILIENCE
PROGRAM WE CAN ENCOURAGE
INVESTIGATORS TO IDENTIFY
PATHWAYS UNRELATED TO DISEASE.
OR IDENTIFY PROGRAMS OR DATA
COLLECTION THAT ARE UNRELATED TO
DISEASE BUT INSTEAD RELATED TO
HEALTH OR INSTEAD RELATED TO HOW
WE RECOVER BETTER AND HOW BETTER
TO STRENGTHEN THE SYSTEM.
SO IN OUR PANEL, IF YOU REMEMBER
DR. LITWA TALKED ABOUT A PATHWAY
THAT HER SUPPLEMENT HER
INTERVENTION WAS ACT ING ON
STRENGTHENING THE SYSTEM AND
WOULDN'T BETTER ABLE TO RESPOND
AND WE'RE TRYING TO ENCOURAGE
DIFFERENT DESIGNS FOR THE
STUDIES ITSELF.
BECAUSE IF WE CAN -- AND WE NEED
TO PREVENT OUR EXPOSURES AND
KEEP DOING THAT BUT THERE'S ONE
PIECE OF THE PUZZLE WE'RE
MISSING AND THAT POTENTIALLY WHY
WE'RE NOT PROGRESSING THE WAY WE
NEED TO PROGRESS AND THAT'S THE
RESILIENCE PUZZLE.
THAT'S DESIGNING STUDIES WHERE
WE'RE STRICTLY OR INTENTIONALLY
FOCUSSED ON UNDERSTANDING HOW
WE'RE STRENGTHENING SYSTEMS.
SOMETIMES IT FALLS OUT LOOKING
AT DISEASE PATHWAYS BUT IF WE'RE
INTENTIONAL WE CAN MOVE THE
SCIENCE FORWARD.
>> IF YOU HAD THE ABILITY TO
FUND A GRANT FOR THIS, WOULD YOU
FOCUS ON RESILIENCY OF CHILDREN
SO THAT THEY WOULD GROW UP
RESILIENT FROM THE BEGINNING OR
PEOPLE MORE VULNERABLE.
[SPEAKING SPANISH]
>> AND I THINK AND A SPEAKER
PANELIST MENTIONED THIS IT WOULD
DEPEND ON THE RISK OR EXPOSURE
AS TO WHICH PATHWAY SHOULD BE
THE FOCUS AT THE CRITICAL POINT.
WE NEED TO UNDERSTAND WHAT IS
THE CRITICAL STAGE WHERE WE CAN
DO THE BEST INTERVENTION?
NOT ONLY FROM A DISEASE
PERSPECTIVE BUT ALSO FROM A
RESILIENCE PERSPECTIVE AND THEN
ANSWER THE QUESTION.
I'M SORRY, I DON'T KNOW IF I
ANSWERED YOUR QUESTION.
>> WE HAVE TO UNDERSTAND HOW IT
WORKS IN DIFFERENT POPULATIONS.
>> AND DIFFERENT LIFE STAGES.
THANK YOU.
VIE.
>> INDIGENOUS PEOPLE ARE SOME OF
THE MOST CONTAMINATED PEOPLE ON
THE PLANET.
MOST PEOPLE DON'T KNOW THAT.
IT'S IMPORTANT WE ARE IN THE
ROLES THAT WE HAVE KNOWLEDGE AND
EXPERIENCE AND INDIGENOUS
PEOPLE'S KNOWLEDGE IS
INCORPORATED BECAUSE RELIANCE ON
FOOD AND IN MY COMMUNITY 90% OF
PEOPLE EAT TRADITIONAL FOOD.
IT'S IMPORTANT WE FOCUS ON
ARCTIC INDIGENOUS PEOPLE.
WE'RE VERY GRATEFUL FOR NIH AND
WE HAVE 19 PEER REVIEW PUBLISHED
ARTICLES AND PUBLICATIONS WHICH
ARE AVAILABLE ON THE WEBSITE.
WE ARE ONE OF THE FEW IN THE
NATION BECAUSE OF CONCERNS TO
ECDs.
