(September 2013) ANTI-BIOMASS CAMPAIGN CALL RECORDING & NOTES: “A Pediatrician’s Perspective on Air Pollution and Children”

Anti-Bio­mass Incin­er­a­tion Cam­paign — Nation­al Con­fer­ence Call Notes

Thurs­day, Sep­tem­ber 5, 2013 at 3pm EST

Top­ic: “A Pedi­a­tri­cian’s Per­spec­tive on Air Pol­lu­tion and Chil­dren” — We dis­cuss the human health impacts of bio­mass incin­er­a­tion and oth­er forms of indus­tri­al air pol­lu­tion, with a focus on our nation’s most vul­ner­a­ble pop­u­la­tion: our children.

Guest speak­er: Dr. Nor­ma Kreilein, MD, Fel­low of the Amer­i­can Acad­e­my of Pedi­atrics 

RECORDING: 

A Pedi­a­tri­cian’s Per­spec­tive on Air Pol­lu­tion and Chil­dren — Sep­tem­ber 2013

Facil­i­ta­tor: Josh Schloss­berg (Ener­gy Jus­tice Net­work, VT)

Notes: Saman­tha Chir­il­lo (Ener­gy Jus­tice Net­work, OR)

On the Call: Mer­cedes Brugh (IN), Josh Schloss­berg (VT), Toby Thaler (WA), Chris Zin­da (OR), Saman­tha (OR), Paul, Lar­ry Edwards (AK), Nor­ma Kreilein (IN), Roger (IN), Mike Ewall (DC), Anony­mous Lurker

See the video (3–4 min­utes) that Dr. Nor­ma Kreilein ref­er­ences on the call -

http://www.youtube.com/watch?feature=endscreen&v=FQwqhblxz3I&NR=1

See the Con­gres­sion­al brief­ing Sept. 25, 2012, includ­ing Nor­ma’s presentation — 

http://www.saveamericasforests.org/Forests%20-%20Incinerators%20-%20Biomass/Documents/Briefing/Presentations/Presentations%20PDF/Inflammation.pdf

Nor­ma Kreilein (Jasper, IN): Orig­i­nal talk was 45 min­utes for the Con­gres­sion­al brief­ing. Could have spent all day explain­ing what’s rel­e­vant medically. 

Josh Schloss­berg (Ener­gy Jus­tice Net­work, VT): Let’s start. Press *6 to mute. Start­ing record­ing. Thanks for join­ing us, this net­work call is the 1st Thur of each month, time varies. See a link to the video in the email I sent ear­li­er today and Nor­ma’s Con­gres­sion­al brief­ing Pow­er­point pre­sen­ta­tion at saveamericasforests.org

Nor­ma:  I’m a pedi­a­tri­cian. Degrees from Notre Dame and Indi­ana State Uni­ver­si­ty. I’ve prac­ticed in IN for 20 years and have seen what hap­pens to bod­ies over time, the lim­i­ta­tions to med­i­cine. Ohio Riv­er area has always been quag­mire of aller­gies and asth­ma — Ohio Riv­er fever. Rur­al area rel­a­tive­ly. Became involved in bio­mass. Thought the town lead­ers were on the same page, but turned out they were not mon­i­tor­ing, restrict­ing pol­lu­tion in the area. A lot of stud­ies equat­ing inflam­ma­tion with dis­ease. Med­ical diag­no­sis is like a 911 address. We try to be spe­cif­ic but not all diag­noses are spe­cif­ic. Diag­no­sis does not explain the rea­son.  Process that leads to heart attack or can­cer is usu­al­ly an inflam­ma­to­ry process. Pedi­atric board recer­ti­fi­ca­tion required every 7–10 years. Inflam­ma­tion wear­ing and tear­ing at the body + more pol­lu­tion = under­tow. This has lead me to oppose the bio­mass facil­i­ty not built yet here. Much of the pol­lu­tion is coal, wood fur­ni­ture. City decid­ed to make her life hell, moved prac­tice 28 miles east. Iron­i­cal­ly then com­mut­ed past coal plant (see slide) — the Peters­burg Coal Plant. Indi­ana claims to meet air qual­i­ty stan­dards. Patients soak­ing in this all night long. How can we be com­ply­ing? Clos­est mon­i­tor is 20 miles east. Often agency places mon­i­tors to prove what it wants to prove …

