Posts Tagged ‘health’
Towards comprehensive management and regulation of cyanotoxins in drinking water
By Jennifer M. Panlilio, PhD
Cyanobacteria are naturally found in freshwater lakes and ponds. With the right conditions – warm temperatures, bright light, abundant nutrients – they proliferate rapidly (bloom), form thick sludge mats, and in some cases, produce potent toxins that pose a threat to human health. Exposure to these cyanotoxins occurs through touching and swallowing water during recreational activities, through breathing in aerosolized toxins, and through drinking contaminated water. Health effects range from skin rashes and nausea to acute liver failure and even death. These symptoms vary by route of exposure, toxin concentration, and toxin type. Toxin types produced during these blooms depend on the cyanobacteria species that produce them, with the most common toxins being microcystins, cylindrospermopsins, and anatoxins-a. These toxins target different organ systems, with microcystins primarily targeting the liver, cylindrospermopsins targeting the liver and kidney, and anatoxins targeting the brain.
An estimated 30-48 million people rely on lakes and reservoirs for their drinking water, making cyanotoxin monitoring and management critical. As a part of the 2012 National Lakes Assessment, the cyanotoxin microcystins were detected in 39% of lakes and all 48 of the contiguous states. Sometimes, cyanotoxins reach dangerous levels and leave people without drinking water. In Fall 2014, more than 400,000 residents of Toledo Ohio were unable to drink their tap water for 3 days due to a spike in the microcystins during a cyanobacterial bloom in Lake Erie. Since then, cyanotoxins have shutdown local water supplies, leading to water health advisories across the continental U.S. from Clear Lake, California to West Palm Beach, Florida.
Inequitable exposures and unequal impacts
Not everyone is equally exposed to cyanotoxins, nor does everyone get affected similarly.
Children, pregnant women, and people with pre-existing conditions are more likely to suffer adverse health outcomes from cyanotoxin exposures. Children tend to drink more water for their body weight and are more likely to swallow contaminated water during recreational activities, leading to higher toxin concentrations in their bodies. People with pre-existing liver and kidney conditions may be particularly susceptible to further insults, as cyanotoxins inhibit critical organ processes and exacerbate underlying conditions.
No studies have directly assessed potential socio-economic disparities in cyanotoxin exposure. However, drinking water treatment facilities that serve low-income, communities of color generally produce poorer water quality. Even with regulated contaminants like nitrate and arsenic, drinking water that serves people of color are more likely to exceed the federally mandated maximal contaminant levels. These disparities also tend to be worse in ‘smaller systems’ or those that serve less than 10,000 people.
Climate change and the rise of cynanotoxins
Toxic cyanobacterial blooms are expected to continue to rise with climate change, as conditions for their blooms become more favorable. Climate change is predicted to lead to more frequent extreme precipitation events, resulting in soil erosion and higher rates of nutrient run-off that lead to an explosion of cyanobacterial growth. Future sea surface temperatures are also expected to warm, selecting for heat-loving, UV-resistant, and fast-growing cyanobacteria which outcompete non-toxic microscopic plants in the ecosystem. Warmer water also leads to ‘stratification’, which is the phenomenon where the water column forms distinct layers, creating a stable warm, nutrient rich upper layer for buoyant cyanobacteria to concentrate and thrive.
Cyanotoxin monitoring and management challenges
Monitoring and management of cyanotoxins can be challenging. Knowledge that a cyanobacterial bloom exists is not enough. Sometimes cyanobacterial blooms will occur without the production of cyanotoxins. Other times, blooms will barely be present, but cyanotoxin levels produced will be dangerously high. To further complicate matters, cyanobacterial blooms commonly contain several cyanobacteria species with mixtures of cyanotoxins. A 2010 study found that all water samples collected from lakes along the Midwest had a mixture of 5 of the 6 types of cyanotoxins for which they tested.
Knowing what types of cyanotoxins are present in the water is critical because there is no universal management process for cyanotoxins. For example, the addition of free chlorine will neutralize cylindrospermopsin and microcystin – but only if the pH is below 8 – while it will not oxidize anatoxin-a. Some cyanobacterial species only release toxins when they die or their cells rupture, while others are capable of releasing toxins while they are alive. This matters because cyanotoxin removal strategies vastly differ based on whether the toxin is present within the algae (intracellular) vs. whether it has been released into the water (extracellular). Furthermore, using the wrong treatment could exacerbate rather than address the problem, resulting in cells lysing and releasing toxins rather than removing the toxins from the water.
