California Asthma Summit December 5-6: Putting Research into Practice

We thought SF Bay Area PSR members might be interested in this exciting Summit!

California Breathing, the asthma program of the California Department of Public Health, will be holding the department’s biennial asthma research summit on December 5-6 in San Francisco. The aim of the summit is to bring together leading experts in asthma and asthma-related topics, to connect, discuss new research, and develop future strategies for addressing the burden of asthma. The summit will highlight both research and how it is translated into interventions, clinical practice, and policy. Physicians, nurses, researchers, asthma advocates, health educators, policy makers, and environmental health advocates are all encouraged to attend (CME and CEU credits available).

This year’s summit will include many exciting speakers. Much of the first day will focus on outdoor air pollution – from new research on how pollutants affect asthma at the cellular level to the global effects of climate change. Other speakers will discuss local efforts to reduce air pollution, including both government and grassroots programs. The second day will cover the latest research on indoor air quality, as well as interventions that aim to improve housing conditions for people with asthma. In addition, there will be sessions focused on psychosocial stressors, clinical tools, genetics, work-related asthma, obesity, and even the hot topic of acetaminophen and asthma.

For more information, visit http://www.asthmaresearchsummit.org/.

Conference sponsors include the American Lung Association in California, Bay Area Air Quality Management District, Children’s Hospital of Oakland, and RAMP.

Kaiser Permanente Hosts “Weight of the Nation” Event

On April 26^th, Kaiser Permanente hosted a screening of one segment of Weight of the Nation, a documentary series that premiered on television in May. The series is a collaboration between HBO and the Institute of Medicine (IOM), in association with the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), and in partnership with the Michael & Susan Dell Foundation and Kaiser Permanente. Weight of the Nation highlights the variables that contribute to the obesity epidemic in this country, one of which is an unhealthy food system and the ways that food is produced, processed, marketed, and distributed. Lucia Sayre, SF Bay Area PSR Co-Director, commended the series for highlighting the link between nutrition and environmental health. Weight of the Nation highlights many of the healthy food issues SF Bay Area PSR addresses in the Healthy Food in Health Care campaign. The series features several of SF Bay Area PSR’s partnering organizations, including Health Care Without Harm (HCWH), as well as professionals and experts with whom HCWH works.

Approximately 500 people attended the Kaiser-hosted screening, which was held at the Oakland Museum and featured a panel discussion and Q&A session. Dr. Preston Maring, who works closely with SF Bay Area PSR, praised the chapter for its coordination of the regional produce sourcing project with Kaiser Permanente and the Community Alliance with Family Farmers. In the Q&A session, Dr. Bob Gould highlighted Dr. Jeff Ritterman, SF Bay Area PSR Vice-President, for his work introducing a soda tax in Richmond. Click here to view a video (scroll down to April 26 post) of the panel discussion and Q&A.

HBO has 40,000 kits available, including DVDs and accompanying materials, for people to host house parties where they can screen the documentary and stir up community conversation about healthy eating.

Dr. Peter Joseph’s Response to New York Times Letter to the Editor on Nuclear Power

The letter below was written in response to the New York Times Letter to the Editor “Invitation to a Dialogue: Using Nuclear Energy.”  Dr. Joseph submitted his response, but it was not published.

Re: Invitation to a Dialogue: Using Nuclear Energy

Why is it that nuclear proponents always cite our seemingly insatiable demand for more energy while never mentioning its elasticity, the potential for massive improvement in efficiency of use, and the potential for a revolution in production and distribution of clean energy? Posing as “realists” they invariably overstate the arrogant assurances that “this time it will be safe,” the waste can be safely managed, and no bombs will grow stealthily from the fuel stream. Tell that to the Israelis now nervously fingering the safeties on their nukes as Iran, under the guise of wanting clean nuclear electricity, builds its reactors, also known as bomb factories. This world does not need more Plutonium floating around, even with Bin Laden at the bottom of the Indian Ocean.

Each nuclear power plant costs around $10 billion, and counting inevitable cost and time over -runs, takes a decade to build. Oh, has anyone figured out how to take one apart yet? How is that financed? We don’t have that kind of time according to the climate scientists and the IEA, who give us just a few years to get it right. Besides, who wants one one in their neighborhood? Can you imagine in a post-Fukushima world what a new nuke would do to property values over wide area? The Realtors alone would go crazy.

