What We CAN Do About Environmental Toxins with Dr. Bruce Lanphear, MD, MPH of Little Things Matter

In this episode, Dr. Bruce Lanphear discusses what we all CAN do about environmental toxins, which is a WE problem, not just a ME problem- we need to band together to solve this ! He also discusses what you CAN do as an individual, as well. A REALLY important topic!
Bruce Lanphear, MD, MPH, is a preventive medicine physician and professor at Simon Fraser University in Vancouver—and one of the world’s leading voices on how toxic chemicals shape children’s health. For more than 30 years, he’s studied everyday exposures like lead, fluoride, and pesticides, helping drive the landmark conclusion that there is no safe level of lead and informing federal health standards along the way. What sets Bruce apart is his focus upstream: not just treating disease but
preventing it. Through his project Little Things Matter, he creates clear, engaging videos that reveal how invisible chemical exposures affect our kids—and what we can do to stop harm before it starts. He also writes on Substack about the hidden burden of toxic chemicals and why protecting our health begins long before the doctor’s office.
https://littlethingsmatter.ca/
https://blanphear.substack.com/

Oulthote Phthalates SRS EHP 2020 (1).pdf

Alampi Chemical Mixtures Folate ASD Env Epi 2025 (1).pdf

https://nontoxicneighborhoods.org/

https://www.sfu.ca/fhs/about/people/profiles/bruce-lanphear.html
Cover art by Charlotte Feldman
Please note that while I am a pediatrician, I am not your child's pediatrician. This podcast is for informational purposes only and does not constitute medical advice. For any medical concerns or decisions, please reach out to your child’s health care professional.

Transcript

0:06

Welcome to Kids Matter. I'm Dr. Elisa Minkin. As a pediatrician, mom and grandma, I understand how challenging it can be to help our kids grow into their best selves. We are so much more powerful together. Here I will be sharing the knowledge and wisdom of a wide range of people who understand and care deeply about children. I'm hoping for your input as well because kids really do matter. They are our future.

Alisa Minkin 0:37

Welcome back. Today I will be speaking with Dr. Bruce Hi,

Bruce Lanphear 0:44

Good morning.

Alisa Minkin 0:46

so happy to have you here. Dr. Lanier md. MPH is a preventative medicine physician and professor at Simon Frazier University in Vancouver, and one of the world's leading voices on how toxic chemicals shape children's health. For more than 30 years, he studied everyday exposures like lead, and pesticides, helping drive the landmark conclusion that there is no safe level of lead and informing federal health standards along the way. What sets Dr. Landey apart is his focus upstream. It's not just treating disease but preventing it. This gets to the heart of my pediatrician, preventative medicine heart. This is the essence. It's so important. Through his project, little things matter. He creates clear, engaging videos that reveal how invisible chemical exposures affect our kids and what we can do to stop harm before it starts. He also writes on Substack amazing substack. I'm going to link to it in the show notes about the hidden burden of toxic chemicals and why protecting our health begins long before the doctor's office. So welcome again, Dr. Lanier. Thank you so much for doing this with me.

Bruce Lanphear 2:01

Thank you for having me.

Alisa Minkin 2:03

It is really an honor and a pleasure, and it's such an important and timely topic. We're hearing so much about it in the news with RFK Junior and the Maha movement, I think we have mixed feelings about that, but I wanna focus on the positive aspect, which is that there is more of a grassroots movement. From the ground up to change what's happening. And I want this to be a positive, empowering talk, not a monkey. Hands on the ears. I can't, wanna hear about this I think there's things we can do and that's gonna be the focus both on an individual level and on a a larger level. So I wanna start with just the basics. What do we mean by environmental toxin? S.

Bruce Lanphear 2:47

We typically think about. Things like lead or arsenics or toxic metals. Many of the pesticides that are still in use today are toxic. A whole host of synthetic chemicals like the PFAS or forever chemicals PBDEs chemical Flame retardants. So there's a whole range. I mean, there's anywhere from. More than a hundred to 304, 300 40,000 of these chemicals used in commerce. And then we have pollutants, things that are emitted from smokestacks, from motor vehicles. So it's really toxic chemicals used in commerce and pollutants that we're concerned about. There are, of course, natural toxins. Whenever you say toxins like spider venom, those are not typically what we're talking about.

Alisa Minkin 3:37

That's a good short summary of that. How do we know what effects these have on us and what is the research showing us so, so far about that?

