Health & Science
Biomonitoring: A New Way to Look at Health Policy
Could your surroundings impact your health as much as your diet, genetics, and lifestyle? The field of environmental health seeks to understand how the natural and manmade elements of our homes, work, and leisure environments impact health. To understand environmental impacts on health, experts examine a tremendous range of factors from community noise levels to the availability of public parks; some even look at dust.
I know that seems strange, because when you look at dust, I’m sure you probably see nothing but unsightly grime that makes you sneeze. But when researchers at the California Department of Toxic Substances Control look at dust, they see a possible indicator of chemicals people might be exposed to from various synthetic materials commonly found in homes.
Dust holds clues to multiple facets of your domestic life. Companies use an array of chemicals, including flame retardants, to manufacture your appliances, furniture, and even curtains. Your appliances, furniture, and curtains also contribute to the powdery detritus obscuring your coffee table. Dust offers researchers a way to investigate the holistic chemical composition of the average home atmosphere, all from the contents of a vacuum cleaner.
So why do we spend time studying dust and hundreds of other tiny environmental factors? Well, the experts in the University of Michigan video below estimate that 25-33 percent of disease globally stems from our environments. If we understood what specifically caused that percentage, we could take the first steps toward developing interventions.
With so many aspects to consider, it’s hard to make a solid connection between one environmental factor and a health outcome. But solid connections do make for golden evidence in influencing policy decisions that promote better health outcomes. A relatively new science called biomonitoring could help environmental health scientists make those golden connections by linking a pollutant directly to a health problem.
What is biomonitoring?
Biomonitoring quantifies bodily absorption of pollutants by measuring chemical amounts in human specimens like blood or urine. In the dust example mentioned above, researchers could incorporate biomonitoring by comparing the chemical composition of dust samples with the chemical levels present in residents’ blood or urine samples. This would allow them to look beyond what chemicals are present and find out if people are actually absorbing them, since atmospheric presence doesn’t automatically indicate absorption.
For example, an elemental mercury spill in a Massachusetts school caused panic when air samples revealed high mercury vapor air levels after the initial clean up. The Massachusetts Department of Public Health responded to the panic by offering urine tests. It turned out they had nothing to worry about–none of the samples indicated elevated urine mercury levels.
We worry about chemical levels in the environment because of what they might be doing to human health, but they need to be absorbed in order to cause harm. Environmental health scientists can bypass the need to study the presence of environmental pollutants one by one, by using biomonitoring to directly assess human impact. Outside of individual cases, cross-population biomonitoring data could reveal locations with disproportionate chemical exposures, a red flag that something fishy is going on.
According to the Association of Public Health Laboratories, manufacturers in the United States use more than 100,000 chemicals, yet we don’t understand what they could all do to human health. Combine this uncertainty with the rise of chronic diseases and you have a concerned public that demands many answers. Biomonitoring strives to find out which of these 100,000 chemicals make it into our bodies so we can figure out what to do about it.
How can biomonitoring affect health policy?
In the 1970s when researchers discovered that lead exposure could cause serious health problems, the U.S. implemented laws to bar it from many products like food cans, paint, and gasoline. Biomonitoring through blood testing has confirmed decreased blood lead levels since the laws were enacted, but also pointed out that low income and minority children still have levels above the CDC safe reference value, with lead in housing being the major source. After hearing these results, officials looked to housing policies as a way to decrease the problem:
- The U.S. Department of Housing and Urban Development (HUD) and the U.S. Environmental Protection Agency (EPA) required landlords to disclose lead hazards in all residences built before 1978.
- HUD made lead safety mandatory for federally funded housing and created grants for removing lead hazards from current buildings.
- The EPA began regulating painting and repair practices in all residences built before 1978.
These efforts achieved lower levels of lead hazards in government-funded housing, but did little to decrease levels in low-income or non-assisted housing.
At the state level, officials focused on finding children with elevated blood lead levels and then tried to remove lead from their environments. Some states, including Maryland, Massachusetts, and Rhode Island, implemented more prevention-based laws, but many still struggle with compliance.
To respond to a high concentration of children with elevated blood lead levels, Philadelphia officials combined public health with law in the Philadelphia Lead Court. The court was designed to increase compliance of city health codes related to lead hazards. If the court hears of a lead hazard, it issues an order to the property owner to remedy the situation. If they don’t complete hazard control activities, they’re sent to the Lead Court.
Before the court, property owners complied with lead regulations seven percent of the time. After the court was established, the compliance rate spiked to 77 percent.
These intervention successes were made possible through biomonitoring, and the connections between health and a contaminant that it revealed.
Biomonitoring and Fracking
Hydraulic fracturing (or fracking), a new and unconventional method for extracting natural gas, poses a possible health hazard to the people who live closest to fracking wells. Self reports show a disproportionate amount of respiratory problems like itchy eyes, coughing, and nose bleeds among people living near fracking wells.
In this New Haven Register article, researcher Dr. Peter Rabinowitz summarizes the limitations of this self-reported data:
It’s more of an association than a causation. We want to make sure people know it’s a preliminary study. … To me it strongly indicates the need to further investigate the situation and not ignore it.
Use of biomonitoring in this instance could provide more clarity on which chemicals are present and could be causing health problems in the residents. A doctor from Aspen Integrative Health in Colorado has already tested some people who live close to drilling sites for chemical exposures. His results showed some elevated levels, but didn’t provide any conclusive links. The results could serve as a baseline comparison for other communities wishing to test residents.
The new federal rules on fracking don’t include any biomonitoring measures, but they take small steps toward understanding the possible health effects of fracking by requiring more care and accountability from drilling companies. Per the new rules, government workers can inspect fracking wells for safety, companies will have to tell the public what chemicals they use in their extraction processes, and companies will have to abide by new rules on chemical storage and disposal of flowback water.
The future of our health depends on our ability to make connections as we constantly introduce new chemicals into our lives through food, construction, manufacturing, and more. Environmental health scientists, supplemented by biomonitoring, work to make those connections in the hope that their findings will result in legal and policy decisions that keep people healthy.
Daunting as achieving these connections may be, daily advances, like this new University of Miami instrument to detect atmospheric mercury, bring us closer to understanding the interaction of our environment and our health. If we encourage advances in biomonitoring and other new technologies, all the vague correlations of the past could become solid connections.