Now that the public is not so naive and gullible about nuclear power’s too-cheap-to-meter amazing benefits, it’s renaissance faces high hurdles without massive public subsidies. If it’s so great, let the “free market” work its magic without government (i.e. public) loan guarantees, and while we’re at it let them pay their own malpractice insurance, like I do, by getting rid of Price-Anderson. Why then not give those subsidies to a nascent industry that actually deserves it so that we –modern civilization — can live like every other creature on this planet: within its energy budget. Spend those billions on renewables, ignite a clean tech revolution in the US before we are eating out of the bowls of the Chinese tech industry.

Given that there is not enough money in the universe to build enough nukes to make a serious dent in carbon emissions, the real choice is between nukes and energy efficiency/renewable investments to stimulate rapid deployment of distributed clean energy production. I vote for clean and green, and if I have to reduce my consumption, well, after Pearl Harbor Americans did so willingly to support the war effort. Apparently that felt good according to folk lore. This IS war. It’s a war on carbon. A war for  survival of civilization as we’ve come to know it. Let’s not let our great civilization become too lazy to fail.

Put a steadily rising price on carbon, refund the money to households, get rid of subsidies to fossil industries and unleash the massive amounts of corporate cash just waiting for the Next Big Thing. The old nukes are just not ready for their come back. Try again when their next generation is ready for prime time.  Locate the first one on The National Mall and the second in Central Park. Then we shall see who’s the fairest of them all.

Peter G. Joseph, M.D.
San Anselmo, CA

Mercury Exposure Investigation

Several SF Bay Area PSR chapter members and Steering Committee member Dr. Gina Solomon were recently involved in an investigation of mercury exposures in California and other states. The investigation was triggered by the discovery that a local family was mercury poisoned by a skin cream imported from Mexico. These creams are sold to lighten the skin and reduce age spots and acne, but they are illegal in the United States and can cause serious health effects, especially in children. The investigation eventually spread to Virginia, where additional cases were uncovered. The investigation was a collaborative effort with the California Department of Public Health, Alameda County Health Department, faculty at the UCSF Pediatric Environmental Health Specialty Unit, and others. Health care providers in California should be aware that patients can be mercury-poisoned from use of imported skin care products, and should screen for this possibility in their patients. Mercury causes subtle neurological symptoms including fatigue, difficulty with memory and concentration, and peripheral neuropathy. Infants exposed in utero can have serious delays in neurodevelopment.

Click here to read the write-up in MMWR
Click here to read and print the California Health Alert in English and Spanish

Dr. Robert Gould’s Oregon Speaking Tour

Dr. Robert Gould, SF Bay Area PSR President, gave several talks in Oregon in November, part of a grant-supported effort allowing members of the National PSR board to travel to selected regions around the country to speak on nuclear weapons issues.  In his talks, Dr. Gould covered legacy issues of nuclear weapons dating back to the dropping of the bombs in Japan, including the public and environmental health impacts of nuclear weapons development on local communities, and the profound budgetary costs of the nuclear arms race to date. Dr. Gould also explored the contradiction between President Obama’s stated desire to rid the world of nuclear weapons and his Administration’s planned marked expansion of expenditures for the U.S. nuclear weapons program, as well as the problems for safety and proliferation posed by the Administration’s commitment to expand nuclear power worldwide. In this context, Dr. Gould explained how an unfolding U.S.-India nuclear deal would increase the nuclear arms race within South Asia and negatively impact the Administration’s stated goal to control the fissile materials that could lead to the proliferation of additional states’ nuclear weapons programs and increase the risk of nuclear terrorism. Dr. Gould also underscored the lesser-known global impacts of even a regional nuclear war between India and Pakistan that would directly kill millions of people, including recently published predictions of ensuing “global cooling” that could cause over 1 billion deaths due to worldwide malnutrition.

The three talks took place November 17^th and 18^th in Portland and Eugene, OR. His first talk in Portland at Oregon Health Sciences University (OHSU) was entitled “Public and Environmental Health Impacts of Nuclear Weapons.” This Grand Rounds presentation was cosponsored by OHSU’s Global Health Center. Approximately 50 people were in attendance, the majority of whom were medical students, and 30 signed up to work with Oregon’s PSR chapter. The talk was well received and available as a simulcast webinar around the country, and helped to solidify the relationship between the Oregon PSR chapter and OHSU’s Global Health Center, which will aid in reaching future students on these important issues. Click here to hear listen to the talk and view the power point Dr. Gould shared.