In fact, there is a wide discrepancy in cyanotoxin removal, with efficiencies ranging from 50-99.9%. This inexperience is also reflected in a national survey of water plant managers where many managers reported having limited experience treating toxic cyanobacterial blooms. Combined with inadequate infrastructure, this creates an opportunity for a “predictable surprise,” where managers are unprepared to deal with inevitable future cyanotoxin incidents. This is concerning as cyanobacterial blooms are expected to expand geographically and temporally, showing up in new places and during unexpected times.
Current policy landscape for cyanotoxin monitoring and management
Given these challenges, the federal government has several programs and policies designed to monitor cyanobacterial blooms and mitigate risk from cyanotoxin exposures.
The Cyanobacteria Assessment Network (CYAN) is a joint project between the National Aeronautics and Space Administration (NASA), the National Oceanic and Atmospheric Administration (NOAA), the United States Environmental Protection Agency (EPA) and the United States Geological Survey (USGS) that collects real-time satellite image data and estimates the intensity of cyanobacterial blooms across over 7,000 lakes in the U.S. While satellite imagery cannot directly measure cyanotoxins, it identifies potential cyanobacterial blooms, allowing Tribal and State government officials to prioritize direct water sampling in those places. CYAN imagery is also publicly available so anyone can monitor their local waterways through an application on their phone.
One Health Harmful Algal Bloom Systems (OHHABS) is a national system for voluntarily reporting cyanotoxin exposure data. It allows the federal government to track where cyanotoxin exposures occur, and how many people have gotten sick from cyanotoxicity. In 2019, 14 states reported 242 harmful algal bloom (HAB) events, 63 human-related illnesses and 367 animal-related illnesses.
Through the Drinking Water Protection Act, the EPA has developed a comprehensive plan to assess the health risks from cyanotoxins in drinking water. The EPA has also created a support document that advises drinking water system managers on best practices for monitoring and removing cyanotoxins. In 2015, it released a health advisory for acceptable limits for cyanotoxins in drinking water. For example, children of preschool age and younger should not be exposed to greater than 0.7 micrograms of microcystins per liter for more than 10 days, while school-aged children and adults should not be exposed to greater than 1.6 micrograms per microcystin for more than 10 days.
While helpful, all these programs require complete voluntary buy-in to be successful. This is because there are currently no federal regulatory limits for cyanotoxins in drinking water. This leaves it up to individual States and Tribal governments to deal with cyanotoxins, creating a slew of unstandardized systems throughout the country. To highlight just how patchy implementation is, as of 2018, 35 states had cyanobacteria guidelines for their recreational waterways. Out of the 35 states, only 24 had numeric guidelines for cyanotoxin limits, while others relied on visual inspection rather than quantification to identify cyanotoxin blooms.
Future efforts and policy recommendations
Cyanotoxins are predicted to become a more pressing human health concern. To reflect this, we need to set stronger federal policies that allow us to better predict, monitor, and regulate toxin exposures in our drinking water.
• Develop regulatory limits for cyanobacterial toxins that are legally enforceable – There is no federally-mandated limit on the amount of cyanotoxins in drinking water. The EPA currently monitors the occurrence and health risks associated with cyanotoxins under the Unregulated Contaminant Monitoring Rule. Data from this should be used to develop federal regulatory limits. Of note, regulatory limits already exist for other algal bloom toxins found in seafood such as saxitoxin, domoic acid, and brevetoxins. This limit enables the FDA to set federal standards for monitoring and measuring these toxins in seafood. Establishing enforceable limits for cyanotoxins will ensure systematic, standardized testing nationwide, eliminating the need to rely on local buy-in and patch-work state management. Testing done on a national scale would also reduce the burden of monitoring for smaller communities with less resources.
• Establish a robust nationwide reporting database for HAB illnesses – OHHABS is a central resource for tracking HAB illnesses and identifies trends in cyanobacterial blooms and exposures. It is a key tool in predicting health risks from future bloom events. However, it is currently populated with data provided voluntarily, making data incomplete and potentially ‘patchy’ year to year, state to state. States should be required to report their bloom occurrence and exposure data to ensure a more complete dataset with better predictability. Having a mandatory database also allows us to assess the true risks from toxin exposure.
