Prescription: Enviro-Knowledge for Doctors

Chances are your doctor doesn’t know much about environmentally-related
illnesses. Ann Murray looks at why most US doctors and nurses aren’t even
talking about environmental connections to their patients’ health and what’s
being done to remedy the situation:

Transcript

Chances are your doctor doesn’t know much about environmentally-related
illnesses. Ann Murray looks at why most US doctors and nurses aren’t even
talking about environmental connections to their patients’ health and what’s
being done to remedy the situation:


In 1999, Jo Ann Meier was diagnosed with breast cancer. She was shocked
to discover she had the disease. No one in her family had a history of cancer.
And she only had one of the standard risk factors for the illness:


“Of course, you always speculate when you have a disease like this. Was it
something I did or was it something that I was exposed to?”


Meier says her doctors never talked to her about possible environmental
links to her illness. Today, Meier is cancer free and runs a non-profit that
raises money for breast cancer research. She hears similar stories about other
primary care physicians from the breast cancer patients she works with every
day.


“There’s a great deal of anger about the misinformation or lack of
information given to them in general. I mean, it would be great if your PCP would
say you have to look at what you’re doing on a day-to-day basis that might
be affecting your health.”


Jo Ann Meier’s experience isn’t unusual. Experts agree that most doctors and
nurses aren’t ready to deal with the environmental links to dozens of
illnesses like cancer or lung disease. Sometimes crowded doctors’ schedules
or fear of being seen as an environmental advocate get in the way. Leyla
McCurdy directs the Health and Environment Program at the National
Environmental Educational and Training Foundation in Washington, DC.
McCurdy says medical providers don’t know much about environmental
health issues because training is so hard to come by.


One of the challenges that we are facing in terms of integrating environmental
health is the lack of expertise in the area. There are very few leaders who
are willing to take the time and create their own materials to educate the
students at the medical and nursing schools:


“As a result of this small pool of experts, and an already crowded set of
courses, most med students get only about seven hours of environmental
health education in four years of school. Established doctors and nurses have
even fewer training options.


A small but growing number of health care institutions, non-profits and
agencies are stepping in to fill the training gap. On this morning, medical
residents and staff doctors crowd into a hospital lecture hall.


“Welcome to medical grand rounds. Our speaker today is Doctor Talal ElHanowe,
who is going to talk to us about estrogenic pollutants in the environment and
the risk they pose to people.”


“Can these chemicals, which resemble estrogen, in one way or the other, cause an increase in the risk
to develop cancer? And the answer is yes.”


ElHanowe is a medical doctor and research scientist. He works with the
University of Pittsburgh’s Center for Environmental Oncology. The Center
is developing environmental health training for doctors and nurses. After his
seminar, ElHanowe says response to the program has been good. But his job
of relating environmental health risks can be tough because doctors aren’t
used to treating diseases with causes that are hard to pin down.


“In the scientific community, we can’t prove everything. Many things are
very difficult to prove.”


ElHanowe’s boss, Devra Davis, says medical providers will have to be
satisfied with substantial evidence, not absolute proof, that certain
environmental toxins increase the risk of illnesses, and steer patients to safer
alternatives. Davis is a nationally known epidemiologist. She says
environmental medicine’s emphasis on prevention is the shot in the arm
American health care needs:


“Because no matter how efficient the health care system becomes at finding
and treating disease, if we don’t reduce the burden of the disease itself, we’ll
never be able to improve the health of Americans.”


But to make environmental medicine standard issue in schools and practice,
a lot more doctors and nurses will need to be educated. And that means a lot
more funding. It’s hoped as medical providers make the connection between
environmental exposures and public health, funding sources will open up
and environmental medicine will make its way into mainstream health care.


For the Environment Report, this is Ann Murray.

Related Links

Pet Health Records to Help Track Bird Flu?

Health experts say the medical records of cats and dogs could serve as an early warning system for diseases such as avian flu. The GLRC’s Rebecca Williams has more:

Transcript

Health experts say the medical records of cats and dogs could serve as an
early warning system for diseases such as avian flu. The GLRC’s
Rebecca Williams has more:


The health records of thousands of dogs and cats throughout the country
are tracked by the National Companion Animal Surveillance Program.


Larry Glickman helped design the system. He’s an epidemiologist at
Purdue University. He says it was originally designed to track anthrax or
plague outbreaks in pets. Glickman says now, the system could be used
to monitor pets for avian flu symptoms.


“What we’re concerned with in the U.S is for example, a pet animal like a
cat will come in contact with a bird that is sick or even died of avian
influenza, then the cat will pick up that virus and will become infected,
and the very same day it might climb in bed with people and transmit
that virus to people.”


Glickman says the system can pinpoint areas where quarantines are
needed… to slow the spread of disease in both pets and people.


For the GLRC, I’m Rebecca Williams.

Related Links

Is Our Water Too Clean?

Diseases caused by contaminated water are common in the developing world, but they’re also making a comeback in the United States where the water might be too clean. The Great Lakes Radio Consortium’s Charity Nebbe
explains:

Transcript

Diseases caused by contaminated water are common in the developing
world, but they’re also making a comeback in the United States where
the water might be too clean. The Great Lakes Radio Consortium’s
Charity Nebbe has more:


In 1993, the water-borne pathogen Cryptosporidium claimed 54 lives in
Milwaukee. Incidents of that magnitude are rare, but outbreaks of
water-borne pathogens are increasingly common.


Floyd Frost is an epidemiologist at Lovelace Respiratory Research
Institute in New Mexico and he believes the increase in disease is
linked to improvement in water purification technology. As evidence he
points to his research, published in The Journal of Infectious
Diseases, that shows lower incidence of disease in communities that
drink surface water…


“Perhaps the low dose exposures in surface water are immunizing
people so that they don’t get sick, whereas in the ground water it’s
relatively clean most of the time, but when contamination occurs people
get much sicker.”


Frost believes that to prevent future outbreaks water treatment
facilities need to focus on preventing plant failures rather than
improving purification.


For the GLRC, I’m Charity Nebbe.

Related Links

Study: Home Births Safe for Low-Risk Moms

Only about one percent of North American babies are born at home. But a study in the British Medical Journal reports home births can be a safe alternative for low risk women. The Great Lakes Radio Consortium’s Karen Kelly reports:

Transcript

Only about one percent of North American babies are born at home. But a study
in the British Medical Journal reports home births can be a safe alternative
for low risk women. The Great Lakes Radio Consortium’s Karen Kelly reports:


Researchers followed more than 5,400 pregnant women in the U.S. and Canada who were
planning a home birth with a professional certified midwife.


They looked at the death rate of newborns, the number of mothers who ended up in the hospital,
as well as the number of medical interventions used during labor.


They found low risk women who planned to give birth at home had the same likelihood of their
child dying as low risk women who went to the hospital. That’s fewer than two deaths out of
every 1,000 births.


Kenneth Johnson is an epidemiologist with the Canadian government.


“The participants experienced substantially lower rates of epidurals, episiotomies, forceps
deliveries, vacuum extractions, and cesareans.”


Home birth remains controversial in North America. While several Canadian medical societies
endorse home births, the American College of Obstetricians and Gynecologists remains opposed
to them.


For the GLRC, I’m Karen Kelly.

Related Links

Scientists Push for Tougher Arsenic Standards

Groundwater in some Great Lakes states has been found to meet or exceed
acceptable levels of naturally occurring arsenic. Growing concern about
the health effects of arsenic consumption recently prompted the U-S
Academy of Sciences to recommend that the federal government create more
stringent standards for human consumption of arsenic. The Great Lakes
Radio Consortium’s Marisa Helms has the story: