Molly Jacobs

Alternatives Assessment Frameworks: Research Needs for the Informed Substitution of Hazardous Chemicals

Background Given increasing pressures for hazardous chemical replacement, there is growing interest in alternatives assessment to avoid substituting a toxic chemical with another of equal or greater concern. Alternatives assessment is a process for identifying, comparing, and selecting safer alternatives to chemicals of concern (including those used in materials, processes, or technologies) on the basis of their hazards, performance, and economic viability. Objectives The purposes of this substantive review of alternatives assessment frameworks are to identify consistencies and differences in methods and to outline needs for research and collaboration to advance science policy practice. Methods This review compares methods used in six core components of these frameworks: hazard assessment, exposure characterization, life-cycle impacts, technical feasibility evaluation, economic feasibility assessment, and decision making. Alternatives assessment frameworks published from 1990 to 2014 were included. Results Twenty frameworks were reviewed. The frameworks were consistent in terms of general process steps, but some differences were identified in the end points addressed. Methodological gaps were identified in the exposure characterization, life-cycle assessment, and decision–analysis components. Methods for addressing data gaps remain an issue. Discussion Greater consistency in methods and evaluation metrics is needed but with sufficient flexibility to allow the process to be adapted to different decision contexts. Conclusion Although alternatives assessment is becoming an important science policy field, there is a need for increased cross-disciplinary collaboration to refine methodologies in support of the informed substitution and design of safer chemicals, materials, and products. Case studies can provide concrete lessons to improve alternatives assessment. Citation Jacobs MM, Malloy TF, Tickner JA, Edwards S. 2016. Alternatives assessment frameworks: research needs for the informed substitution of hazardous chemicals. Environ Health Perspect 124:265–280; http://dx.doi.org/10.1289/ehp.1409581

Mobile Phone Apps for Preventing Cancer Through Educational and Behavioral Interventions: State of the Art and Remaining Challenges

Background Rapid developments in technology have encouraged the use of mobile phones in smoking cessation, promoting healthy diet, nutrition, and physical activity, sun safety, and cancer screening. Although many apps relating to the prevention of cancer and other chronic diseases are available from major mobile phone platforms, relatively few have been tested in research studies to determine their efficacy. Objective In this paper, we discuss issues related to the development and testing of new apps for preventing cancer through smoking cessation, sun safety, and other healthy behaviors, including key methodologic issues and outstanding challenges. Methods An exploratory literature review was conducted using bibliographic searches in PubMed and CINAHL with relevant search terms (eg, smartphones, smoking cessation, cancer prevention, cancer screening, and carcinogens) to identify papers published in English through October 2015. Results Only 4 randomized controlled trials of the use of mobile phone apps for smoking cessation and 2 trials of apps for sun safety were identified, indicating that it is premature to conduct a systematic search and meta-analysis of the published literature on this topic. Conclusions Future studies should utilize randomized controlled trial research designs, larger sample sizes, and longer study periods to better establish the cancer prevention and control capabilities of mobile phone apps. In developing new and refined apps for cancer prevention and control, both health literacy and eHealth literacy should be taken into account. There is a need for culturally appropriate, tailored health messages to increase knowledge and awareness of health behaviors such as smoking cessation, cancer screening, and sun safety. Mobile phone apps are likely to be a useful and low-cost intervention for preventing cancer through behavioral changes.