>> THANK YOU, VIE.
VIE, SOME OF THE INSTITUTIONS
IN ALASKA ARE ANY WORKING WITH
YOUR COMMUNITY?
>> INVESTIGATION OF ALASKA
FAIRBANKS SOME PARTNERS ARE
NORTHERN ARIZONA UNIVERSITY MUCH
ALBANY.
WE HAVE SO MANY RESEARCH
PARTNERS.
SOAR -- SORRY, MY MEMORY IS
AFFECTED AND I HAVE FAMILY
MEMBERS FIGHTING CANCER.
ALL OUR RESEARCH PARTNERS ARE
SOME OF THE MOST TOP IN THE
NATION AND DOING RESEARCH IN
ARCTIC INDIGENOUS PEOPLE.
MILITARY TOXICS AND NEUROTOXIC
CHEMICALS INCLUDING PFAS EDC
CHEMICALS AND FLAME RETARDANTS.
EEN --
ANYWAY IT'S IMPORTANT WE PARTNER
WITH SOME OF THE BEST ACADEMIC
PARTNERS IN THE NATION BECAUSE
STATE OF ALASKA HAD A PROBLEM
WITH PCB LEVELS UP OUR BLOOD AND
WE'RE NOT DUMB ESKIMOS.
IT'S IMPORTANT WE ALSO ADD
ARCTIC INDIGENOUS PEOPLE AS A
VULNERABLE POPULATION.
THANK YOU.
>> THANK YOU, VIE.
THANK YOU VERY MUCH.
>> I'M THINKING HOW OUR NIH
REVIEW PROCESS WORKS AND MOST
WHO SIT ON THE PANELS EXPECT
SPECIFIC MECHANISTIC DRIVEN
HYPOTHESES AND IT'S VERY
REDUCTIONIST AND THIS IS A
COMPLICATED ISSUE AND I'M
WONDERING HOW ARE WE GOING TO
STUDY ALL THE MIXTURES IN THE
DIFFERENT WAYS OF MITIGATING OR
PREVENTING SYMPTOMS WHEN WE'RE
DOING THINGS ONE CHEMICAL AT A
TIME, A FEW CHEMICALS IN A
SPECIFIC CLASS AT A TIME?
AND THAT'S THE GAP AND
TRANSLATING TO HUMANS NOT SURE
HOW WE DO THAT FROM THE PEOPLE
REVIEWING THE GRANTS WE CAN'T DO
IT IN AREDUCTIONIST WAY AND
TRANSLATE IT TO HUMANS.
HOW DO WE SOLVE THAT?
>> THAT WAS MENTIONED BY ANOTHER
SPEAKER TODAY IN TERMS OF THE
REALITY THAT HUMANS HAVE
MULTIPLE EXPOSURES AND DISEASES
AND CONDITIONS.
THIS CAME UP AT A PRAGMATIC
TRIALS MEETING A FEW MONTHS AGO
WHERE A CENTER DIRECTOR
MENTIONED THE IMPORTANCE OF US
THIRD-PERS
THINKING BEYOND A SINGLE ANSWER
AND MOST PEOPLE HAVE MORE THAN
ONE DISEASE.
>> I WANT TO FIRST OF ALL THANK
YOU AND TELL YOU BROUGHT ME FULL
CIRCLE HERE TO THE ROOTS OF MY
WORK 25, 30 YEARS AGO WHICH WAS
REALLY INTERVENTION AND
PREVENTION-BASED AND I THINK
WHAT I'M HEARING THE LAST COUPLE
DAYS GIVING ME HELP BECAUSE
EVERY STAGE OF DISEASE AND
DEVELOPMENT IN THE LIFE COURSE
THERE'S OPPORTUNITIES FOR
PREVENTION.
WE THINK OF INTERVENTION AS
EARLY INTERVENTION BUT
PREVENTION IS CRUCIAL BECAUSE
WITH ENDOCRINE DISRUPTORS BE IT
PFAS WE HEAR ABOUT THE
PROGRESSION OF DISEASES.
