2021 Big Visions, Bigger Accomplishments

Despite year two of the pandemic, PRHE and the EaRTH Center achieved some major milestones in our research, policy work, education, and communications.

PRHE’s Navigation Guide establishes largest global burden of occupational disease

In May 2021, the World Health Organization / International Labour Organization (WHO/ILO) Joint Estimates on the global health burden of working long hours released its ground-breaking study which showed for the first time a 17% increase in risk of heart disease and a 34% increase in risk of stroke for those working 55 hours/week or more. This occupational risk factor went from zero to the biggest burden of disease globally because of the ability to evaluate and estimate the evidence.

Dr. Tracey Woodruff served as a technical advisor on the study and WHO/ILO used PRHE’s Navigation Guide systematic review methodology to evaluate the evidence. This led to an editorial by the New York Times of the importance of addressing the burden of long work hours that can disproportionately affect lower income countries and has led to global press coverage across ~180 news outlets. Robust evidence evaluations are essential for policymakers to shape policies that protect public health.

Ensuring EPA utilizes science to protect health

As EPA evaluated chemicals under the Toxic Substances Control Act (TSCA), it adopted a systematic review method to evaluate the evidence that essentially allowed the Agency to ignore studies the chemical industry complained about, such as evidence that TCE harmed children’s developing hearts. Fortunately, we have been monitoring these actions closely. After a National Academies of Sciences report found the TSCA method had alarming deficiencies and EPA failed to publicly release its new TSCA systematic review method for evaluating the ongoing risk evaluations, we briefed policymakers.

This led House Committee on Science, Space & Technology Chair Rep. Eddie Bernice Johnson to send a letter to EPA chief Michael Regan asking when the Agency will release its updated TSCA method – and recommending that EPA consider using PRHE’s systematic review method. Rep. Johnson’s letter is an important step in holding EPA accountable to the law and its mission to protect health and the environment. We are continuing to monitor EPA’s actions on this front as they underpin all efforts to protect populations disproportionately affected by harmful chemicals.

Unlocking environmental mysteries to disease

We are part of two major initiatives that we anticipate will reveal environmental mysteries to cancer and endometriosis. 

Discovering cancer Risks from Environmental contaminants And Maternal/child health (DREAM)

PRHE researchers are partners in phase one of a $14 million grant from the National Cancer Institute that will examine how pollutants increase cancer risk by comparing a racially and economically diverse group of pregnant women and children in the San Francisco Bay Area to those who live in California’s Central Valley, a community of primarily low-income Latinx disproportionately impacted by pesticides and other toxic chemicals. In collaboration with UCSF adjunct professor and epidemiologist Peggy Reynolds, PhD, MPH, the DREAM study will examine the effects of about 200 chemicals on health and pregnancy, including mixtures of exposures to phthalates, pesticides, air pollutants, and contaminants in water, to get a better sense of real-world experiences and exposures.

This research is supported by the National Cancer Institute of the National Institutes of Health under Award Number UG3CA265845. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

UCSF Stanford Endometriosis Center for Discover, Innovation, Training, and Community Engagement (ENACT)

To improve endometriosis diagnosis and treatment, and better understand the origins of a debilitating and painful condition that affects millions of women, UCSF is partnering with Stanford University to launch the NIH-funded ENACT Center. Spearheaded by PRHE founder and UCSF ob-gyn Linda Giudice, MD, PhD, the new center will explore the environmental influences of a disease that is 50% genetic and 50% environmental, work to improve diagnosis and treatment, and help to address endometriosis-related health disparities. Dr. Woodruff is among the multi-disciplinary team of investigators, educators, and community representatives who will make these goals a reality. 

Connecting the dots on pregnancy and climate

Our efforts to collaborate with health care professionals on how environmental factors affect their patients’ health reached a new milestone. Dr. Woodruff was a coauthor of a special article highlighting the “impact of the climate crisis on human reproduction and the fundamental risks it poses to the very continuation of our species,” published in the International Journal of Gynecology & Obstetrics.

Released just prior to COP26, PRHE helped elevate this work by coordinating a social media campaign with multiple international partners to ensure the climate impacts on women’s reproductive health were on the climate leaders’ radar. Led by Linda Giudice, MD, and new International Federation of Gynecology and Obstetrics (FIGO) President Jeanne Conry, MD, the article detailed how climate, chemicals, and fossil fuels are connected, how the impacts disproportionately affect women of color and vulnerable communities and threaten the future of humanity, and encourages OBGYNs to “raise awareness, educate, and advocate for mitigation strategies to reverse climate change affecting patients and families.” 

Elevating environmental justice

As we confront environmental threats to human health – climate, chemicals, plastics, and pollutants – that disproportionately impact communities of color, the EaRTH Center developed two initiatives to help health care professionals explore systemic solutions and alleviate harms:

  • Environmental Justice Mini-Medical School series to examine environmental contributors to human health and disease through the lens of vulnerable populations. The series engaged more than 100 health professionals and community members in identifying solutions and advocating for change. 
  • The Environmental Scholars Program supporting medical and nursing students as they research solutions to community-based environmental health problems. Four awardees are working on projects such as helping the Bayview Hunters Point Community Advocates support people who live in a contaminated neighborhood, researching the impact of wildfires on pregnancy (a growing problem given climate and droughts), and mapping power grids to help low-income communities access solar power and other clean energies.

Discovering more methylene chloride deaths than EPA acknowledged

Methylene chloride was killing people and EPA was failing to act. Prior to this year, PRHE was one of several environmental health groups that raised awareness on the dangers of methylene chloride, which helped to pressure major retailers like Lowes and ACE Hardware to remove the toxic paint stripping chemical from their store shelves. Soon after, EPA restricted the chemical for consumer use, but continued to allow it for occupational use, leaving workers vulnerable.

PRHE investigated further. Led by UCSF medical student and PRHE fellow Annie Hoang, MD and then-PRHE Science & Policy lead Veena Singla (now at Natural Resources Defense Council), the study revealed that there were far more worker deaths due to methylene chloride exposure than EPA had acknowledged – and that deaths from this toxic chemical were on the rise. The study generated major news coverage and helped make the case for EPA to update the rule and protect workers from methylene chloride.

We have grown – again!

After hiring 6 new people in 2020, we continued to expand our team in 2021. Please welcome new Science & Policy Team Research Analyst Dr. Chanese Forte, Research Team Coordinator and doula-in-training Ariel Eastburn-McCormick, and Science & Policy Coordinator Andrea Phillips. We also want to congratulate PRHE staff who were promoted this year, including Courtney Cooper, who moved from research coordinator to Science & Policy analyst, Anne Sausser who moved from Science & Policy administrator to communications coordinator, and Allison Landowski, who moved into a higher Data Systems Analyst position. Our entire team is producing amazing work and we are so proud of them.

Thank you

Our 2021 accomplishments would not be possible without our funders and partners, who we thank for their commitment to this work, environmental health, and protecting everyone from harmful chemicals.

Wishing you warm and wonderful holidays and a Happy New Year!