Bruce Lanphear 3:49

Well, so. Over the past, let's say 60 years, there's been a pretty concerted effort. Up until that point, there wasn't federal funding to do these kinds of studies, so it was sort of hit and miss. I mean, we've known, for example, that led even in Roman Times was a poison, but more in a more concerted way. We've learned over the past century, and especially over the past 50 or 60 years. Typical study that's done besides say acute poisoning in a child either from pesticide or lead, are studies, cohort studies or case control studies. And the case control studies would compare kids with higher exposure, let's say, to something like lead or pesticides with lower exposures and see whether there's differences With the cohort studies, which are really the the primary focus of how we've learned, we will recruit. Pregnant women typically and measure everything from lead and arsenic in their blood or urine. We measure the forever chemicals. We measure pesticides, and we'll also measure things like socioeconomic status. Vitamins like folate to try to get a complete picture. Right. And this is to kind of move us past this idea of correlation. Most of the epidemiologic studies are not correlation studies. They're association studies. They still have limitations like most observational studies, but they try to take into account even when we find kids who have higher exposures to these chemicals, either in utero or during early childhood, do we see differences in their health outcomes? And we do, we find, for example, that kids who are more heavily exposed to some of the forever chemicals like pfoa are more likely to be obese when they're older. We see that kids who are exposed to lead and highway traffic and certain pesticides are more likely to have diminished IQ later on if they're exposed either in utero or sometimes in childhood. And so we've seen this consistent picture. Now, if you can imagine if these were drugs, they would've been much more carefully tested before they were put on the market. We don't do that kind of testing. There's some, but it tends to be one or two studies, and sometimes they're done by industry and sometimes they're flawed. One of the most commonly used organophosphate pesticides, chlorpyrifos was shown to have used the wrong statistical analysis when it was first approved 50 years ago. Leanne Shepherd, who called that out said, look, if they had used the right statistical analysis, it may never have been approved. And yet we've spent the last 50 or 60 years trying to demonstrate if that's safe or toxic, and the evidence is consistently toxic. But here's the dilemma. When a pesticide or other chemical that's used in the environment and commerce has shown to be safe in a small laboratory study of 50 rats or mice, it gets a golden seal of approval. Now the burden is shifted to government shifted to independent scientists to prove. It's toxic. So now with something like Lead, we have thousands and thousands of studies showing it's not safe. But we have had a legacy of poisoning over the past century that were still cleaning up. And so the industries that benefited, that profited Guggenheims and the Rockefellers and DuPont and Sherwin Williams, they profited immensely. Particularly during the first half of the century, and then they moved on and we were stuck with the legacy, the health effects, the cleanup, and even proven that it, these, that lead was toxic. Even though we were warned before it was put in leaded gasoline, before it was put in gasoline not to do it. It would cause a scourge worse than tuberculosis. That determination, it's called the keyhole rule, is the same. Pattern. The same rule we use today. Once we have one or two small laboratory studies, often done by industry that has been shown to be safe. It's up to government, it's up to industry to prove that those chemicals aren't safe, which is really challenging, and that's the dilemma we don't have. Regulations that are protective like drugs, and yet there really isn't any difference between chemicals prescribed and chemicals that we're exposed to in the environment, in our food, in the air, except for one thing, for drugs. We can choose not to take 'em for the environmental chemicals. It's really hard to avoid them. Even for somebody like me that studied these things for 30 years.

Alisa Minkin 8:52

Right. I don't want people to throw their hands up in the air because I feel like that's the typical reaction. You know, something's gonna kill you. We just give up and we, we can. Can't be like that. You know, the story of lead, which you've had such an impact on, is a story of triumph, right? And a lot of fighting. And I wanna go back just for a couple points. One is that what drug companies do is they do, right? RCTs, they do these controlled trials, ideally double blind, right? We can't do that for these compounds by definition,

Bruce Lanphear 9:21

So it's an interesting question. It it would be very uncomfortable, but let me ask you a question. If we had, let's say, a new pesticide and it was, touted as the best thing since, well, let's say DDT, which turned out to be a poison. And there's a two laboratory studies in Mice and rodent that said, look, we don't see any harm in these 50 rodents, so we think it's safe. Alright, so now we have an option. We have an option to get that approved and put it on the market. Then what happens? People like me, scientists like me, will spend the next 30 to 40 years looking at people who are exposed, trying to distinguish between lower SES, maybe poor nutrition, these chemicals and this new chemical. Is it really safe? Right? That's one option. The other option would be maybe we should at least consider randomized controlled trials, maybe in adults, maybe volunteers. Because the alternative is maybe those thousand volunteers would be harmed, but they would protect the billions. Who would've been harmed. Now, I'm not necessarily suggesting we do this. This is really more of a thought experiment. Let's say those thousand people couldn't be found, nobody wanted to volunteer. Well, that tells us something. Maybe we shouldn't. Maybe we don't need that chemical, and I think that's probably the first thing we should be asking. For example, pesticides. United Nations scientists have gotten together and said, you know what? We don't need pesticides to feed the world. Now that's an interesting thought. You can do away with pesticides. We don't need them for our gardens. You can shift from. Planting non-native plants that require a lot of input, including fertilizer, fertilizers, and pesticides, and avoid using pesticides. So there's a lot we can do to shift to regenerative, to shift to organic, and that in many ways if we're looking about where are the positive things that we can do, that's the direction we should be moving.

Alisa Minkin 11:33

But it can't just be on the individual person, and that's. YI think it's amazing that you have your organization that we're gonna get to later. But I wanna go back a little bit to studying, because you mentioned correlational studies. And I think we need to really spell that out because classically what we hear in the news is, thing is correlated with X thing and then the people come back and say, oh, correlation is not causation. And so I think we really need to dive into that a little deeper. Please.