That same night, Dr. Gould gave a talk to a small group of people in Portland at the home of Oregon PSR President Dr. John Pearson.  In addition to the topics mentioned above, Dr. Gould shared developments from the national Board meeting, including ongoing discussions regarding the challenges of reaching young physicians, health professionals and medical students on nuclear war issues.  He pointed to the fact that many younger professionals are apparently more focused on the types of social justice issues that are captured in the Occupy Wall Street movement around the country and less compelled by nuclear weapons concerns.

The following morning, Dr. Gould appeared as a call-in guest for an hour on Jefferson public radio, a station that reaches southern Oregon to northern California.  Dr. Gould spoke on the issues he covered at his previous talks and also answered listeners’ questions regarding a full range of nuclear weapons and nuclear power issues. Click here to hear his talk (begins at minute 5:52).

Later that night, Dr. Gould gave a talk entitled “Nuclear Weapons: The Ultimate Health Threat” at the First United Methodist Church in Eugene. This talk was sponsored by Women’s Action for New Directions (WAND) and Community Alliance of Lane County (CALC) and was attended by approximately 25 people. Beyond the rich discussion that underscored the imperative of nuclear abolition, a number of questions that came up focused on PSR’s position on nuclear power. Dr. Gould addressed the organization’s extensive work on opposing the nuclear “renaissance” that has accelerated since the disaster at Fukushima, including numerous media appearances by many National PSR members throughout the country.

Exciting Developments from the National PSR Board

Dr. Robert Gould, SF Bay Area PSR President has also been a member of the national PSR Board since 1993. Upon returning from the most recent Board meeting in Washington, DC, he shared some exciting developments on the national level that impact the local SF Bay Area chapter:

“First, Dr. Catherine Thomasson has been appointed PSR’s new Executive Director.  She shares our chapter’s view regarding the importance of a deeper involvement on a range of social justice issues. She also has a great deal of experience with environmental health work that is developed by and oriented toward PSR chapters. Examples of this type of work in our own chapter include SF Bay Area PSR’s partnership with Health Care Without Harm and collaborations with medical and public health associations as central mechanisms for advancing a wide variety of environmental health issues, and for organizing new physicians and other health professionals into our work.  SF Bay Area PSR would expect support for efforts such as these, as well as expanded efforts in which our chapter can provide leadership in organizing other chapters into these projects, and help provide the programmatic basis for chapter development in regions that currently do not have a strong PSR presence. (Click here to read more on Dr. Thomasson)

The Board discussion also included  support for better meshing of our Security and Environmental Health programs with Social Justice issues that have become increasingly prominent in the midst of unfolding national and global economic crises. This integration is strongly supported by incoming President Andy Kanter as a way to facilitate the organizing of younger physicians and medical students. It will make clear the connections between our declining health and social fabric and PSR’s traditional work on nuclear weapons, the military budget and the national and global costs of the arms race.”

Interview with Lena Brook, Outgoing Senior Program Associate

By Emily Galpern

What have been the highlights of your work at SF Bay Area PSR?

I’ve been with SF Bay Area PSR for 5½ years and have enjoyed immensely working with the “Healthy Food in Health Care” Campaign.  I was brought on as the northern California coordinator of that work.  One of most gratifying experiences has been to see this campaign grow and evolve and to see how much Lucia and I have provided leadership both locally and nationally. When I first took this job, we had a lot of explaining to do about why a health care facility should engage around food; now they come to us! Or, if we approach them, it’s for much more higher-level discussions; the foundation has been set, both by us and because there has been an explosion of media coverage and education around food issues in this country.

Lucia and I have tried to seed a lot of interesting projects in the SF Bay Area and to bring it to our colleagues in other parts of country. We partner with hospitals, who then pilot these projects, and we get to see the projects grow. The “Balanced Menus Challenge” is a perfect example of what one small organization can do locally that gets picked up by a broader range of allied interests: it can really change the discussion and amplify the work in a powerful way.

How do you see the role of physicians in this work?