• Invest in research on cyanobacteria growth and toxin production – Management of cyanotoxins starts with understanding the organisms that produce them. The ability to predict the timing, species composition, and toxins produced is critical for prioritizing where to test and what toxins to test. Continued basic research funding for this work should be prioritized by the EPA, USGS, USDA, and NSF.
• Mitigate nutrient flow into water basins – Enhanced nutrient influx is one of the primary drivers for bloom production, and a key environmental problem. In 2015, 45 states identified nutrient pollution as an important priority. In response, the EPA issued a memorandum that expressed its support for multi-stakeholder projects to reduce nitrogen and phosphorous pollution that contribute to HAB exposures. While the EPA cannot directly regulate non-point source pollution, it can support states through Clean Water Act section 9 by providing technical and financial assistance to upgrade systems that reduce nonpoint source pollution.
• Invest in water treatment facility upgrades and water treatment plant manager training – Many water treatment facilities are either not equipped or well-maintained enough to efficiently remove cyanotoxins. Furthermore, many managers have limited to no experience with cyanotoxins. To address this, the federal government should expand their investments in programs that upgrade water treatment plants and train water treatment managers. The EPA provides grants to support drinking water plant upgrades through the 2016 Water Infrastructure Improvements for the Nation Act (WIIN Act). To address disparities in drinking water quality, within the WIIN Act, the Small, Underserved, and Disadvantaged Communities Grant Program provides funding to improve access to safe drinking water in communities without a public drinking water system or with systems that exceed any Maximal Contaminant Level.
Cyanotoxins pose an emerging public health concern that are slated to become more prevalent both geographically and temporally in the future. The federal government must address factors that lead to cyanotoxin expansion and create a robust monitoring and regulatory landscape to address this. The future of our clean water and health depends on it.
Science Policy Around the Web October 1st, 2020
By Maria Disotaur, MPH, PhD
Neuroscience Has A Whiteness Problem. This Research Project Aims to Fix It
Diversity in research studies and clinical trials has been a sore topic for decades. For years, government agencies, academic, and non-academic institutions have tried to pass laws and policies to increase the number of women and minority volunteers in scientific studies. Since 1993, both the National Institutes of Health (NIH) and the Food and Drug Administration (FDA) have tried to prioritize the inclusion of these underrepresented populations in clinical trials. Despite this push, the number of minorities in studies is persistently disproportionate to their white counterparts. For African Americans, a major contributor is the deep-rooted distrust of the medical system and science due to the horrific events of the Tuskegee studies. In general, however, minorities have historically been excluded from the benefits of scientific studies, which have primarily focused on individuals with European ancestry.
The issue is that many illnesses and diseases affect minorities disproportionately. For example, African Americans are approximately 20% more likely to experience serious mental health issues and are more prone to Alzheimer’s disease than other individuals, yet they and other underrepresented minorities make only 5% of people in genetic studies. These disparities have led a group called the African Ancestry Neuroscience Research Initiative to start an initiative to increase the number of African Americans involved in neuroscience research. The group is a partnership between community leaders and the Lieber Institute for Brain Development, which is a nonprofit research organization with the goal to reduce health disparities in brain research. For the past decade, the organization has been able to collect more than 700 post-mortem brains from African Americans donated by their families to help advance science. Thus far, researchers have been able to analyze molecular data for more than 300 brains with the hopes of using the data to develop new therapies and treatments.
These progressive steps to reduce racial disparities in research studies do not completely ablate the core issues: How do we develop policies that enhance the diversification of research, and how do we continue to leverage and build trust in communities that have associated science with systemic racism? Community leaders assert that transparency and inclusivity are key to answering these vital questions.