Bruce Lanphear 12:01

Sure. And that's absolutely true. So let's say for example. We saw that heart disease plummeted in the 1970s, and at the same time, let's say that people stopped eating macaroni and cheese. Did, did that cause the decline in coronary heart disease? No, absolutely not. And so we do have to be very careful. And so the way we get around that is first we account for other factors in the modeling that we do and the analysis. So for example, with that idea of coronary heart disease, which did plummet by 20% during that one decade period, which was extraordinary we could put into the model. Well, what happened when we look at declines in macaroni and cheese consumption? It doesn't actually play out. We don't see the connection. Maybe because it wasn't even the adults that were eating the macaroni cheese in the first place. So we have to try to take into account other variables or other factors that might help confound what we're trying to understand. So we can't just look at two things going together. Moving inversely. And so the association studies are an attempt to do that. And the vast majority of studies, like the ones that I do take into account things like if we're looking at children's intellectual abilities, for example, mother's iq. Socioeconomic status. Sometimes you might consider looking at whether the child is born preterm, but we have to be careful because many of the chemicals we're studying like lead, like PFAS, like air pollution can actually lead to preterm birth. So it's on the causal chain. And so we don't want to account for a a factor that's on that causal chain. But the key is that we do need to understand and account for other factors that might be contributing. One of the, one of the key things that I think is quite confusing to journalists and even physicians and others is heredi ability studies, right? So these twin studies, they take identical and non-identical twins, and they say, okay, if we can find out these differences. Then we can say what percent is due to heritability? And people take that and interpret it as genetics inevitable, fixed. And that's not what it means. In fact, there's this fascinating study that looked at children, twins who grew up in obesogenic diets OB genetic households and non-obese genic households. And actually the kids who grew up in the obesogenic. Households, the heritability was much higher. So what's happening? The environmentally rich environment for obesogens trigger the genes to act. It's the environment that's triggering obesity in the genetically vulnerable population.

Alisa Minkin 15:05

Is this what we mean by epigenetics? And maybe we can go into that a little bit because I think this is so important, but so. Using this concept of something could be heritable but not genetic.

Bruce Lanphear 15:14

Yeah, well, epigenetics is a little different. There's different kinds of epigenetics, but basically in the simplest form, epigenetics are not changes in the DNA sequence, but in things that are. Added onto the sequence, so like methylation that can either silence or activate certain genes. And so one of the main drivers, well the main drivers of epigenetics is the environment. Now epigenetics has the potential to reveal mechanisms, but it also can be quite complicated, just like understanding. Genome. For example, there was a study of let's say 30 or 40 Swedish men, I believe it was Swedish Scandinavian. Anyway, and they did this fascinating study where they isolated one of their two legs. They took muscle biopsies of both legs at bi muscles at baseline, and then they did intensive training of one leg. Over the next several months, and then they took another muscle biopsy, and what they found was that there was over 4,000 changes in the epigenetic marks in the legs, right? It's complicated. There will be some epigenetic patterns that are quite revealing that illuminate things, but we can also expect that it's gonna be very complicated.

Alisa Minkin 16:42

It's really complicated, and I think what you're explaining really well is that there's a difference between heritable, epigenetic changes that could be triggered by environmental things, say in a previous generation, but passed on, right? It looks genetic, it's heritable. But it's really environmentally triggered actual environment we're in right now with the same family is experiencing, right. Those are two different things,

Bruce Lanphear 17:05

That's right. And so Michael Skinner's done some fascinating work looking at chemicals and showing that the changes, the epigene changes that can result, can now be passed on through generations.

Alisa Minkin 17:19

right?

Bruce Lanphear 17:19

Over four generations. That's really quite striking and a little bit scary, right? Because we think about legacy exposures being led in the soil things that are out there in the environment, but they can also impact our genes and be transmitted over many generations.

Alisa Minkin 17:40

And that gets back to whole problem of genetics versus environment. I think a lot of these studies on genetics are, are. Misleading because it makes it seem like, oh, well it's just your genes. Oh, well, there's so much money, for example, with autism, for looking at the genetics of autism. You keep hearing it so genetic. It's so genetic, and yet it's rising and something should not rise. That's purely genetic the way it is.

Bruce Lanphear 18:04

Right. I think you know, like many conditions, there is a subset. Of children with autism, of people with autism that appear to be predominantly genetic, but that seems to be a relatively small fraction of the overall population, and that's true for other things like a LS. So my dad died from a LS, and about 10% of a LS is genetic. The vast majority is environmental. And I think we're gonna find it, and we are finding that the vast majority of autistic traits are driven by. Environmental triggers operating on common genes. So it's not a matter of genes or environment. They're both important, but here's where it becomes more important to think about the distinction. If we're seeing a rise in autism and we are despite. People are arguing that it's all genetic because of the heritability studies. We are seeing a rise in autism. That is a function of environmental triggers acting on existing genes, mostly common genes. So they're both important, but here's the trick. How do we figure out where to focus? Should we start manipulating people's genes or should we be. Reduce the exposures, the triggers, identify and reduce the exposures or triggers that have led to the rise or led to the increased risk. As a population scientist, I don't wanna start messing with people's genes. I wanna start modifying the environment.

