Session 2 Q&A and Resources

Answers to questions submitted by participants:

Q: Would it be possible to share the link where we can find the recording of session 1?
A: Here is the link to the Session 1 recording: https://www.youtube.com/watch?v=Uc6AxRPZJXI.

Q: How are exposures to smoke from wildfires tracked and considered in these environmental trends? Asking this question given the lower PM values shown on the trend slide in the western portion of the country from 1998-2016.
A: Thank you for your question! The map of the PM2.5 trends from 1998-2016 there is derived from NASA’s Socioeconomic Data and Applications Center (SEDAC) gridded annual PM 2.5 data. You can check out the data and explore further here: https://www.esri.com/arcgis-blog/products/arcgis-living-atlas/analytics/explore-air-quality/. There is concern that wildfire smoke will impact downward trends in air pollution; see this article.

Q: If EPA’s most recent stats are from 2014, how do you know that air pollution levels are falling?
A: Thank you for your question. The downward trends in air pollution are clear for “criteria air pollutants”: six pollutants, including particulate matter, which must meet National Ambient Air Quality Standards.  These data are more recent; the slide in the presentation showed a graph of decreasing levels of these 6 pollutants from 1990-2018. You can explore the graph further here: https://gispub.epa.gov/air/trendsreport/2019/#highlights.

In terms of the data from 2014, that was in reference to the National Air Toxics Assessment (NATA) which compiles emission estimates for chemicals called “air toxics.” These 180+ chemicals are regulated differently than the six “criteria pollutants.”  Many of these “air toxics” confer additional cancer risk.  The NATA data are less precise and the trends are less clear; levels appear to be decreasing for some air toxics, increasing for others.  You can find more information about NATA here: https://www.epa.gov/americaschildrenenvironment/national-air-toxics-assessment-nata.

Q: Is radon considered “air pollution”?
A: Yes. Radon is a particular concern for indoor air pollution, because it concentrates in confined settings. It is also a concern in other confined settings, such as exposures experienced by miners.

Q: Are any agencies or scientific groups tracking human body burden of dioxin?  Incinerators generate trace amounts of dioxin.
A: Thanks for your question. The EPA used to have a Dioxin Exposure Initiative studying sources of human exposures to dioxins, but it has since been discontinued. You can find more information here: https://www.epa.gov/dioxin/dioxin-exposure-initiative#trend.

Q: We know a lot about ambient pollution and its adverse effects, including cancer.  But most people spend most of their time (>80%) indoors.  Outdoor pollution does come in, but indoor pollution contributes to our outside pollution, especially for VOCs.  How do we work to reduce levels of indoor pollution, or maybe first estimate how much of our risk is due to indoor pollution?
A: You can find tips for reducing chemical exposure in a home and personal context through Silent Spring Institute's Detox Me app: https://silentspring.org/detox-me-app-tips-healthier-living. To learn more about Silent Spring Institute's research on indoor air pollution & dust, see here: https://silentspring.org/our-science/household-air-and-dust.  There are other sources of indoor air pollution and solutions; these will be discussed in the Q & A for the session.

Q: Is there a best or standard model we can use to attribute cancer or other diseases to air pollution at the community level? If so, where can we learn about using it? Attribution science seems to be incredibly impactful but finding experts on the process has been challenging.
A: The EPA has another screening tool called EJScreen that looks at NATA data in concordance with demographic data to identify possible pollution burden disparities. The EJScreen Tool also has a list of other resources, including certain states that have more extensive monitoring and mapping programs: https://www.epa.gov/ejscreen/additional-resources-and-tools-related-ejscreen#other-maps.  We will post more information about more resources following this session.

I would also note that it could be helpful to contact your regional or local environmental department and/or public health department to learn more about specific monitoring that may be occurring in your local area.

Comment from another participant:
If people are interested in getting access to air pollution or NATA data (or other environmental exposures), we can help through the HSPH NIEHS Center www.hsph.harvard.edu/niehs.

Q: There is an increase in colorectal cancer in young people - as young as teenagers and people in their twenties.  Some of this risk was recently attributed to maternal obesity (C. Murphy et al., 2022) - could this play a role in cancer survivors as well?
A: There are studies published showing that obesity during pregnancy increases risk for diagnosis of colorectal cancer. Our study specifically examined PM2.5 and risk for cancer mortality after diagnosis. We did not look at effect modification of the association of PM2.5 and cancer mortality by obese vs. non-obese status during pregnancy in this study.

Q: Was there a link between susceptibility to PM 2.5 and radiation therapy to the chest?
A: We were not able to identify the site of radiation therapy in our initial study of childhood cancer survivors, which is why we focused on chemotherapy. We are looking at radiation exposure in breast cancer patients in our current R03, who do have chest radiation.

Comment:
Clean Water Action is working on bills to lower exposure levels in air pollution and also in consumer products. It would be so valuable to have scientists and medical professionals supporting any of the bills we are working on.

Q: On the slide with the reference Myers et al., Environmental Health 2020-2021, a tool was mentioned. Can you share the link for the tool?
A: The original study is published here.  https://ehjournal.biomedcentral.com/articles/10.1186/s12940-020-00613-x. A subsequent publication applied the model to lung cancer incidence in Allegheny County, PA.  See https://ehjournal.biomedcentral.com/articles/10.1186/s12940-021-00737-8.  There is “Supplementary Material” attached as a file in that publication which walks people through the steps for doing their own calculations. 