WHATEVER YOU CAN DO TO BRING
THIS KNOWLEDGE TO THE NATION AT
LARGE AND ABOUT WHAT IS THE
VENUE AND DELIVERY SYSTEM
BECAUSE HEALTH CARE 20 YEARS AGO
USED TO HAVE A PATIENT EDUCATION
PIECE WE DON'T SEE ANYMORE BE IT
LESS TIME GIVEN OR THE PROFIT
MODELS THAT HAVE TAKEN AWAY
WHO'S JOB SIT TO IMPART THE
MESSAGES AND IF WE CAN FIND A
WAY TO BRING THAT BACK ALL THIS
GOOD ADVICE AND GOOD STRATEGIES
HERE THE V.A. IS USING, I HEARD
IT FROM VETERANS IN NEW
HAMPSHIRE HEALS PEOPLE SO WHILE
WE'RE TRYING TO SOLVE BIG LEVEL
HUGE PROBLEMS WE CAN DEFINITELY
INTERACT TO PREVENT PROGRESSION
OF DISEASE.
THANK YOU.
THAT'S MY BIG TAKEAWAY FROM THE
TWO DAYS.
>> I'M GLAD YOU'RE TAKING THAT
AWAY.
I'LL LED -- LET YOU GIVE ONE
LAST COMMENT BEFORE DR. LANGEVIN
GIVES CLOSING REMARKS.
>> I'M A WOMAN DEALING WITH SOME
REPRODUCTIVE HEALTH ISSUE THEY
WANT PROGRAMS AND INTERVENTIONS
AND RESOURCES AND INFORMATION TO
SUPPORT AND PREVENT THE HARM
FROM HAPPENING.
MANY ARE FINDING IT SHORT
SIGHTED.
WE HAVE A HEALTH CARE SYSTEM
THAT FOCUSES MORE ON THE DISEASE
RATHER
RATHER THAN PRIORITIZATION
PEOPLE BEING SICK.
I'M ALWAYS THINKING WHY DO WE
SPEND BILLIONS AND BILLIONS
WHERE WE SOMEHOW I THINK PERHAPS
IT'S SOME ARROGANCE IN WESTERN
MEDICINE WHERE WE WANT TO FOCUS
MORE ON THE DISEASES AND WRITING
A PRESCRIPTION.
OKAY.
THE TWO BIGGEST WEAPONS WE HAVE
IN DEALING WITH THIS IS AROUND
AND SURGERY AND MEDICATIONS.
WHAT IF THERE COULD BE A SWITCH
WHERE WE ADD --
[SPEAKING SPANISH]
-- AND PREVENTION THAT COULD
JUST KEEP PEOPLE SAFER RATHER
THAN TRYING TO MITIGATE.
WE DO WANT TO MITIGATE BUT WHAT
IF THE MITIGATION STARTS WITH
CENTERS ON THE INTERVENTION AND
PREVENTION.
>> RIGHT.
AND I THINK WE HEARD SEVERAL
TALKS YESTERDAY AND TODAY THAT
HAVE THE POTENTIAL OF PREVENT
THE DOWN STREAM EFFECTS OF ECDs
AND THAT'S WHERE WE NEED TO
SUPPORT THE RESEARCH TO BUILD UP
THE BODY OF EVIDENCE TO MAKE
CONCRETE CLINICAL
RECOMMENDATIONS IF THEY DO PROVE
TO BE POSITIVE STUDIES.
I HEAR WHAT YOU'RE SAYING.
DR. LANGEVIN WE'D LOVE YOU TO
FINISH UP THE WORKSHOP WITH YOUR
COMMENTS AND QUESTIONS.
PLEASE, GO AHEAD.
>> FIRST, CONGRATULATIONS.
THIS WAS REAL TERRIFIC ALL
AROUND.
I WANTED TO ADDRESS SOME OF THE
RECENT COMMENTS IN THE LAST FEW
MINUTES ABOUT HOW DO YOU DEAL
WITH SOMETHING THAT IS SO
COMPLEX?