Alisa Minkin 19:37

Right, and I mean, yes, research is important, but don't we already know these so many compounds are toxic. Don't we have enough information about them already?

Bruce Lanphear 19:46

In many cases I absolutely agree, and we should also change and overhaul the regulatory system given what we know now that we didn't 50 or 60 years ago when that regulatory system was put in place. Right? And again, we could look back to what happened with drugs. For decades, there were progressives, public health progressives, who were calling for changes to the way we regulated drugs. They were largely dismissed. I mean, there was some, let's label this better, but up until a crisis, that thalidomide crisis. Now the question is, have we seen enough about these environmental chemicals to say it's time to overhaul the regulatory system and the 2016. Change the Ladenburg, bill Toco was inadequate. It didn't go far enough. Autism, I thought, might be enough to convince us that it was time to overhaul or modernize, let's say, the regulatory system. But it really hasn't happened yet. And part of that is there's a skepticism. Isn't autism, primarily genetic people might say, and that's been a fairly common. Argument in the New York Times by scientists. But when you begin to step back and look at what does heritability mean, you begin to realize that that can explain the tremendous rise. Now, having said that, again, we've got at least two different general categories. Well, we've got more than this. We've got neurodiversity and we wanna respect individuals, right? But we also have to think about the population impact and look at whether there are. For example, some chemicals that increase the risk of autism, and we have good evidence. Is it definitive? No, but it's really good. Pesticides appear to increase the risk of autistic traits or autism, especially in women who have low folate or inadequate folate circulating in their blood phthalates a type of plastic chemical. Might also. Yeah.

Alisa Minkin 21:58

Sorry, you said folate. Okay. That was a major trigger for me for a couple things

Bruce Lanphear 22:03

Okay.

Alisa Minkin 22:03

what's been in the news is leucovorin and leucovorin is a metabolite of folic acid. It's not the same. It's supposed to be absorbed through the CNS for people who can't absorb it. There are people who actually have cerebral folate deficiency, which is very rare. if we're talking about genetic variance, you know, there's huge talk about the M-T-H-F-R variance. Again, we are not here for medical advice. We are not gonna talk in, in about leucovorin here in detail, when you say folate, I can't go past this and not mention that. There are different people with M-T-H-F-R variants and I would love to see on a practical basis how that impacts. Folate metabolism, so we could actually help people use that with evidence-based

Bruce Lanphear 22:52

Well, first a disclaimer. A physician, but I'm not a clinician and I'm not an expert at Leucovorin. There are some signals that indicate that polymorphisms of M-T-H-F-R do have an impact on folate metabolism. Absolutely. And may interact differently with some of the chemicals we're concerned about. Like phthalates like arsenic. Arsenic seems to arsenic and even secondhand smoke tend to diminish the availability of folate in pregnant women. There is some growing evidence, but nothing, I think we can say anything definitive about that. For some people who have the, an anti folate receptor antibody might need more. Folic acid or some other form of folate that they may need something different. We are just starting to look at that in our Canadian birth cohort, but I don't have any answers about that. But these are really important questions. There is something going on with folate that's really important and there is something really important going on with chemicals, phthalates. Air pollution, pesticides in particular, perhaps arsenic. And so in a way, as I'm thinking about autism today, and again because of this neurodiversity, that it's almost like, you know, those mixers sound mixers, they've got thousands of or hundreds of buttons on 'em, and you can modulate the sound here and the bass there. You know, when we think about children's development and think about just brain development for a moment. I think what's going on in utero is that there is this ongoing modulation in the environment and the human body will, will modulate a lot of this to some extent, right? If you don't have enough calcium, the mother will pull some from her bones and give it to the kid, right? If there's not enough folate. And it's really deficient, then that might cause some issues, especially if there's anti folate receptor antibody. So there's all these things modulating all the time. When we look at personality, you know, we often say, ah, well my grandson, he's just like his father. Right? I mean, that's sort of the way we think about it, and I think that's why the heritability studies seem so easy to believe. But really what's going on is we've got this blueprint. Our genetic code with all those little epigenetic marks and that changes during in utero development and then modulating all of those things is this environmental mix of chemicals and nutrients and stress of the mother and all of these things. Now, on one hand, thinking about this positively, I think overall we're pretty resilient. I think, you know, we. When I think about my family and we've been trying to change our environmental milieu, what we eat what we cook with for decades, HEPA air cleaners, particularly with forest fires out here, we think about all of these things that we can modulate, and there are some things we can do in the short term, but what we really need help is to modulate them systematically. That's what the regulatory system is there for. I remember being interviewed by Joel Bachan. He wrote a book called. Well, he wrote the Corporation, which became a documentary, and then he wrote a book about how big business targets children for profit. And he was asking me about all these chemicals that we study, and I was responding and I was going on and on and you know, maybe talking five or 10 minutes. And he finally says, wait a minute, wait a minute. He says, you have kids, right? I said, yeah. He says, you've been studying this for a long time? I said, yes. He said, can you protect your own children? I said, no, not by myself. I can try to reduce exposures. There's things we know I can do that we can all do to reduce our exposures, but I need the help of my government. We all do.