Reducing the use of carcinogens: the Massachusetts experience

Abstract Toxics use reduction (TUR) is one part of a comprehensive cancer prevention strategy. TUR emphasizes reducing the use of cancer-causing chemicals by improving manufacturing processes and identifying and adopting safer alternatives. This analysis draws on 20 years of data collected from industries reporting to the Massachusetts Toxics Use Reduction Act (TURA) program to assess trends in the use and release of chemicals associated with cancer. We used a master list of known and suspected carcinogens developed from authoritative sources and a list of carcinogens grouped by their association with 11 cancer sites to analyze trends in use and release of chemicals by industrial facilities reporting to the TURA program from 1990 to 2010. The trend analysis shows that reported use and releases of carcinogens by these Massachusetts companies have decreased dramatically over time. Reported use declined 32% from 1990 to 2010, and reported releases declined 93% from 1991 to 2010 (1991 is when additional industrial sectors, including electric utilities, were phased into the program). Particularly large reductions were achieved in the use of trichloroethylene, perchloroethylene and cadmium and cadmium compounds. The analysis of groups of chemicals associated with specific cancer sites shows similar trends. Important opportunities for further reductions in many carcinogens, including formaldehyde, hexavalent chromium, and a variety of halogenated compounds are identified. Continued work to minimize the use of carcinogens can help to reduce the burden of cancer in Massachusetts and elsewhere.

Alternatives assessment: new ideas, frameworks and policies

Scientific, policy and consumer concerns regarding the health and environmental impacts of toxic substances have resulted in increased pressures to restrict potentially hazardous chemicals in processes and products.1 However, selecting chemical alternatives without regard to their hazard profiles can have regrettable consequences when substitutes are as toxic or are even more toxic than the chemicals they replace. Examples of regrettable substitutions include flame retardants (eg, substituting tris(1,3-dichloro-2-propyl) phosphate for polybrominated diphenyl ether), solvents (eg, substituting n-propyl bromide for methylene chloride and trichloroethylene (TCE)) and replacements for endocrine disrupting plastics components (eg, substituting bisphenol-S for bisphenol-A).2 These mistakes occur, in part, because performance and cost are elevated over health and safety in chemical selection decisions. They also occur because the environmental health community has been slow to provide strategies and guidelines for identifying, evaluating and adopting alternatives that include a thoughtful examination of environmental health and safety alongside cost and performance considerations. When public health scientists identify problematic chemicals, scientific justification for substituting that chemical based on identifying a safer alternative is rarely pursued. In a previous JECH commentary, we noted the challenges related to an over-reliance on studying environmental problems versus solutions in environmental health science, using the example of bisphenol-A.3 We argued that the ‘problem-centred’ approach to chemicals management is often reactive, extremely resource intensive, fosters extended debates over regulatory benchmarks, and inaction that benefits neither health nor innovation. This reactive approach is fortified by a number of factors including policies that require significant evidence of risk before action can be taken, which then focuses research and agency resources on risk assessment, risk management and enforcement; the lack of interdisciplinary collaboration between those designing molecules, materials, and products and those evaluating their risks; and the fact that many chemicals of concern have important functionality and cost …

On the Need for Research-Tested Smartphone Applications for Reducing Exposures to Known or Suspected Breast Carcinogens in Work and Home Environments.

Rapid technological developments have led to the development of smartphones that combine the voice and text messaging functions of cellular phones with computing technology that can support Internet access and third-party applications[1]. Major smartphone platforms provide third-party developers with application programming interfaces that can be used to build special purpose applications referred to as native apps[1]. To an increasing extent, smartphones are gaining widespread use in health promotion research and practice. For example, smartphone apps have been developed and shown to be effective for promoting healthy diet and nutrition, weight control, physical activity, and other behaviors associated with reduced risk of breast cancer and a variety of other chronic diseases[2,3]. Smartphone apps for promoting healthy behaviors should be based on health behavior theories and frameworks and include evidence-based features such as positive reinforcement and self-monitoring. Several web-based databases --for example, the Chemical Hazard and Alternatives Toolbox (ChemHat), the Pharos Project, Haz-Map, the U.S. Library of Medicine’s Genetic Toxicology Database (GENE-TOX), Environmental Working Group resources, and the California State Office of Environmental Health Hazard Assessment’s Proposition 65 list of chemicals[4-9] have been developed for providing information about toxic chemicals, including known or suspected breast cancer carcinogens. Not all of these databases, however, are intended for use by lay persons who are not well-versed in toxicology, occupational health and safety, or environmental epidemiology, and some key resources require a paid subscription. In a synthesis of scientific data from national and international sources, Silent Spring Institute researchers identified 216 chemicals that caused increased mammary tumors in an animal study[10]. An estimated 100 of these chemicals are likely common sources of exposure in everyday life. For example, people are exposed to carcinogenic polycyclic aromatic hydrocarbons (PAHs) in grilled and smoked food, tobacco smoke, and air pollution from auto exhaust. Ethylene oxide is used in hospitals and other medical facilities to sterilize instruments[10]. Mammary carcinogens are also found in certain furniture finishes, dyes, and solvents. Although conclusive evidence from epidemiologic studies is lacking, it is plausible that exposures to chemicals with estrogenic or other properties relevant to sex steroid activity (e.g., bisphenol A, polybrominated diphenyl ethers, and certain dioxins or dioxin-like compounds) could influence breast cancer risk if the exposures occur at critical life stages or in combination with exposure to similar chemicals[11]. Several studies have found an association between shift work and disruption of the circadian rhythm and risk of breast cancer[12].

