Chemicals Policy Development

Understanding the Need

There is growing scientific evidence that chemical exposures are contributing to many of the critical and chronic diseases and conditions now being addressed by our healthcare system, including obesity, diabetes, learning disabilities, cancers, and infertility--to name a few. Even more alarming is  relatively new science suggesting that for some of these chemical to have effect, the doses are miniscule--measured in micrograms or nanograms or parts per trillion. While we know alot about some of these chemicals and very little about others, we know almost nothing about how or if these chemicals interact synergistically with each other. And since most of us don't live in a bubble or a test-tube, we are typically exposed to hundreds if not thousands of different chemical compounds each day in the air we breathe, the water we drink, the food we eat and the substances we come into contact with through work, personal hygiene or home use. What we do know is that the availability of scientific data on certain chemicals is lacking. And that in many cases, we can't even determine the ingredients or components of a particular product because the manufacturer doesn't list them--either because it is not required or considered "proprietary information". The current chemicals policy framework in the United States is broken and is not appropriately protecting human health.

Historically,  Practice Greenhealth and many other sustainability organizations have taken a “chemical-by-chemical” approach to toxicity avoidance and reduction.  In healthcare, much of the initial focus was on mercury elimination, then polyvinyl chloride and phthalates took center stage, followed by a slow push for minimization of chemicals with serious worker exposure risks such as ethylene oxide (EtO) and glutaraldehyde, and most recently--pharmaceuticals. As evidence mounts that chemical exposures are taking a growing toll on the health of the population, it makes sense to move beyond this piecemeal approach to create a broader chemical policy where multiple chemicals can be addressed when identifying safer materials for building materials, medical devices, supplies and furniture. Healthcare, with its tremendous buying power and its mission to "first, do no harm", is perfectly positioned to begin the dialogue around substantive chemicals policy development.

What is TSCA?

The U.S. federal government has been lax in overseeing chemical safety for many years.  At the same time, its European counterparts have surged forward with a number of pieces of legislation aimed at better protecting human health from chemical exposures--the hallmark being REACH (Registration, Evaluation and Authorization of Chemicals). The last major piece of legislation regulating chemicals in the United States was passed in 1976, and called theToxic Substances Control Act (better known by its acronym, TSCA--pronounced 'toss-ka').  Many organizations, including Practice Greenhealth’s sister organization Health Care without Harm, are calling for regulatory reform to update TSCA.  The American Academy of Pediatrics (AAP), issued a strong policy statement in April 2011 recommending chemical management policy overhaul in the United States, stating:

[TSCA] is widely recognized to have been ineffective in protecting children, pregnant women, and the general population from hazardous chemicals in the marketplace.It does not take into account the special vulnerabilities of children in attempting to protect the population from chemical hazards. Its processes are so cumbersome that in its more than 30 years of existence, the TSCA has been used to regulate only 5 chemicals or chemical classes of the tens of thousands of chemicals that are in commerce...chemical-management policy needs to be rewritten in the United States.be revised to protect children and pregnant women and to better protect other populations."

The Safer Chemicals Healthy Families Coalition explains the shortcomings of the current TSCA regulation on their website:

• Americans assume that chemicals used to make products like toys and food containers sold in the U.S. are regulated and tested for safety — but they are not.
• When passed into law, TSCA approved more than 60,000 chemicals that were in existence prior to 1976; only 200 of the original 60,000 chemicals have been tested for safety; some uses of only 5 of these toxic substances have been restricted.
• Today there are more than 80,000 chemicals on the market which have never been fully assessed for toxic impacts on human health and the environment.
• TSCA allows chemical manufacturers to keep the ingredients in some chemicals secret — nearly 20 percent of the 80,000 chemicals are secret, according to EPA.
• TSCA makes it difficult for consumers and businesses to find the information they need to identify which chemicals are safe and unsafe.
• The Environmental Protection Agency (EPA) tried to use TSCA to restrict asbestos 20 years ago and failed. It hasn’t tried since.
• Instead of requiring chemical manufacturers to demonstrate that their products are safe before they go into use, the law says the government has to prove actual harm in order to control or replace a dangerous chemical.
• TSCA perpetuates the chemical industry’s failure to innovate toward safer chemical and product design.

To get a better understanding of the existing Toxic Substances Control Act (TSCA) refer to the EPA website. Food, drugs, cosmetics, medical devices and equipment, and pesticides are excluded from TSCA, and are instead overseen by the US Food & Drug Administration.

What is TSCA Reform?

Due to the shortcomings of TSCA, legislation was underway to reform the regulation in the form of proposed federal legislation H.R. 5820.  The EPA offers details on what they see as TSCA reform, that is, an enhancement of the process where chemicals in use today are better screened to take steps towards protecting human health and the environment.  H.R. 5820 would also require chemical manufacturers and processors to disclose ingredients of their products through the supply chain. The proposed legislation was not signed into law and as of June 2011 awaits further consideration by the Senate Environment and Public Works. Learn more here.

Resources

A myriad of  hospitals and health systems across the country are now exploring ways to develop in-house chemicals policies and chemical disclosure requirements for suppliers. There are a growing number of resources to support healthcare sector interest in chemicals policy development. These include:

• What does Chemical Contamination Cost Health Care? (pdf)
• First, Do No Harm: Paper presented by Gary Cohen, Executive Diector and Co-Founder, Health Care Without Harm. for The Center for Health Design® and Health Care Without Harm at a conference sponsored by the Robert Wood Johnson Foundation, September 2006.
• Guide to Choosing Safer Products and Chemicals in the Health Care Setting (pdf)
• Information on Addressing Safer Chemicals and Sustainable Materials for PGH Member Suppliers & Service Providers (non-members click here)
• Getting Started on Choosing Safer Products and Chemicals at Your Health Care Institution (pdf)
• Comprehensive Chemicals Policy in Health Care: An Implementation Guide (pdf)
• Business Speak on Safer Chemicals (video): This short video highlights business leaders working in the healthcare sector explaining how their organizations are tackling chemical disclosure and policy development.
• EWG Survey links chemical exposures on the job to diseases in nurses
• Safer Chemicals: Good for Health, Good for Health Care (pdf)
• The Safer Chemicals Healthy Families coalition represents more than 11 million individuals and includes parents, health professionals, advocates for people with learning and developmental disabilities, reproductive health advocates, environmentalists and businesses from across the nation. The coalition of diverse groups is united by a common concern about toxic chemicals in our homes, places of work, and products we use every day.
• The Business NGO Working Group for Safer Chemicals and Sustainable Materials: In 2006 Clean Production Action brought representatives from leading corporations, health care organizations and nonprofit environmental & public health advocates in the U.S. together as a model for how businesses and NGOs can work together to change the course of production. The result is the Business NGO Working Group for Safer Chemicals and Sustainable Materials (BizNGO). This unique collaboration develops Chemicals Policy Principles, sustainable biobased polymer specifications the business case for chemicals policy reform and more. 
• The Ecology Center has developed the website: http://www.healthystuff.org/.  This site helps to connect people with the issues related to safer materials selection and to find one’s own voice around safer materials.