HOW DO WE WRITE A GRANT
APPLICATION THAT IS GOING TO BE
REVIEWED FAVORABLY WHEN IT'S SO
COMPLICATED AND GET AWAY FROM
THE TRAP INTO THE REDUCTIONISTIC
ONE THING AT A TIME?
A
AND HOW DO YOU DEAL WITH A
PROBLEM THAT HAS A COMPLEX INPUT
AND COMPLEX OUTPUT?
THE INPUT AT NIEHS HAS BEEN A
WONDERFUL AREA IS THE CONCEPT OF
THE EXPOSOME.
THE SUM TOTAL OF ENVIRONMENTAL
EXPOSURES SOMEBODY IS EXPOSED
TO.
YOU DON'T HAVE TO LOOK AT THESE
ONE AT A TIME.
WE'RE DEVELOPING METHODS TO LOOK
AT THIS AS A SYSTEM.
AND AT NIH WE HAVE A WORKING
GROUP WORKING ON METHODS TO B
BOLSTER ON THE WHOLE PERSON TO
UNDERSTAND THE TOTAL OF THE
COMPLEX INTERACTIONS BETWEEN
PHYSIOLOGY OF THE ENTIRE BODY.
ONCE WE CAN DO THIS WE CAN START
TO APPLY THE ADVANCED
COMPUTATIONAL MODELS TO LOOK AT
HOW A COMPLEX NETWORK SUCH AS
THE HUMAN PERSON CHANGES OVER
TIME IN RESPONSE TO A VARIETY OF
DIFFERENT INTERVENTIONS AND
LONGITUDINAL STUDIES OF ALL
SORTS.
AND THIS TAKES PREPARATION AND
FOUNDATIONAL METHODS DEVELOPMENT
AND BUT IT'S GOING WELL AND STAY
TUNED.
I THINK AS WAS SAID WHAT DO WE
KNOW WE DIDN'T KNOW AT OUR LAST
WORKSHOP?
WE HAVE HINTS I'VE HEARD ABOUT
THE FACT THAT INTERVENTIONS AT
THE WHOLE PERSON LEVEL,
NUTRITION, EXERCISE, STRESS
MANAGEMENT, ALL THESE THINGS, WE
HAVE A LOT OF THE PRESENTATIONS
THAT IT MAY HELP IN WAYS THAT
ARE COMPLEX FROM THE WHOLE
PSYCHOLOGICAL LEVEL DOWN TO THE
MOLECULAR.
LET'S FOLLOW THESE LEADS AND
DEVELOP THE METHODS TO REALLY BE
TO UNDERSTAND AS A COMPLEX
SYSTEM.
SO I THINK HOPEFULLY THE NEXT
PHASE OF THIS WILL CONTINUE TO
PROGRESS THIS.
WE HAVE REASON TO HOPE SO MUCH
OF THE OUTSTANDING RESEARCH
DISCUSSED IN THE LAST TWO DAYS
IS LEADING US IN THE RIGHT
DIRECTION SO THANK YOU ALL.
>> THANK YOU ONLINE FOR
ATTENDING AND DOING AND MAKING
THIS WORKSHOP HAPPEN.
I WOULDN'T HAPPEN WITHOUT YOU.
NO ONE CAME TO LISTEN TO ME.
THEY CAME TO LISTEN TO ALL OF
YOU.
I'M THRILLED TO HAVE MET ALL OF
YOU AND HAVE HEARD THE WORK
YOU'RE DOING.
I WOULD LOVE THE NIH TO CONTINUE
FUND YOUR RESEARCH IN THE FUTURE
AND STAY IN TOUCH.
>> THANKS EVERYONE FOR
ATTENDING.
IT'S BEEN A GREAT EXPERIENCE AND
SAFE TRAVELS.
>> YES.
THE VIDEOCAST WILL BE RECORD ON
THE NIH WEBSITE IN THE NEXT ONE
TO TWO WEEKS AND YOU'RE ABLE TO
WATCH IT AS OFTEN AS YOU WANT.
TAKE CARE.