Saman­tha dropped off call momen­tar­i­ly, then got back on …

Our state says it com­plies, but no way that com­pli­ance when mon­i­tor­ing at 20 miles is legit­i­mate. Baby cough­ing on the slide (pho­to at brief­ing). Can give them oral steroids which is cheap but has bad side effects or neb­u­liz­er which is expen­sive ($200). Doc­tors and drugs are not cheap for treat­ing health effects of incin­er­a­tion. Am. Lung Assoc. oppos­es bio­mass incin­er­a­tion. I do because it trig­gers inflam­ma­tion — a pri­ma­ry immune  response and respon­si­ble for dis­ease. If you turn it off, you turn off the rest of the dis­ease process. Drugs for rheuma­toid arthri­tis and Crohn’s dis­ease adver­tised on TV — can cause immune defi­cien­cy dis­eases. Inflam­ma­tion is a pri­ma­ry immune response to a trig­ger. When trig­ger lingers, so does this response. Infec­tious dis­ease and pol­lu­tion both trig­ger inflam­ma­tion — a cas­cade, not a tight­ly reg­u­lat­ed feed­back loop. Heart rate only goes as high as oxy­gen can feed it — a reg­u­lat­ed feed­back loop in the body. Inflam­ma­to­ry response can con­tin­ue like a domi­no effect with­out any feed­back loop what­so­ev­er. Will per­sist til the trig­ger is removed. The body makes anti­bod­ies to flu virus, body make anti­bod­ies, inflam­ma­tion hap­pens, then virus and response goes away. Chron­ic infec­tion pro­duces chron­ic inflam­ma­to­ry response, much like pol­lu­tion does. Some peo­ple who do not fight infec­tion and have a large inflam­ma­to­ry response — these peo­ple have large aller­gic respons­es. Air pol­lu­tion caus­es dis­ease by trig­ger­ing inflam­ma­tion. Pol­lu­tion is an inflam­ma­to­ry trig­ger. Dis­ease risk and dam­age is relat­ed to pol­lu­tion lev­el, worse with ongo­ing expo­sure, also depends on genet­ic make­up of the per­son. Lungs are often the recip­i­ents of pol­lu­tions, pol­lu­tants enter cir­cu­la­tion via the lungs, inflam­ma­to­ry cells are recruit­ed to the lungs, becomes a chron­ic dis­ease. Many dif­fer­ent dis­eases emerge from inflam­ma­to­ry path­way, often dose-relat­ed to air pol­lu­tion. These include:

autoim­mune dis­eases — type 1 dia­betes, lupus

neu­rode­gen­er­a­tive — Alzheimer’s

meta­bol­ic — type 2 diabetes, 

car­dio­vas­cu­lar — heart attacks, strokes

can­cer — inflam­ma­tion wears down the body, accel­er­ates aging with­out repair

pedi­atric — kids spend more time out­side, less body mass than adults, more expo­sure, still devel­op­ing so pick up some­thing like autism or ADD from chron­ic inflam­ma­tion. Poten­tial impact of pol­lu­tants is far greater than that of vac­ci­na­tions, far greater than that of vac­ci­na­tions will ever be. Expo­sure to large amounts of pol­lu­tants 24–7 ver­sus micro amounts of vac­cine occa­sion­al­ly. Pol­lu­tants are under­re­port­ed. Child’s cumu­la­tive life­time expo­sure is a pub­lic health cri­sis. See cita­tions — CA did study in which chil­dren had lung scar­ring per­ma­nent up to 20% from liv­ing next to free­ways. Mod­ern med­i­cine in terms of trau­ma and infec­tion — can put body back togeth­er again. But if you look at chron­ic dis­eases, med­i­cine is not very effec­tive. Only in past 20 years do we under­stand the role of pol­lu­tion in chron­ic disease. 

The video Josh sent the link to shows the pro­gres­sion of air­way dis­ease. Inflam­ma­tion means swelling around the air­way, which con­stricts, more mucus, more swelling. Next slide — this caus­es dam­age, scar­ring over time in long run. In short run, dam­age to cil­ia. Cil­ia exposed to smoke do not beat effec­tive­ly. Look like tor­na­do hit — increased like­li­hood of get­ting virus, lim­it­ed in air­flow and abil­i­ty to get oxy­gen in. Can’t see but know as physi­cian — look at patient, kids cough­ing, and try to imag­ine what’s going on in lungs. 