(Jon Hamilton, NPR )
Science Policy Around the Web June 8th, 2020
By Tam Vo, PhD
Abortion opponents protest COVID-19 vaccines’ use of fetal cells
A group of anti-abortion activists recently raised ethical concerns about the use of cells derived from human fetal tissue in COVID-19 vaccine development. While the tissues were obtained during elective abortions performed many years ago, in a letter addressed to Stephen Hahn, commissioner of the U.S Food and Drug Administration (FDA), a group of religious, medical, and political organizations urged the agency to consider ethical issues surrounding the development of vaccines for COVID-19 using those cell lines. The letter states that: “ It is critically important that Americans have access to a vaccine that is produced ethically: no American should be forced to choose between being vaccinated against this potentially deadly virus and violating his or her conscience.” In Canada, a similar letter was addressed to Prime Minister Justin Trudeau on May 17. Currently, there is no response to these letters from either the US or Canadian governments.
Using cells derived from human fetuses collected from elective abortions is hardly new. In fact, HEK-293, a cell line derived from human fetal tissue, has been widely used in many research projects including vaccine development for diseases such as rubella, chickenpox, and Hepatitis A. There are currently at least five COVID-19 vaccines that have entered clinical trials that were developed using HEK-293 and PER.c6, another fetal cell line owned by Janssen, a pharmaceutical subsidiary of Johnson & Johnson. The Trump administration plans to back two out of the five candidate vaccines with the total investment up to $1.7 billion through Operation Warp Speed, a program aimed to accelerate the COVID-19 vaccine development by January 2021.
Fetal cell lines are crucial in the development of many vaccines. Andrea Lambotto, a lead vaccine scientist for the candidate developed by the University of Pittsburgh School of Medicine, said that the HEK-293 cells are essential for the production of protein subunit type vaccines. He also stated that the alternative nonhuman cells can produce a different type of sugar molecules compared to their human counterparts. This complication could decrease the effectiveness of the vaccine to trigger a specific immune response in the host.
Opinions from experts are mixed. David Prentice, the Vice President and Research Director at the Charlotte Lozier Institute, argues that the use of fetal cell lines to develop vaccines is unethical and provided a list of vaccines developed by using alternative methods in a paper published on May 6, 2020. Contrarily, Arthur Caplan, a bioethicist at the NYU Grossman School of Medicine, argues that the fact the cell lines were derived from fetal tissue is irrelevant as these fetal cell lines are now decades old.
Last year, the Trump administration established a policy to abolish the use of new fetal tissues in government-funded research at the National Institutes of Health. However, the policy did not rule out the use of currently-established fetal cell lines. The two controversial candidate vaccines that used HEK-293 and PER.c6 in their development are on the shortlist for approval funding from the administration.
(Meredith Wadman, Science)
Science Policy Around the Web June 4th, 2020
By Dorothy Butler, PhD
SpaceX launches astronauts-and a new era of private human spaceflight
May 31, 2020 ushered in a new era in space flight with the launch of the SpaceX Crew Dragon with astronauts Robert Behnken and Douglas Hurley. Since NASA retired the Space Shuttle in 2011, American astronauts have found rides to the International Space Station aboard Russian Soyuz Spacecraft. With the launch of the SpaceX Crew Dragon, NASA astronauts were once again being launched from American soil with a new type of spacecraft. Additionally, it was the first time a private company was entirely responsible for building and launching a manned spacecraft headed to the ISS. The Crew Dragon successfully and automatically docked to the space station the following morning and were welcomed aboard the ISS a few hours later.
This launch with two NASA astronauts was the realization of NASA’s Commercial Crew Program, a partnership with private companies who are tasked to develop and fly human space transportation systems. SpaceX has led the way in commercial space flight in the US and have used unmanned Dragon capsules and Falcon 9 rockets to send supplies to the ISS since 2012.This mission of the Crew Dragon launch was the final major test to certify that Crew Dragon could be used for operational, long-duration missions to the space station. Perhaps one of the most impressive parts of the Falcon 9 rocket is its reusability, something that SpaceX worked hard to achieve to help bring down launch costs. Other private companies are also in this capitalistic battle to provide cheaper and more accessible space access. The growth of the commercial space sector makes space more accessible than ever and brings down the cost for NASA to send astronauts to the space station and perhaps to explore other parts of space.
(Alexandra Witze, Nature)
Sputnik moment or budget breaker: How will the pandemic alter research funding?