Alisa Minkin 26:58

It's not a me problem, it's a we problem.

Bruce Lanphear 27:01

Absolutely. Yeah.

Alisa Minkin 27:02

But I do wanna do the me part for a little bit because I, I don't want anybody to leave feeling that they can't do things. There are things you can do and on a me level too. So I just want you to give us just some basic ideas. First of all, just to start with, this is not possible to fix. There's no such thing as perfection, right? I like Maya. Do the best you can and so you know better. When you know better, do better. Break it down. Just do something rather than get paralyzed. But what would you say?

Bruce Lanphear 27:29

Right. Well, so I can tell you, I can tell you what we've done in my household and how we think about it. And, and I, I say this, that I've kind of looked at the science and I think about the big picture and how to regulate chemicals. When it comes down to what happens in my household, it's my partner Nancy, a pediatrician who makes sure it happens. So what we've done over the past. 20 to 30 years sim some simple steps. Not always less expensive, which would be nice, but it doesn't always work out that way. When possible, we choose organic. If, you know, there are times that either we didn't have enough money early on or other people might not have as much money, then we use the environmental working groups, dirty Dozen and Clean 15 to say, which one should I choose to organic. So we've done that and we've been doing that. Well, for 35 years since we've had kids, what we cook and what we eat, it's really important. There's this misconception out there, and it's a, it's clear who's been pushing it that. Cooking is inconvenient, right? It's easier to go out. Let's just go to a fast food restaurant. Well, it's absolutely not. You gotta get in your car or walk somewhere. And part of the joy of our household is when we cook together, at the end of the day, you get together. We used to be, we'd have gin and tonic. Now we have a, you know, club soda because we're getting old. We don't metabolize alcohol as well, and we talk about the day. And you cook the food you enjoy and you don't have to worry about food poisoning and you know what's in the food, right? It changes everything. You sit around the table together. That is so much more enjoyable than going to some fast food restaurant where the seats don't let you sit more than 12 minutes. 'cause they're hard, they're meant to be. So that's the second thing we've done. And what we cook again, organic. We try to avoid packaged foods. We don't use canned food anymore. You know, there were a few things that were hard initially they're not anymore because used to be getting tomato sauce was hard. Now you can get it in glass jars. We get ours from our friend, the organic farmer. He does his heirloom tomato juice. Oh, is it so good. Avoid plastic packaged foods. You know, that's, it's, you can't do it a hundred percent, but when we use the farmer's market, that helps, Nancy gets most of our stuff at a, the soap dispensary that you bring your own glass jar. So there's ways that you can adapt. Don't use pesticides, don't allow smoking in and around the household. Hepa air cleaners, particularly if you live in a polluted environment, and we all do to some extent, especially with four or fi forest fires, those can be really challenging. So those are some of, oh, and then the one other thing, this was the hardest for my three children, who are all young women, avoid cosmetics. Avoid cosmetics and use few personal care par products. Be very selective about what you use. Save your money. Don't use perfumes, don't use air fresheners, right? Save your money. And then finally think about what you clean with. Those take time, right? We didn't adopt them all at once. It takes some time, but once you've adopted them, and there are a lot of people out there who are helping people learn, I'm not one of those influencers, but there are a lot of people who are helping people learn about using safer products. And if you do it incrementally, it then just becomes part of your routine, part of your rituals.

Alisa Minkin 31:08

Do you have any recommendations for those people? Because people who preferably aren't selling something at the same time. Because Happens is you get anxious and then you just go buy something to feel better.

Bruce Lanphear 31:18

right, why don't we, why don't we add a few connections on your, on your podcast site

Alisa Minkin 31:24

Yeah.

Bruce Lanphear 31:24

than me try to put 'em together now? Yeah.

Alisa Minkin 31:27

I love a lot of what you said. Some of it made me feel like I can't do that. And some of it made me feel like for a lot of people, this is gonna just be for certain privileged people who have the financial time capacity. There's finances, there's time, people are stressed, and so I just wanna emphasize, do the best you can and so you know better when you know better, do better and the way that you can, because one of my lines is stress is a toxin. Anxiety is a toxin. Like everything has to be balanced. I remember when I first learned about a lot of this and I stopped buying produce, couldn't afford the, the organic, and so I had less produce. Well, is risk benefit, right? you have to decide what you can afford, what things have the most bang for your buck. And there are, there are, you know, healthier forms of makeup for people who you know are going to use it. There are phthalate free products. There's people you know, who have businesses with this often costing more, but you know,

Bruce Lanphear 32:25

Yeah, well.

Alisa Minkin 32:26

it's very personal.