Pol­lu­tion is a huge fac­tor in the devel­op­ment of asth­ma and clots caus­ing stroke. Any­time you decrease air­flow or blood flow, you dra­mat­i­cal­ly effect how the body oper­ates. Chil­dren have small­er blood ves­sels — any restric­tion or swelling is more sig­nif­i­cant in a child than an adult. The radius of the tube to the 4th pow­er (^4). Steroids reduce mucus, more effec­tive in neb­u­liz­er but $80–150 per month and sys­temic steroids affect the whole body. Can­not fix it when the trig­ger is ongo­ing. Can’t address the brain and blood flow to brain and what hap­pens chron­i­cal­ly to cir­cu­la­to­ry system. 

Sul­fur diox­ide melts cil­ia togeth­er — mucus can­not move, stag­na­tion breeds infec­tion. Sinus infec­tions, pneu­mo­nia, bro­chi­tis. Bac­te­ria are inflammatory.More pol­lu­tion, more mucus, more bac­te­ria, more mucus, more par­tic­u­late absorp­tion, even more inflam­ma­tion and less air­flow, gets worse and worse. Pol­lu­tion affects the devel­op­ing pla­cen­ta and fetus. More devel­op­men­tal anom­alies when there’s expo­sure to envi­ron­men­tal tox­i­cs, like atrazine com­bined with coal pol­lu­tion — chro­mo­so­mal and embry­olog­ic dam­age that does not repair over time. Can pro­gres­sive­ly end up with can­cer from chron­ic inflam­ma­to­ry response.  Slide — guy has always had aller­gies and asth­ma, devel­oped type 1 dia­betes, can’t take steroids, every­thing worse with dia­betes, greater cost, his school in top 5% dia­betes rate from USA Today. Next slide — bio­mass pol­lu­tion includes ultra­fine par­tic­u­lates — PM 2.5–10 — inhaled and get into cir­cu­la­to­ry sys­tem via lungs, go to brain via blood­stream along with heavy met­als. Pol­lu­tion is way more like­ly to impact autism and ADD than vac­cines because it bypass­es any fil­ter­ing process the body usu­al­ly has. Bot­tom of slide — DNA dam­age or blood brain bar­ri­er dam­age — extreme­ly dev­as­tat­ing. Quag­mire where 26% of chil­dren in coun­ties sur­round­ing Evans­ville qual­i­fy for learn­ing dis­abil­i­ty. Dose-relat­ed. Hits some hard­er than oth­ers. But ulti­mate­ly wors­ens over time. 

Josh: Thanks, Nor­ma. If you came on the call dur­ing Nor­ma’s talk, please give your name.

Mike Ewall (Ener­gy Jus­tice Net­work, D.C.) 

Lau­ra from Minneapolis 

Jim Tra­vers 

Lau­ra (MN): Study talked about low­er aca­d­e­m­ic per­for­mance around incin­er­a­tors. Seems like tests for learn­ing dis­abil­i­ties could real­ly sound some alarms for communities. 

Nor­ma: In Indi­ana, the data is straight off the State’s web­site — the Edu­ca­tion Dept. But scream­ing about it has not helped. Haven’t’ been able to get any­one to take action.

Lau­ra: Any racial disparity? 

Nor­ma: Pos­si­bly, most in S. Indi­ana are white. Have to have jobs even if they kill us. Worst pol­lu­tion to jobs ratio. Coun­ty with the 26% stat just vot­ed to add a sev­er­al bil­lion $ fer­til­iz­er plant to pro­duce < 20 jobs. Pro­po­nents claim that if dis­ease is from air pol­lu­tion, then rate should be going down because air pol­lu­tion has been going down over past so many years.  But the data is faulty. We don’t have real mon­i­tor­ing. Dis­ease rate going up. Can’t get peo­ple upset over it. Cul­ture in which we live. Check state ed dept. 

Paul (IN): I live near Nor­ma — we need more mon­i­tors, like EJN sent out about this past week. Cor­re­la­tion sta­tis­tics sug­gest the need for more mon­i­tors in key areas. Not enough cau­sa­tion stud­ies. Too much anec­do­tal evi­dence. We should be doing more studies.

Nor­ma: There’s poten­tial in satel­lite tech­nol­o­gy in track­ing par­tic­u­lates where mon­i­tors are polit­i­cal­ly dif­fi­cult to get in place.  Has been used in Mass­a­chu­setts to look at asso­ci­a­tion between PM2.5 and pre­ma­ture birth. Dou­ble bind because places with worst pol­lu­tion have least monitoring. 

