Charlotte Brody figured she wasn't completely pure. "I knew that dioxins were in every piece of cheese I'd ever eaten," she says. "I knew that mercury was in tuna fish." So when she volunteered samples of her blood and urine for a recent study of chemical contamination in humans, she didn't expect to be too surprised by the results.
But Brody was stunned by what turned up in her body fluids. Researchers at the Mount Sinai School of Medicine found evidence of 85 contaminants, including more than two dozen types of PCBs, seven dioxins and -- most shocking to Brody -- the Dow-manufactured insecticide Dursban. High doses of Dursban cause neurological damage in animals and humans, and the federal Environmental Protection Agency has banned its indoor use.
Brody, a nurse and environmental activist who lives in Washington, D.C., attacks the weeds in her flower garden with trowels, not pesticides, and fills her shopping basket with organic produce. "If you could lifestyle your way out of Dursban, I've done it," she says. But her body told her the real story: Dursban had been sneaking into her life anyway.
"It was the biggest insult of all," she says. "This was completely outside my control. Dow put this chemical into me without any assistance on my part."
Such unsettling experiences might soon become a lot more familiar to California residents. Senate Bill 689, now wending its way through the state Legislature, would establish a "biomonitoring" program that would test humans for various types of chemical contamination. If the bill passes next year, people in selected communities could volunteer their blood, urine or breast milk for a battery of analyses. For the first time, they'd learn the exact nature and quantity of the pollutants in their bodies.
The rest of us could gain something, too. We've spent years arguing about the ultimate fate of the toxins in our environment, but we've never had a lot of information to go on. Biomonitoring efforts are collecting the most solid and detailed evidence we've ever had, and it's potentially powerful stuff. When combined with other research, it can help strengthen the environmental protections we've got -- and help quash new contaminants before they permeate the planet.
"In the absence of solid scientific information from biomonitoring, we're just groping in the dark," says Gina Solomon, a senior scientist with the Natural Resources Defense Council. "When we do have that kind of information, we know if our regulatory policies are working, we know where to target public information campaigns, and we know which communities need to be cleaned up."
Though the Environmental Protection Agency estimates that some 75,000 industrial chemicals are used in the United States today, fewer than 10 percent have been tested for their effects on human health. Monitoring air and water quality can tell us where these chemicals end up in the environment, but it can't tell us how much and how many of them have soaked into our bodies; that's where biomonitoring comes in.
It's not exactly a new science: The first laboratory analyses of synthetic chemicals in breast milk were carried out back in the 1950s, and researchers have been testing people for high levels of contaminants such as DDT and lead for decades. But this early work focused on people who had obvious reasons to worry, such as those who'd been exposed to massive doses of toxins in accidents or on the job. Modern biomonitoring can suss out much lower levels of contamination, quantifying the chemical cocktail in us average Janes and Joes.
Sophisticated laboratories can now find traces of more than 250 substances ranging from metals to pesticides to dioxins. Some of these toxins accumulate in our fat cells and are best detected in breast milk. Others, such as Charlotte Brody's nemesis Dursban, show up in blood and urine.
But biomonitoring is expensive. The detailed analysis of Brody's body burden, arranged by the nonprofit organizations Commonweal and the Environmental Working Group, cost about $5,000. So scientists have tended toward isolated studies of small groups of people, often foiling public-health efforts to spot general patterns. "The methods have developed in a haphazard way," says Solomon at the Natural Resources Defense Council. "There are lots of different researchers all around the world, but they're not really talking to each other."
In the 1970s, European countries such as Sweden and Germany tackled this problem with nationwide breast-milk monitoring programs, storing samples of human milk for testing. More recently, the United States has kicked off its own large-scale biomonitoring efforts: In 2001, the Centers for Disease Control and Prevention released the results of its first nationwide biomonitoring study, which analyzed thousands of people for evidence of 27 chemicals. In 2003, the agency tested for 116 chemicals and plans to keep expanding its work.
Since these data could not be reliably broken down by region, the agency also granted funds to 33 states -- including California -- to plan their own programs. Only New Hampshire, New York and a group of Rocky Mountain states have received money to put their plans in action. Though the EPA is now funding a small biomonitoring study in California, there's no federal money available for an ongoing statewide effort.
But in mid-2002, at a summit on breast cancer and the environment held in Santa Cruz, Calif., researchers, physicians and activists chose national and state-specific biomonitoring programs as their top policy priority. "By better understanding the kind and nature of chemicals in the breast, we hope we can better understand the linkages between breast cancer and synthetic chemicals in the environment," says Janet Nudelman, program director for the San Francisco-based Breast Cancer Fund.
Representatives from that organization, along with other activists and biomonitoring experts, held an informational session with the California Senate Health and Human Services Committee and the Assembly Health Committee in late 2002. Last February, state Sen. Deborah Ortiz (D-Sacramento), the Senate committee chair, introduced the "Healthy Californians Biomonitoring Project" bill, sponsored by the Breast Cancer Fund and Commonweal and supported by about 50 health and environmental organizations.