It is no secret that the current coronavirus pandemic has taken its toll on economies around the world. While unemployment rates have rivaled those seen in the US during the Great Depression in the 1930s, many science leaders are pushing for an increased support in research and development. But what will the long-term economic consequences for science be? Many countries such as Germany and the UK have already committed to investing more money in research funding and science agencies, one country as part of previously decided legislation and the other with newly promised support. After the last economic recession in 2007-2009, the US government directed stimulus money to federal sciences agencies as part of the American Recovery and Reinvestment Act. For example, the NIH received over a 33% increase in its 2009 annual budget. There are many factors that trigger a need for extra scientific funding such as buffering any delays in grant funding, the cost of re-establishing mice colonies that were killed when labs went to minimal maintenance, and replenishing stores of personal protective equipment that were donated to those on the frontlines of the pandemic response.
Some are hopeful that the pandemic will spur on science in a similar way that the launch of Sputnik by the Soviets resulted in impressive growth within the physical sciences. Several US lawmakers have already drafted the Endless Frontier Act. This bill proposes to transform the current National Science Foundation by increasing their budget, adding a technology directorate, and changing the name to the National Science and Technology Foundation. While some worry about whether a separate agency for technology should be founded or if the amount of money is too high, it is a good step in the right direction to have a bi-partisan legislation aimed at the continued and increased support of scientific research.
(Nidhi Subbaraman, Nature)
Science Policy Around the Web June 2nd, 2020
By Andrew Wright, BSc
Sixth mass extinction of wildlife accelerating, scientists warn
A new analysis published in the Proceedings of the National Academy of Sciences (PNAS) has examined the number of terrestrial vertebrates on the verge of extinction. In examining 29,400 species, researchers found that 515 of them have fewer than 1,000 individuals (the metric for “critically endangered”) and roughly half of those have fewer than 250. Most of these species have lost their geographic range and are nearing an irreversible collapse within the next 20 years, which could have profound effects on their respective environments as their ecological utility is permanently wiped out.
Of those species with between 1,000 and 5,000 individuals, 84% live in an area that overlaps the critically endangered, meaning there is the potential for a domino-like effect. For example, a paper from PNAS in 2015 demonstrated that overhunting of sea otters in the mid-1700s led to the extinction of the Stellar’s sea cow. Since sea otters fed on urchins that in-turn fed on the kelp environments in which the sea cows lived, the elimination of the otters led to over-feeding on kelp and precipitated the loss of a seemingly unrelated species.
The worst-affected global regions are those that are increasingly heavily populated and where ongoing environmental destruction is occurring unabated, namely tropical Asia and South America where deforestation has actually been accelerating as attention has been pulled towards the ongoing COVID-19 pandemic. While there is still room for a comprehensive solution, according to the authors, “…the window of opportunity is almost closed. We must save what we can, or lose the opportunity to do so forever[…]it is something that humanity cannot permit, as it may be a tipping point for the collapse of civilization. What is at stake is the fate of humanity and most living species.”
(Damian Carrington, The Guardian)
What a US exit from the WHO means for COVID-19 and global health
On May 29th, the President of the United States Donald Trump announced that US would be withdrawing from the World Health Organization (WHO) and severing its relationship with the international organization, chiefly accusing it of a faulty coronavirus response and leniency with China. While it is unclear whether the President can unilaterally pull out of the WHO without congressional approval, he does have the authority to pull US funding to the organization that made up 15% of its revenue last year. In place of this funding, reports from the State Department suggest the replacement would be a domestically run initiative called the President’s Response to Outbreaks (PRO) and would cost roughly $2.5 billion in new and transferred appropriation. This new office would also subsume programs run by USAID. This is mirrored by the introduction of a Senate bill called the “Global Health Security and Diplomacy Act of 2020” that calls for $3 billion in appropriations overseen by political appointment.
Critics of this move suggest that a new office would conflict with existing international programs and muddy a cohesive response. As Kelly Lee, a global health researcher at Simon Fraser University put it, “You can’t just show up in Afghanistan and start vaccinating people.” Others pointed to the ongoing Ebola outbreak as an example of where there is little response apart from that provided by the WHO, particularly in regions with ongoing violence or negative sentiments against the US. Furthermore, in those areas where the US solely funds programs, they are often coordinated by the WHO. Lee also notes that there could be a loss of expertise and knowledge sharing should US researchers and international researchers be deprived of collaborative avenues supported by the WHO.