? — Com­ment about sewage is per­ti­nent. Sewage has come far over last 50 years. Years from same sort of aware­ness about air. What’s in air will be in water, not fil­ter­able. Air and water share same envi­ron­ment. Where mer­cury is con­cerned, mer­cury in air will end up in soil and water.

Lar­ry: Can satel­lite mon­i­tor­ing dis­tin­guish size classes?

Nor­ma: Don’t know. 

Chris: Are pub­lic health agen­cies involved in the process and how?

Nor­ma: No — they focus on infec­tious dis­ease, sewage. envi­ron­men­tal pol­lu­tion usu­al­ly under sep­a­rate depart­ments which are not attuned to pub­lic health. Gov. of Indi­ana makes sure envi­ron­ment dept. takes care of envi­ron­ment, pub­lic health is some­thing else. 

Chris: Per­mit­ting is poor, esp. in regard to PM2.5. Offi­cials won’t com­ment on PM2.5 in these process­es. Are there resources for cit­i­zens to comment? 

Nor­ma: As for coal pow­er plants under­go­ing con­ver­sion — we had a fire last year but because of bud­get cuts it got approved with­out com­ments. No objec­tion to it, but this is typ­i­cal for indi­ana. No account­abil­i­ty. Until last 10–15 years, there appeared to be much progress. But not since takeover of indus­try over envi­ron­men­tal guidelines. 

Chris: This is the pat­tern, with indi­vid­ual states doing enforce­ment, there is no con­sis­ten­cy of envi­ron­men­tal enforce­ment. States can claim they are com­pli­ant. EPA defers to states like OR, then wash­es its hands. Med­ical pro­fes­sion­als have greater sta­tus than ordi­nary cit­i­zens though.

Nor­ma — I’m in a minor­i­ty as an advo­cate. Med­ical pro­fes­sion­als usu­al­ly don’t live in a place long enough. ? dis­ease among chil­dren increased 300% since ?

? — told not to talk about smoke stacks in IN. Pres­sure to keep qui­et is per­va­sive in our culture. 

Mer­cedes — Where can we see the pow­er­point? is there a video also?

Nor­ma:  Brief­ing pre­sen­ta­tion is at www.saveamercasforests.org

Josh: Will send link to video along with record­ing and notes.

? — how do par­ents get their information?

Nor­ma: We need to send the mes­sage that we can’t have more jobs for poor­er health. In the Hos­pi­tal I was employed at the indus­tri­al under­tow silences oppo­si­tion out of fear of los­ing a job or few­er jobs. This is true of past 5–10 years. Pol­lut­ing chil­dren to this degree to have jobs …

? — how about get­ting Prop­ub­li­ca or Front­line involved?

Nor­ma: Have not been able to get any­one to take this seri­ous­ly at the nation­al level.

Josh — Con­tin­u­ing to speak up will help. 

Nor­ma — 20,000 doc­tors in Mass­a­chu­setts vot­ed that bio­mass is a human health risk. Can’t get this many doc­tors to agree to any­thing. Just a mat­ter of ? Doc­tors are less advo­cates than they used to be. They told me my busi­ness would suffer.

Jim Tra­vers — Cement plant across from high school, 400 lb mercury/year. Paid close atten­tion to fine par­tic­u­lates. Epi­demi­o­log­i­cal stud­ies scarce. Sick chil­dren make good busi­ness, oppo­si­tion hurts busi­ness. Some of these plants are main eco­nom­ic engines in these areas. Would be great to have an ani­ma­tion of a cubic meter of air, what’s in it, what it does. any­thing like back­yard buck­et brigade?

Nor­ma: Pro­duc­ing this and get­ting it on nation­al TV might wake peo­ple up. Ultra­fines are relat­ed to sur­face area.

Jim: These pass through blood brain and pla­cen­tal bar­ri­ers. Need to look at eco­nom­ics. EPA arbi­trar­i­ly delayed regs. 

Nor­ma: CAA alone has 40:1 pay­out on health­care ben­e­fits. Past Gov Mitch Daniels called indus­try the “employ­ment pro­vi­sion agency”? …?

Jim: Regs not strin­gent enough?

Nor­ma: EPA has got­ten over­rid­den by last few admin­is­tra­tions, ergs unglued by the exec­u­tive branch.

Josh: Time to wrap up. thanks again to Nor­ma and every­one. 1st Thur of every month. Role of wild­fire in ecosys­tems next month. 

End of call. 


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