Bruce Lanphear 32:27

Mark Bittman's done a nice job of talking about how actually cooking at home can be less expensive. Using less processed food can be less expensive, right? So if you're selective about what you choose to eat organic, so for example, strawberries, blueberries, those tend to be some of the fruits that have high amounts of pesticide on them. I'm absolutely getting those organic or. I get the frozen ones that we've already bought from the farmer's market last summer and put in the freezer. So there are some things. Buy 'em when they're fresh from a farmer's market, the organic, and then freeze 'em and use that.

Alisa Minkin 33:07

Not, not everybody has access to farmer's market. You know, you're talking about things also that cost a lot of. Time and for a lot of people, time is money. So, you know, there it's, it's really good to know all this, but I just wanna say to my listeners, just do the best you can and then I wanna talk about the we part, because no matter, I feel like sometimes you're just like the sorcerers apprentice just going

Bruce Lanphear 33:29

right.

Alisa Minkin 33:30

there and you feel hopeless and hopeless. And I don't want people to feel like that.

Bruce Lanphear 33:33

Absolutely. When I first started talking to community groups 25 years ago, I would always push, we've gotta change the system. We've gotta change our regulatory system. And inevitably people would come up afterwards and say, look, you scared the shit out of us. What do we do today? Because I can't wait for government. It's gotta be a balance.

Alisa Minkin 33:55

Right. And I, I don't know. What about the folate metabolism, whether there's anything people can do about that right now? You can definitely talk to your healthcare professional about that. I, it's really food for thought. I wish there were better studies. but it's just, if we metabolize it differently, maybe that's standard, you know, dose that's prescribed for women and children. Maybe different for different people. Again, I'm not here for medical advice. I'm just putting that out there because that's what I thought about when I read the studies you showed me. About folate levels and autism, and that's something that people could look into now, right?

Bruce Lanphear 34:28

Yeah, and maybe we also add another link onto your website

Alisa Minkin 34:32

yeah,

Bruce Lanphear 34:32

about,

Alisa Minkin 34:32

studies. Yeah. No, I'm, I'm getting lots of links and so speaking of links, I really wanna talk about the we and specifically about the little things matter organization.

Bruce Lanphear 34:44

Yeah, well, so I've been studying children's environmental health for, well since 1995. And at that point, you know, it felt like there's maybe a few dozen people doing that. And I was even, in some ways I was coming on. Late. I was young. There had been a generation before me that had really set the foundation. We are seeing a lot more interest and that's really, that's great. I mean, there's still a lot of questions. Of course. So I thought as this naive young scientist, that the solution was to do the studies. And once we had the science, the EPA, the FDA, other regulatory agencies would pick up that science and run with it, and my job was done. I would go on to do another study. Well, it took me about 10 years, but you know, by 2005 I knew that wasn't working particularly well. And absolutely by 2000. 14. After we'd immigrated to Canada, it became very clear that the science was not being translated. The EPA wasn't doing it. The FDA wasn't doing it. Many of the medical societies when it came to environmental chemicals were not doing it adequately. And so my brother and I, my brother's a graphic designer, Bob, he lives in Bellingham. Cool. Decided to start producing videos and we did it under the umbrella of little things Matter, and the point of little things matter was little people matter, children matter, and even very small concentrations of chemicals found in all of us, those matter because 60, 70 years ago for non carcinogens, for chemicals that don't cause cancer, there was a major assumption made that. They're safe at low levels. Don't worry about 'em. Well, that's not what my studies were showing. We're finding there's no safe level of lead. There's no safe level of air pollution. Others have found there's no safe level of asbestos or benzene. And for most of the other chemicals, we don't see evidence of a threshold. There's still questions about what happens down at parts per trillion, but in many cases, what we're seeing in the parts per billion range of exposures, there doesn't appear to be safe levels. And so that really should change, should overhaul the way we regulate chemicals because the assumption is made. That there are safe levels of non carcinogens, carcinogens. We assume that there isn't a safe level and that there's sort of this, we call it a linear, no threshold model. And in some cases that isn't adequately protected because we see greater than linear effects for things like benzene and asbestos. And so even that doesn't work. So that's, these are sort of the basic nuts and bolts of how we regulate chemicals and we know they don't work anymore.

Alisa Minkin 37:45

So I wanna hear more about little things matter because it's not just the videos, right?

Bruce Lanphear 37:51

That's right. We've got in 2019. At a International Society for Children's Health and Environment meeting, we had a group mostly of younger scientists younger scientists and physicians who said, we want to be part of this. So we've got about 12 volunteers who work with us and we put out regular posts about new science Facebook, Instagram. We are now working with three young scientists, we call 'em fellows. They're research to action fellows who are helping us launch a plastic campaign using the idea of we warriors that kids who, the cartoon kids who with innocence, with honesty say, why do we keep. Putting pesticides, poisons in our food, or I've got plastic in my veins and I'm pissed. Right? So we're letting these kids. Speak for

Alisa Minkin 38:51

Right.