Advancing alternatives assessment for safer chemical substitution: A research and practice agenda

Alternatives assessment has emerged as a science policy field that supports the evaluation and adoption of safer chemistries in manufacturing processes and consumer products. The recent surge in the development and practice of alternatives assessment has revealed notable methodological challenges. Spurred by this need, we convened an informal community of practice comprising industry experts, academics, and scientists within government and nongovernmental organizations to prioritize a research and practice agenda for the next 5 years that, if implemented, would significantly advance the field of alternatives assessment. With input from over 40 experts, the agenda outlines specific needs to advance methods, tools, and guidance in 5 critical areas: hazard assessment, comparative exposure characterization, life cycle considerations, decision making, and professional practice. Fifteen research and practice needs were identified, ranging from relatively simple efforts to define a minimum hazard data set to the development of more complex performance and decision-analytic methods and data integration tools. Some research needs involve adapting existing approaches to the alternatives assessment context, while others will require the development of entirely new methods and tools. The proposed research and practice agenda is ambitious. Implementing it will require expanding the current network of researchers from academia, government, and industry, as well as increased funding for methodological, application, and evaluation research. Integr Environ Assess Manag 2018;00:000-000.

Environmental and Economic Strategies for Primary Prevention of Cancer in Early Life

This article summarizes the evidence for environmental toxic exposures contributing to cancers in early life, focusing on the most common cancer sites in this age group. It provides examples of widespread avoidable exposures to human carcinogens through air, water, and food and then describes recent examples of successful initiatives to reduce exposure to chemicals linked to these cancer sites, through government policy, industry initiatives, and consumer activism. State government initiatives to reduce toxic chemical exposures have made important gains; the Toxics Use Reduction Act of Massachusetts is now 25 years old and has been a major success story. There are a growing number of corporate initiatives to eliminate toxics, especially carcinogens, from the products they manufacture and sell. Another important opportunity for cancer prevention is provided by online databases that list chemicals, their toxicity, and lower-toxicity alternatives; these can be used by businesses, health care institutions, consumers, and workers to reduce exposures to chemicals of concern. The article concludes by inviting pediatricians and public health professionals to include elimination of carcinogen exposures in their work to promote primary prevention of cancer in early life.

Emissions and Health Effects of Wood Biomass Combustion

This chapter provides an overview of what is known and not known about emissions from wood combustion, with a particular focus on the nonresidential scale. In addition, it reviews the state of the evidence on health effects associated with of exposure to emissions from wood combustion, information that is relevant to decisions about wood biomass applications at any scale. Finally, the chapter describes policy approaches available for protecting public health from pollution and concludes with solutions: recommendations for changes in technologies, policy and programs to better protect public health. While the discussion focuses on the Northeast region of the USA, it has broader implications, providing a framework for incorporating health in renewable energy decision-making across the country.