I think that the connection between food and health outcomes is still tenuous for a lot of people working in the health care sector. There’s a tremendous amount of work to be done to connect the operational home for food service with the clinical side of a health care institution. This disjuncture is slowly being bridged at health care facilities.

Clinicians have a powerful role to play in that integration. PSR’s “Food Matters” is a perfect illustration of how clinicians can impact health care facilities’ approach to food. Clinicians, including doctors, nurses and dieticians, have a lot of power in a health care institution. When doctors want something, the administration pays attention, whereas, unfortunately, Food Services Directors won’t necessarily be heard. Clinicians can be advocates at their respective institutions and make reform toward sustainability a much easier path. They also have a broader role to play as food systems advocates in the way they interact with their own patients around food issues and the way they engage with their communities.  Kaiser Permanente’s Dr. Preston Maring is a perfect example of how a doctor can contribute to a hospital’s approach to food.

Food Matters provides the opportunity for physicians to speak in an informed way on food in the public policy arena and to media. I’d love to see dozens of doctors speaking on these issues.  PSR has incredible power to help realize this vision because they have an extensive network nationally, due to their regional members and contacts. I have a lot of faith that as Food Matters takes off, there’s going to be a great opportunity for PSR to assert itself.

What are your hopes for the organization?

I would love to see PSR’s capacity to mobilize the clinical community grow and expand and for them to own this subset of advocacy. With health care reform on the horizon, and prevention at core of that reform, we’re going to see a radical shift in the health care sector, and food will hopefully be at the center. PSR is really well positioned to assert itself as a leader.

Do you have any last words to share?

I’ve really appreciated working with everyone who I have met at and through SF Bay Area PSR. Their commitment and dedication is impressive. They’ve been at it for a long time, and they don’t lose that spark, the fire in their commitment, which I find amazing. I’ve deeply appreciated the supportive environment that PSR offers for its employees, especially for parents of young children. It stands out to me as being fairly unique. I am grateful for a positive experience, and I look forward to working with the SF PSR team again one way or another the future.

Appreciations from SF Bay Area PSR Board and Staff

Dr. Bob Gould, SF Bay Area PSR President says, “Lena has done such exceptional work with PSR, and I really appreciate the major accomplishments she’s left for us to build on. Her work in partnership with Lucia Sayre on “Healthy Food in Health Care” has been groundbreaking, both on its own obvious merits as well as how it fits into our climate change efforts to reduce hospitals’ environmental footprints. I want to underscore that the results of Lena’s work have not just accrued to the SF Bay Area chapter of PSR, but have been groundbreaking for our organization nationwide. I wish Lena the absolute best in all of her endeavors.”

SF Bay Area PSR Co-Director Lucia Sayre says, “Lena has been a pleasure to work with over the past 5 ½ half years. She is a passionate, smart, and creative organizer who cares deeply about the health of our food systems. During her years at SF Bay Area PSR, Lena led several collaborative efforts in our food work, such as the “Balanced Menus Challenge” and the “Hospital Leadership Team,” that have emerged as models for the national “Healthy Food in Health Care” campaign. She also helped to cultivate many important relationships with key partners and organizations throughout the state of California and nationally that will benefit our sustainable food in health care work for years to come. We will miss her at SF Bay Area PSR and wish her well in her next adventure.”

Kaiser Highlights Environmental Health Work

On November 8^th, Dr. Robert Gould spoke at Northern California Kaiser Permanente’s Environmental Stewardship meeting, which was attended by Kaiser Northern California regional administrators, as well as numerous doctors and other health professionals active on local green teams in their hospitals. Dr. Gould presented at an afternoon break-out session, speaking on the predicted health consequences of global warming, and the related work of mitigating impacts of climate change in the health care setting, as illustrated by the work of the Climate Change Literacy Consortium and Healthier Foods in Health Care campaign led by the partnership including PSR and Health Care Without Harm (HCWH).  A representative working on developing Kaiser’s commitment to alternative energy spoke at the same session, and indicated that Kaiser will announce its new energy plan as a system-wide imperative in the coming days. The break-out session discussion included all of the creative endeavors that Kaiser is currently engaged in through its leading role in the Healthy Hospitals Initiative, within which SF Bay Area PSR/HCWH projects such as Food Matters play an important role. On November 9, Kaiser’s News Center feature story highlighted Kaiser’s great strides on these issues, including coverage of its creative partnerships with PSR, HCWH and UCSF’s Program on Reproductive Health and the Environment (PRHE) regarding sustainable food guidelines and initiatives.