Bruce Lanphear 38:52

all of us with a sense of irreverence. And so we, we launched the plastic campaign a year ago in Ottawa at the international Plastic Treaty, and this group of young scientists now wants to bring it back to life. And so we've got a year strategy where they're gonna help us develop this, and then we'll launch it in about nine months.

Alisa Minkin 39:13

That's amazing. I think there were also political op opportunities from this website for like local grassroots. Advocacy. Am I right?

Bruce Lanphear 39:22

We work with a lot of advocacy groups. A lot of advocacy groups follow what we do. One of the ones that we've been working with Kim Conte and her team at non-Toxic Neighborhoods since 2016, and this is a great story. So, kim and her, her team were at, at the time in orange County, California, and they were watching their kids play on sports fields and school playgrounds and, and saying, wait a minute, why are they spraying pesticides? On these fields and they didn't quite feel comfortable with it, but they weren't quite sure if it was okay. And then they saw one of our videos. And so Kim contacted me and I've been to her advisor ever since. And what that video did is it gave her confidence that from credible scientists that they were on the right track. And this is extraordinarily important because. I can't be everywhere and people like me can't be everywhere who study these things. And ultimately, in the absence of a systematic approach, a federal approach or even a state approach that is adequate, what we rely on is local community groups. So I worked with non-toxic neighborhood and they've worked with over 200 cities in the United States to help get rid of. Pesticides on sport fields and, and gardens and other things. We work with community groups to help. Them understand the science and bring the science to their own communities to, to ban or accelerate the ban on leaded aviation fuel. I'm working with groups across the world to try to eliminate lead poisoning. Now, we've seen blood lead levels come down dramatically in the United States and Canada, and parts of Europe globally. One in three children are lead poisoned today. One in three children lead accounts for an estimated five and a half million deaths every year, and 765 million IQ points lost around the world. Mostly in low to middle income countries are what I like to call them, industrializing countries because it's the industrializing part that helps us understand why lead poisoning is rising, why diabetes is rising, why cardiovascular disease is rising. So we've, what we try to do is take the science and make it more accessible through videos. Now, you, you asked for more positive things. One of the things that we've highlighted, and this is around lead this, remember I talked about that dramatic decline in coronary heart disease? Well, since its peak. Coronary heart disease was really an epidemic or now pandemic of this past century and coronary heart disease deaths peaked in 1968 in the United States, and then they began to come down and they've come down by over 75% since the peak. Why? Well, we've been looking at data and we've got some new studies ongoing, and what they suggest very strongly is that lead. Is one of the key reasons, particularly leaded gasoline. Beginning in the 1968 production of leaded gasoline began to come down. We saw blood lead levels plummet in lockstep with the decline in coronary heart disease, deaths with heart attacks. We also saw, saw hypertension in adults plummet. Now, it's not only lead, other heavy metals also appear to be big risk factors for coronary heart disease. And of course we can't forget air pollution and secondhand smoke or tobacco smoke, but I think a more appropriate way, I mean, it's important to think of them both ways. Cigarettes are part of the problem. Air pollution is part of the problem. Lead and other heavy metals are part of the problem. But we can also think about them as a spectrum. Because what air pollution is, what tobacco smoke is, is a lot of particles with a lot of other contaminant, contaminants and heavy metals like arsenic and lead. And so I think what, what, what I've come to the conclusion is that this epidemic of coronary heart disease, the leading cause of death still today in the United States and Canada and around the world, is primarily been driven by heavy metals. Air pollution or heavy metals in air pollution. We don't know the answer to that yet. That's hopeful. Why? Because it isn't all about. Stents. It isn't all about surgery. It isn't all about drugs. Although they can be powerful and important in the short term. But ultimately our goal, I think should be to get to the point where we don't need to take anti-hypertensive drugs, right? That's the population strategy and that's the the power of prevention, and that's why I wanna become a prevention wizard.

Alisa Minkin 44:21

I love it. That's great. Brands a on marketing. We need more marketing and branding of this

Bruce Lanphear 44:29

Yeah,

Alisa Minkin 44:30

I keep thinking they're not coming to save us. We have to do this because you're, you're fighting against huge corporate interest. I mean, we didn't even really talk about, we could have about the fight of all of the things that we've done made progress and say like lead was against tremendous, tremendous corporate resistance

Bruce Lanphear 44:47

that's right.

Alisa Minkin 44:47

doubt.

Bruce Lanphear 44:48

That's right, and I think what we're learning now about democracy is also relevant to about how we regulate chemicals, right? The failure to regulate these chemicals. Because our democracy has been fraying. What we're learning about democracy today is that we all have to step up if we want to re, to retain that sense of democracy, to make sure that people are representing our best interest. And one of those interests is protecting us from toxic chemicals and pollutants.

Alisa Minkin 45:23

Absolutely, and I'm gonna just take hope from the fact that we have fought this before and we have made tremendous progress. I'll go back to my training. I trained in the late eighties and early nineties, and we used to do chelation on kids for lead.

Bruce Lanphear 45:36

Right.

Alisa Minkin 45:36

with lead levels of 45, 50, you know, severe cognitive impairment, and I watched the levels go down with the regulation of how high those levels could be.