Finally, pulling out of the WHO altogether may weaken US control over the global health agenda. Contrary to the US President’s apparent intent, this could in effect grant countries like China a path to take over in both in funding and decision-making.
(Amy Maxmen, Nature)
Science Policy Around the Web May 28th 2020
By Thomas Dannenhoffer-Lafage, PhD
Coronavirus antigen tests: quick and cheap, but too often wrong?
The United states is currently administering about 400,000 coronavirus tests a day, but public health officials recommend that this number should be much higher numbers to safely reopen the country and monitor future outbreaks. However, it is unlikely that the current nucleic acid tests will be able to be scaled-up to meet this demand. One reason for this is the test requires a sophisticated procedure. An important step in the procedure is PCR, which makes many copies of the target DNA or RNA, allowing for more sensitive and accurate detection.
An alternative to the nucleic acid tests is antigen tests. These tests detect viral proteins within a biological sample, such as a nasal swab, and are already used to detect diseases such as HIV, influenza, and tuberculosis. One major advantage of the antigen test is that the tests can be administered as point-of-care tests with virtually no wait and with no technicians. Another advantage is the scalability, as the antigen tests are easy to manufacture in bulk and don’t require additional reagents that the nucleic acid tests do.
The antigen test does have some issues still. First, it can be difficult to determine what to target with the test, since interactions with other proteins or antibodies may interfere with the test. Sensitivity (ability to detect the disease) is also an issue with antigen tests, since the test doesn’t create more copies of the target like the nucleic acid test. The best antibody tests have a sensitivity of 90%, which means many people will be told that they don’t have virus when they actually do when the test is deployed on millions of people a day. Because of the lack of sensitivity, the FDA has only given emergency use authorization to one coronavirus antigen test.
(Robert F. Service, Science Magazine)
Science Policy Around the Web May 26th 2020
By Silvia Preite, PhD
A defect in our cells` power plants could make us age faster.
T cells are crucial cells of the immune system that help fighting infections and eliminating cancer cells. T cell function declines with age, contributing to the decreased ability of seniors to mount vaccination responses and to their higher susceptibility to viral and bacterial infections.
Mitochondria are cellular organelles at the core of our metabolism, an efficient site of cellular energy production. Age-related decline of mitochondrial function has been previously observed in multiple cell and tissue types. A recent study, published in Science, showed that a genetic defect in the mitochondria, which decreases their function, impacts T-cell activity in mice. These T cells produce higher inflammatory cytokines resembling chronic inflammation (called “inflammaging”). Mice bearing defective T cells were sluggish and less active compared to regular mice. They had inadequate protective responses to viral infection, weak muscles and suffered from weakened hearts, thus resulting in premature death.
Overall, these defects led to accelerated senescence in several tissues and premature death. The authors found that blocking one of these pro-inflammatory cytokines or boosting cellular energy production enhanced the mouse aging phenotypes and increased their strength.
The translatability of these findings to humans remains to be determined. Indeed, it is not clear how affected the function of mitochondria in elderly T cells is. However, this study highlights the interconnection between immuno-metabolism, inflammation, and aging, possibly driving new opportunities to manage diseases associated with aging.
Source: (Gabriela Desdín-Micó et al., 2020, Science)
School-Based Health Education Works – But Fails to Meet Education Guidelines
By Kristyn Kamke, PhD
A considerable burden of disease in the United States is attributed to 17 risk factors, including tobacco use, poor diet, alcohol and drug use, limited physical activity, and risky sexual activity. These risk factors represent modifiable health behaviors, highlighting an opportunity to prevent leading causes of disability and death, including cancer, heart disease, and diabetes. Studies show that primary prevention, which refers to intervention prior to the onset of a health problem, not only provides the optimal chance of reducing disease incidence but is also more cost-effective than secondary or tertiary prevention (i.e., intervention at early stages of a health problem or management of an existing health problem to slow or stop progression, respectively). Health risk behaviors typically begin in adolescence, establishing childhood and early adolescence as prime developmental stages to implement primary prevention strategies. Given children and adolescents spend an average 7 hours per day in school on 181 days of the year, school-based health education serves as one of the most common, effective, and opportune methods of primary prevention. Unfortunately, many state- and school-level health education policies and/or implementations fail to meet established guidelines, limiting the overall health impact of school-based health education.