SF Bay Area PSR Supports Six Environmental Health Resolutions Passed by the California Medical Association

Following is a summary of a number of the environmental health resolutions passed by CMA at the House of Delegates Meeting October 17, 2011. Click here for the text of the final resolutions, including the preambles (which are not part of the final CMA policy).

To view a more comprehensive and historical list of environmental health resolutions passed by medical and public health associations, click here for a compilation posted by UCSF’s Program on Reproductive Health and the Environment.

The following resolutions were passed at the California Medical Association House of Delegates (HOD) meeting October 17, 2011. SF Bay Area PSR President Dr. Robert Gould serves as a delegate from the Santa Clara County Medical Association to the HOD, and in this capacity has worked with members of his delegation to introduce and support many of the environmental and public health-protective policies adopted by CMA over the last 15 years.

Healthy Fast Food Children’s Meals: recommends chain restaurant adherence to appropriate nutritional standards for meals that are marketed specifically to children; that meals marketed to children should adhere to healthy guidelines in accordance with the best available evidence and/or well-researched national nutrition standards.

Healthy Food Marketing for Children: supports efforts to regulate the advertising and marketing of unhealthy food and beverages to children; discourages the advertising and marketing of unhealthy food and beverages in public places frequently visited by children or adolescents; encourages media education programs to reduce harmful health influences of food and beverage marketing to children and to promote the consumption of healthy foods.

Healthy Agricultural Practices: supports the development of healthier food systems through federal farm subsidies and legislation; supports healthy agricultural practices.

Nanoparticle Testing, Monitoring and Regulation: recognizes both the benefits and the potential risks to public health and the environment from the widespread use of nanoparticles; endorses responsible regulation of existing or new nanoparticles prior to their introduction in industrial or consumer products.

Triclosan Antimicrobial Soap: recognizes the toxicity and potential adverse health and environmental effects of Triclosan-containing products and endorses efforts to eliminate this chemical from consumer and health care products; encourages the Food and Drug Administration to finalize the antimicrobial monograph first drafted in 1978 and updated in 1994; encourages the education of members on the issue of the importance of proper hand hygiene and the preferential use of plain soap and water or alcohol-based hand sanitizers in health care settings.

Nuclear Power Plant Safety: calls upon the Nuclear Regulatory Commission to expeditiously implement the recommendations of its Japan Task Force report; encourages the Nuclear Regulatory Commission and other oversight agencies to apply new technologies that will assess seismic risk prior to any licensing renewal of nuclear plants.

Food Matters Webinar Series

PSR, in collaboration with the American Medical Association, Health Care Without Harm (HCWH), and Kaiser Permanente, presented a free national webinar series for physicians and other health care professionals through the Food Matters Program. SF Bay Area PSR President Dr. Robert Gould moderated each of the three webinars. Approximately 80 people attended each webinar, comprised primarily of dieticians, but some physicians from around the country participated as well.

The following topics were presented: 1) Clinical Guidance to Help Your Patients Make Healthier Food Choices; 2) The Role of the Environment and How to Promote Greener and Cleaner Food for Maternal and Child Health; and 3) The Role of Physicians and Other Health Care Professionals in Creating a Healthier Food System.

Participants were able to receive CME credits for participating, and those who did not participate in the live webinars can also receive CME credits by listening to them online for up to 1 year.

The webinar series is part of the larger Food Matters project, which was launched as a pilot program in the last year. SF Bay Area PSR is one of the coordinators of the nationwide program and developed the curriculum  with HCWH and the Program on Reproductive Health and the Environment at UCSF.  Lucia Sayre, SF Bay Area PSR Co-Director, said, “The project has ballooned. We were initially only going to offer three half-day in-person trainings in Oakland, Boston, and Philadelphia, but we now have trainings scheduled for Portland, OR and Grand Rapids, MI, and already hosted a Grand Round series in Oakland. In 2012, we plan on translating our curriculum into Spanish to offer it as part of Promotoras (community health workers) trainings. People are clamoring for this information. Once they hear about this kind of curriculum and training opportunity, there’s a great deal of interest. It’s a fairly new topic.” For more information about Food Matters, click here.