The project, which would be administered by the state Department of Health Services and funded by a tax on toxic emissions, would start by testing breast milk from volunteers in three "economically, racially and geographically diverse" communities. An advisory board of public-health experts, activists and community representatives would select the locations and the chemicals to be investigated in each. The program would later expand to milk, blood and urine testing in other areas throughout the state. Though individual results would be available to the participants themselves, only pooled results would go public.
But biomonitoring, especially the testing of breast milk, can put new mothers in a frightening quandary: If my milk contains synthetic chemicals, should I be feeding it to my child? Most researchers agree that the health benefits of breast-feeding still outweigh the risks, but they acknowledge the risks. Ecologist and author Sandra Steingraber has said that human milk is "absolutely the best food for infants" as well as "the most chemically polluted food on the planet."
The California biomonitoring bill would establish an education program to promote the health benefits of breast-feeding, especially in communities targeted for biomonitoring. "We unequivocally want to send the message that 'breast is best,'" says Nudelman. "The process of breast-feeding actually builds a stronger infant -- it helps the infant fight the very diseases we're trying to fight through biomonitoring program." Though Sweden has a breast-milk monitoring program, she adds, about 98 percent of Swedish mothers choose to breast-feed.
Still, organizations such as the San Francisco-based Breast Cancer Action have stayed away from the biomonitoring campaign. "We're very concerned about the impact on breast-feeding," says executive director Barbara Brenner. Breast-feeding advocates have long faced tenacious opposition from infant-formula manufacturers, she says, and "biomonitoring is not going to help."
The biomonitoring bill has drawn criticism from other quarters, including the American Chemical Council, but the industry group has not yet opposed the bill outright. Last April, the measure passed the Senate Health and Human Services Committee by a 9-3 vote, and it is expected to face a vote in the Senate Appropriations Committee before the end of January. Gov. Arnold Schwarzenegger has not taken a position on the measure.
Ortiz expects plenty of opposition, especially if the bill makes it out of the Senate and into the Assembly. "Anytime we look at environmental exposures to pollutants and chemicals, we get a very strong visceral reaction from the business community," she says. "It's going to be a difficult bill. But I've got three years left -- and I'll keep coming back with it each year until I leave."
On its own, of course, biomonitoring proves just about nothing; it simply spits out long lists of parts per billion and parts per trillion. If researchers already know how much of a certain chemical will harm our health, those numbers can be immediately put to use by regulators and activists. "We suddenly have a very direct measure of exposure," says Jane Houlihan, vice president for research of the Environmental Working Group. "We no longer have to make sloppy corrections."
Much of the time, the path from data to action is not so clear. So there are a few parts per trillion of Nasty-Sounding Chemical X in your bloodstream. Will it hurt you? "The response from the chemical industry is always 'Show me the link,'" says Theo Colborn, an authority on hormone-disrupting chemicals and the author of the 1996 book "Our Stolen Future."
It's extremely difficult for scientists -- and politicians -- to blame particular pollutants for health problems. Congress didn't ban PCBs until almost 40 years of research had established their disastrous effects, and it took us about 20 years to decide that smoking caused disease.
But when biomonitoring data is paired with detailed health studies, such links can emerge more quickly: If Chemicals X and Y coincide with curiously high rates of Disease A, researchers have good reason to dig deeper.
Biomonitoring has already helped lawmakers take precautionary steps. In the late 1990s, for instance, Swedish scientists studied archived breast-milk samples and found that their levels of PDBEs -- a group of flame retardants widely used in the plastic components of computers -- had been doubling every five years for the past 25 years. Researchers in California followed up with a study of human breast tissue, finding that women in the San Francisco Bay area exhibited the world's highest recorded PDBE levels.
PDBEs are related to the notorious PCBs, but their health effects are not as well understood. Yet news of their rapid accumulation in human bodies led the European Union to reduce its use of PDBEs in the late 1990s; this year, it approved a ban on PDBEs that will take effect in mid-2006. The California Legislature recently prohibited the use of certain types of PDBEs beginning in 2008.
This better-safe-than-sorry approach is controversial, but some say precautionary regulations are based in medical tradition. "If we have reason to believe that an agent causes disease, we can invoke the old public-health principle of prevention," says Michael McCally, the president-elect of Physicians for Social Responsibility. "We simply need to revisit it."
For the test subjects themselves, these knotty political issues have become painfully personal. Brody might never be sure if the traces of Dursban in her body are eroding her health, but she's certain they've added a new urgency to her daily work: She's the founder and executive director of the nonprofit Health Care Without Harm, a group that promotes environmentally safe medical practices.
"It made me understand more deeply how we're all in this together," she says. "If there's Dursban in me, this can't just be about being a smarter shopper. It has to be about having the kind of government that protects us from the problems we can't protect ourselves from."
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