Q: This has been a hugely helpful webinar. But I'm feeling a major disconnect between this info and the situation here in Louisiana, where state agencies are using county-level cancer data and behavioral factors to dismiss pollution concerns. Is there a listserv of epidemiologists/experts that we could reach out to when we need experts to weigh in on these local issues? It's very hard to find local public health experts who are willing to discuss industrial pollution.
A: As Dr. Polly Hoppin mentioned, Cancer Free Economy Network is a network of health & science professionals, policy advocates, community groups and market partners coming together to advance primary cancer prevention. For more information, see https://www.cancerfreeeconomy.org/.

Q: Is there any way to see the statistics on the indoor air quality you are measuring in Chelsea?
A: I am glad to share the latest data with you when we have it ready to be shared beyond the study participants (for this new indoor AQ effort).  In the meantime, I encourage you check out our website and see the AQ section of our HEC report.  Some of the earlier data we captured is in that section. www.greenrootschelsea.org

Q: Are there any current NIEHS RFAs that are particularly relevant to environmental justice and community engaged research? I am familiar with the Research to Action call but has that been renewed?
A: Here is the link to our program.  I believe the RFA is in its final year and that staff are exploring options to renew it.  Dr. Lindsey Martin at NIEHS is the point of contact.   https://www.niehs.nih.gov/research/supported/translational/rta/index.cfm

Comment:
Another resource that may be of interest to those on this call is a recent project on environmental racism in Boston - several of the modules are specific to housing and outdoor air pollution exposures: https://www.hsph.harvard.edu/niehs/environmental-racism-project/

Comment: If anyone is interested in further understanding of the tenants of environmental justice check out The Principles of Environmental Justice from the National People of Color Environmental Leadership Summit: https://www.ejnet.org/ej/principles.html

Q: Question to Dr. Judy Ou: Could you share the reference to the Waters paper, on Perceptions (slide with quotes, about (lack of) link between effect of air pollution)? Thank you!
A: Sure thing - Waters AR et al. Perceptions and knowledge of air pollution and its health effects among caregivers of childhood cancer survivors: a qualitative study. BMC Cancer. 2021 Dec;21(1):1-9. 

Q: I was hoping to figure out how to get the simple steps info like vacuuming and fans, which is widely available, to the pediatric cancer caregivers who know nothing about it. The oncologists do not seem to be the conduit for this information. Is there anyone working on integrating this info into what oncologists share with their patients, especially in pediatrics?
A: Thank you for your question. Silent Spring Institute has a few resources on simple steps for reducing indoor air pollution, including how to reduce levels of flame retardants in the home: https://silentspring.org/news/gathering-dust-many-toxic-flame-retardants-linger-homes-sometimes-levels-above-health; Tips for safer cleaning: https://silentspring.org/detox-me-app-tips-healthier-living/tips-cleaning; General tips for reducing exposures in all aspects of everyday activities & product use: https://silentspring.org/detox-me-app-tips-healthier-living.

Silent Spring Institute is committed to cancer prevention and interested in working with medical professionals to more widely disseminate these materials. For more information, feel free to contact: info@silentspring.org.

Resources

Resource for environmental health science updates, funding opportunities and partnerships:

Partnerships for Public Health (PEPH) Program.  https://www.niehs.nih.gov/research/supported/translational/peph/index.cfm

PEPH is a network of scientists, community members, educators, healthcare providers, public health officials, and policymakers who share the goal of increasing the impact of environmental public health research at the local, regional, and national level. Read about the program, see past newsletters and sign up to get the newsletter.

Outdoor air quality—general

https://www.epa.gov/report-environment/outdoor-air-quality

Indoor air quality—general

https://www.epa.gov/indoor-air-quality-iaq/indoor-pollutants-and-sources 

Speaker Judy Ou’s publications

Fine Particulate Matter Air Pollution and Mortality among Pediatric, Adolescent, and Young Adult Cancer Patients | Cancer Epidemiology, Biomarkers & Prevention | American Association for Cancer Research (aacrjournals.org), Judy Ou, PhD, MPH, Huntsman Cancer Center, University of Utah, 2020.

Fine Particulate Matter and Respiratory Healthcare Encounters among Survivors of Childhood Cancers (mdpi.com), Judy Ou, PhD, MPH, Huntsman Cancer Center, University of Utah, 2019.

Speaker Mary White suggested resources

To learn more about CDC's Air Quality Data and Monitoring see here: https://www.cdc.gov/nceh/tracking/topics/AirQuality.htm#anchor_1606247930783

Cancer Data:

Environmental Public Health Tracking:

EJSCREEN: Environmental Justice Screening and Mapping Tool: https://www.epa.gov/ejscreen

National Comprehensive Cancer Control Program:

National Association of Chronic Disease Directors/CDC and partners Environmental Health Webinar Series:

National Association of Chronic Disease Directors: https://chronicdisease.org/page/cancerprograms/cancer-prevention-across-the-lifespan/

Additional resources provided by Melanie Steeves, Massachusetts Department of Health
melanie.steeves@state.ma.us

In January, the program published a Radon CME on the Massachusetts Medical Society’s website: Radon Exposure and Health Risks. It focuses on how healthcare providers can play an integral role in providing education and directing patients to available resources.

The Massachusetts Environmental Public Health Tracking program (https://matracking.ehs.state.ma.us/) links information through a web-based tool documenting health conditions related to the environment, including radon and lung cancer.

For more information about joining the coalition or signing up for the program’s quarterly newsletter, contact: regine.thevenin@mass.gov