Bruce Lanphear 45:48

That's right.

Alisa Minkin 45:48

I, I thank you for your work in this area.

Bruce Lanphear 45:51

Yeah, well, I'm the second generation. There's a, a slew of people before me that really brought those heavy levels down. What my work did, in a way was to extend Herb Edelman's work, which is to say, do we see effects at lower and lower levels? Now, all of this is quite hopeful. I absolutely agree, but a bit of caution as well. In the sixties and seventies, Claire Patterson showed using. Glacial ice samples and bone samples that people at that time were about a thousand times more heavily exposed to lead than our pre-industrial ancestors. We've seen blood, blood levels come down almost well by 95% since then, and yet. Our blood, the levels are still 10 to a hundred times higher than our pre-industrial ancestors, and even down at levels of less than one microgram, pede, or let's put it in the context of a one microgram pede increase, which is equivalent to a 10 part per billion increase. We can see a 50% increase in preterm birth. Among pregnant women. With that little bit of lead, we still see evidence of an increased risk in coronary heart disease, deaths or heart attacks with very small increments and lead, we still see decrements and IQ ability down at very small levels. So we may not have achieved the levels we want yet, but we have seen tremendous reductions in lead exposure and reductions in conditions, health conditions associated with that.

Alisa Minkin 47:26

Which is what I'm gonna take home with me and for our listeners, right, that we can make a difference, but. First, we have to see what the problem is, honestly, with our eyes wide open so that we can actually make it better and not fall into the trap right of the monkey with their hands over their eyes,

Bruce Lanphear 47:43

Right,

Alisa Minkin 47:44

ears and mouth.

Bruce Lanphear 47:45

and that's really it is the hopeful part. I mean, what we're learning from studying environmental chemicals is that they are. Major risk factors for many common problems today, from depression to heart disease to A DHD. Why is that promising? I mean, it's a little troubling 'cause we've done it to ourselves, but why is it promising? Because without knowing anything more, without more genetic studies, without surgery, without expensive drugs, we could actually begin to reduce the risks and those actual conditions.

Alisa Minkin 48:18

And I think we also have to put money into studies of, now that we are living in this stew of chemicals, how do we help people it as healthy as possible? Right back to that folic acid and maybe other things, you know, more individualized precision medicine. think we have the capacity. We just have to put our money where our mouth is.

Bruce Lanphear 48:36

That's right. And one of the things that, just to play this out a little bit, there was a, a scientist who said, look, we don't want to scare people by telling them their kids' blood, blood levels. And in one sense I agree with that, right? Particularly if we're talking about levels down around one microgram per deciliter, 10 parts per billion. But we do wanna have enough sense of urgency that we continue to fund the replacement of lead service lines that we continue to fund abatement strategies to get rid of lead in homes, right? So that's really the effort. What I'd like people to think about is differences between clinical strategies and population strategies. Now they're complimentary, but if, if anybody's interested in being a prevention wizard, I've got a book for you and it's called A Strategy for Preventive Medicine by Jeffrey Rose, first published in 1993, and he talks about these two strategies. Again, they're complimentary. We need both. But we have underemphasized population strategies and population strategies are much more powerful than clinical strategies if we want to prevent disease. If you look at why did life expectancy increase so greatly, it was virtually all population strategies. Very little to do with medical care. One patient at a time, which doesn't mean that that's unimportant. It just means we need to have a place and resources devoted to population strategies, vaccinations, great population strategy, taking lead outta gasoline. Beautiful. When I first started studying lead, you know what we told families, do a better job cleaning your house. Watch. My first big study was a randomized trial to see if we worked with families to reduce their lead exposure by cleaning their house. It didn't work,

Alisa Minkin 50:30

Right.

Bruce Lanphear 50:31

but you know what worked? Taking lead outta gasoline. That's why blood that plummeted. That's the power of prevention population strategies.

Alisa Minkin 50:40

Right, right. It's really, really important place to end because again, I feel like we're putting it all on the individual. It not only feels impossible, it is impossible. It's not fair, but we can make things better. And I wanna thank you so, so much for doing this with me. This was amazing. You're doing such important work, and this was such an honor for me to get this chance to interview you. Thank you.

Bruce Lanphear 51:01

Well, thank you. This has been a great opportunity for me as well.

51:15

Thank you for listening to Kids Matter. Raising Healthy, happy Children Takes a village, and I'm grateful you are part of ours. If today's conversation resonated with you, please share this episode with another parent, grandparent, teacher, or anyone who cares about kids. Together we can build a supportive community our children deserve. I'd love to hear from you. Share your thoughts, questions, or suggestions for future topics at Kids Matter podcast@gmail.com. With no explanation for your voice truly matters. Until next time, keep advocating for the children in your life because kids really do matter. They are our future. I'm Dr. Elisa Minkin and this has been Kids Matter. Please note that while I am a pediatrician, I am not your child's ped. This podcast is for informational purposes only and does not constitute medical. For any medical concerns or decisions. Reach out to your child's healthcare professional.