Health education is a theory- and research-based academic subject, which imparts health knowledge onto students, encourages them to develop skills in behavior maintenance and change, and models healthy behavioral norms. The National Health Education Standards advise students in grades 3-12 receive 80 hours of health education per year, amounting to about 27 minutes per day each school year. In 45 states and DC, health education is required every year from elementary school through high school, and health education is either recommended or required for some grade levels in the remaining 5 states. This requirement is based on research showing that establishing and maintaining health behaviors requires time and sustained education and practice to be effective. However, a Centers for Disease Control and Prevention (CDC) report on school health reveals that a median 49% of schools in each state required more than one health education course for grades 6-12 in 2018, suggesting students are receiving inadequate time for learning and practicing health behaviors.
In addition to insufficient time spent on school-based health education, health education policies and implementation are not adequately comprehensive. According to researchers at Child Trends, only 30 states and DC have comprehensive health education laws (i.e., those that address at least 75% of recommended health education topics). Physical activity topics are most comprehensively covered (69.3%), whereas pregnancy, HIV, and STD prevention are covered at the lowest rate (17.6% for grades 6-8; 42.8% for grades 9-12). Some of the most neglected coverage areas for each health topic are those focused on skill development. Thirty-two states and DC require that health education includes health skills training, such as analyzing the influences of health behavior; accessing valid health information, products, services; goal-setting; decision-making; interpersonal communication; self-management; and advocacy. While educators report teaching these skills in health education, it is unclear to what degree students are able to practice them, a necessary component for establishing healthy behaviors. For example, teachers in only 60% of schools per state reported that students had the opportunity to practice sexual health skills (e.g., communicating with a partner about sex), the only topic area in which skill practice was assessed.
Perhaps most alarming is the lack of requirements for an evidence basis for school-based health education. While a median 86% of schools provide information on goals, objectives, and expected outcomes of health education for teachers, only about 76% provide written health education curriculum, 65% provide guidance on the sequence of health education, and 67% provide plans to assess student performance. This lack of guidance is exacerbated by the fact that only 3 states require and 8 states recommend health education teachers have a certification in health education, and 15 states advise health educators pursue professional development training, although both certifications in health education and professional development training are associated with better student outcomes. Thus, it is unclear what education students are getting and if that education results in increased implementation of healthy behaviors.
Implementation of health education without a supporting evidence-based foundation risks more than just failure to improve health outcomes — it can also make health worse. A notable example of this is the substance abuse prevention program D.A.R.E., widely implemented across the United States with little research backing. Subsequent evaluations of D.A.R.E. suggested that D.A.R.E., at best, had no effect on drug use behavior and, at worst, actually increased drug use, disproving the proverb that something is better than nothing. Unfortunately, the ability to implement evidence-based health education is limited by the dearth of evidence-based, comprehensive health education programs. Most extensively evaluated and efficacious health education programs target a specific health topic (e.g., tobacco use), with only 3 commercially available programs that cover multiple topics. Even if schools were financially able to acquire multiple health education curricula targeting individual health topics, difficult for schools who lack funds for health education, evidence would still be needed to support the sequence in which health education topics should be covered and whether multiple curricula can be effectively combined. Furthermore, comprehensive health education interventions are more efficient than those covering individual topics, given many health-related skills can be translated across health domains. This highlights an area in which researchers must intervene, to both aid in development and evaluation of comprehensive health education interventions.
Schools are optimally positioned to engage in primary prevention of key health risk behaviors in the US through provision of health education to students. While states have embraced the necessity of health education, often recommending or requiring it, implementation of health education in schools has failed to meet many established guidelines, of which just a few are presented here. Discrepancies between state policy and school-based health education policy and implementation may be attributable to several factors, such as perceived lack of time for health education in already busy schools attempting to meet federal academic standards, lack of oversight from states to evaluate implementation of health education, unclear guidelines for educators responsible for delivering health education, or lack of funds to acquire evidence-based health education programs. Regardless of reason, traditional academic subjects, such as science or math, are prioritized above health education, which threatens the health of children and adolescents. However, academic achievement-focused goals should not preclude efforts to establish rigorous health education guidelines. In fact, academic achievement is bolstered by student health. The time has come to support health education as a vital element of education, providing students with the opportunity to live longer, more productive and healthier lives.
