The Senate Health, Education, Labor, and Pensions Subcommittee on Public Health held a March 6 hearing to discuss the link between environmental exposures and human disease. Sen. Hillary Rodham Clinton (D-NY) presided over the hearing.
Kenneth Olden of the National Institute of Environmental Health Sciences (NIEHS) at the National Institutes of Health (NIH) detailed his agency’s efforts to investigate the connection between environmental exposure and health, noting that “most chronic diseases…arise from the complex interactions between genes and environmental factors.” The NIEHS has targeted three areas of research: the identification of the suite of gene-environment interactions involved in the development of the major diseases; the development of public health or medical prevention/intervention strategies; and the development of mechanisms to translate knowledge and technology into the practice of preventive and clinical medicine.
In addition to other activities, the NIEHS has partnered with the National Institute of Child Health and Human Development at the NIH to create a National Children’s Study, a “national longitudinal study of environmental influences (including physical, chemical, biological, and psychosocial) on children’s health and development.” The study will identify approximately 100,000 children from early in pregnancy and follow them through birth, childhood, and into adulthood.
Henry Falk of the Agency for Toxic Substances and Disease Registry (ATSDR) at the Department of Health and Human Services detailed the agency’s role in investigating the relationship between exposures to hazardous substances and disease. Mr. Falk testified in support of a nationwide health tracking system, noting that there is not a system that currently tracks multiple sclerosis, Parkinson’s disease, lupus, and other autoimmune diseases. “ATSDR has begun to address one of these diseases—multiple sclerosis (MS)—around multiple Superfund sites,” he stated. “In an article just published in Neurology, ATSDR researchers found nationally a 50% increase in MS in women for the period of 1991-1994, versus an earlier time period of 1982-1986.” As a result, ATSDR is beginning to investigate local clusters of MS cases in Texas, Ohio, and Missouri.
Shelley Hearne of the Trust for America’s Health told the subcommittee that “chronic diseases are responsible for 70 percent of deaths in the United States and affect over 100 million men, women and children, more than one-third of our population.” Adding that a large proportion of chronic disease is preventable by lifestyle changes, Ms. Hearne stated, “Regrettably, we lack the vital information that would help us prevent these deadly diseases because we have no system in place to monitor and track chronic disease and conditions.”
She called upon Congress to increase funding for the newly established Nationwide Health Tracking Network at the Centers for Disease Control and Prevention (CDC). In FY2002, $17.5 million was provided for pilot projects in several states, which CDC will begin funding later this year. Ms. Hearne noted that the program should be funded at $275 million per year.
In addition to the new Nationwide Health Tracking Network, the CDC funds cancer registries in 45 states, 3 territories, and the District of Columbia. Birth defect surveillance is carried out in 35 states, and 37 states conduct asthma surveillance.
Dr. John Harris of the March of Dimes noted the importance of birth defect surveillance, saying that birth defects are the leading cause of infant mortality. “In fact, 1 in 28 babies is born with a birth defect,” he said, adding that California has estimated that the “cost of health care and special education for children with only 18 selected birth defects is over $8 billion per year in 1992 dollars.”
Dr. Harris also discussed the National Center on Birth Defects and Developmental Disabilities at the CDC, saying that the center currently funds cooperative agreements in 28 states and territories. However, due to a lack of funding the center was not able to fund all the states that applied for assistance. “Increasing funding for these cooperative agreements from the current level of $4.1 million to $7.5 million would allow CDC to fund the additional states which applied in 2001.” He also noted that the CDC funds eight regional Centers for Birth Defects Research and Prevention. These centers are currently undertaking the National Birth Defects Prevention Study, “the largest study ever undertaken on the causes of human birth defects.”