Science Policy Around the Web November 19th, 2019
By: Andrew Wright Bsc
EPA’s ‘secret science’ plan is back, and critics say it’s worse
The Environmental Protection Agency (EPA) has been exploring new rules on the incorporation of scientific data in its rulemaking process. The so-called “secret science” rules were originally proposed in 2018 under the EPA’s previous administrator Scott Pruitt, and have since been revised by its new administrator Andrew Wheeler in response to harsh criticism from scientific, environmental, and patient groups. Rather than addressing these criticisms to mollify the proposals detractors, the draft of the newly proposed rule, which was leaked to the New York Times, seems to drastically broaden the scope of which data cannot be used.
According to the 2018 proposed rule, all raw data would have to be made available for studies that assessed a “dose-response” relationship, a bedrock of toxicity research. This could be difficult, if not impossible, when considering patient privacy protection laws and proprietary information requirements that would prevent the dissemination of that data. In the new draft rule, this set of constraints is imposed on all scientific studies used to guide agency procedures, instead of just dose-response studies. The draft also seeks comment on whether these restrictions should be imposed retroactively. According to the draft rule, if the underlying data were not made available, the EPA would be able to “place less weight” or “entirely disregard” those studies.
While the draft does provide room for a tiered data-sharing approach such as those implemented at the National Institutes of Health and the Food and Drug Administration and allows for political appointees to provide exemptions, critics worry that these new requirements will effectively remove science from the EPA’s decision-making process. Thus far, the EPA’s scientific advisory board has not been afforded the opportunity to weigh-in.
(David Malakoff, Science)
‘Insect apocalypse’ poses risk to all life on Earth, conservationists warn
A recent study looking at insect populations in the UK suggests that up to half of all insects have been lost since 1970 and that 40% of all known insect species are facing extinction. Due to the complexity of ecological systems that rely on insect biodiversity to function properly, this level of insect loss could lead to “catastrophic collapse” on a global scale.
This study demonstrates a similar severity of insect decline as has been seen in other regions around the world. In Puerto Rico, for example, insect biomass has declined between 10 and 60 times and has led to the destruction of its rainforest’s food web. In Germany, 75% of flying insects have vanished in the past 27 years.
Solutions to address what is now considered Earth’s sixth mass extinction event are becoming increasingly complex as failing components of anthropogenic damage to the global ecosystem are beginning to interact. However, conservationists suggest that insect numbers could be rapidly recovered through a combination of pesticide reduction and land management.
(Damian Carrington, The Guardian)
Science Policy Around the Web October 8th, 2019
By Mary Weston PhD
A single tea bag can leak billions of pieces of microplastic into your brew
A recently published studyfrom McGill University shows that plastic teabags release billions of plastic micro- and nanoparticles into your tea. Researchers steeped plastic tea bags in 95°C (203°F) water for 5 minutes, finding that a single bag released approximately 11.6 billion microplastics and 3.1 billion nanoplastics. This concentration of plastic particles is thousands of times larger than any other reported food/drink item.
Although tea bags contain food-grade, FDA approved plastics, researchers know little about how plastics can degrade or leach toxic substances when heated above 40C (104F). Based on these new results, the study’s authors conclude that more research needs to be done to both determine how microparticles are released in our foods and the impact those substances have on human health.
To gain insight on the effect of plastic particle exposure, researchers grew water fleas, a common environmental toxicology model system, in the brewed solution, discovering they survived but had both behavioral and developmental abnormalities. While the plastic particle exposure levels these fleas experienced are far greater than what humans would be exposed to, it begs the question of what happens to humans with chronic low-dose exposure over time.
Microplastics are being detected everywhere, from the deepest parts of the ocean to regularly consumed bottled water, and their effect on human health have yet to be seen. One study suggests humans are consuming 5 grams of plastic a week, approximately the weight of a credit card. However, In their first review of microplastics in tap and bottled water, the WHO asserts that microplastics “don’t appear to pose a health risk at current levels,” but also state that knowledge is limited and more research is needed to determine their impact on human health.
(Rob Picheta, CNN)
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