31 March 2015

Mercury puts Arctic kids at risk

There is a long standing debate about the benefits of eating fish particularly for pregnant women and unborn children because of high levels of mercury in fish.
A recently published study shows how high intake of mercury is damaging brain development in Inuit children in the Arctic Quebec, Canada. Children’s IQ level was found to be linked to the intake of  marine animals with high mercury levels e.g. beluga whale, seal, walrus as well as fish.
Pregnant women in the Arctic have been urged to eat more Arctic Char as it is currently considered to be less contaminated.
The high exposure of mercury not only affects children’s IQ it can also effect attention, motor skills, heart rate and lead to respiratory problem and ear infections.

Jacobson JL, Muckle G, Ayotte P, Dewailly É, Jacobson SW. Relation of Prenatal Methylmercury Exposure from Environmental Sources to Childhood IQ. Environ Health Perspect; http://dx.doi.org/10.1289/ehp.1408554. Advance Publication: 10 March 2015
Although prenatal methylmercury exposure has been linked to poorer intellectual function in several studies, data from two major prospective, longitudinal studies yielded contradictory results. Associations with cognitive deficits were reported in a Faroe Islands cohort, but few were found in a study in the Seychelles Islands. It has been suggested that co-exposure to another contaminant, polychlorinated biphenyls (PCBs), may be responsible for the positive findings in the former study and that co-exposure to nutrients in methylmercury-contaminated fish may have obscured and/or protected against adverse effects in the latter.
To determine the degree to which co-exposure to PCBs may account for the adverse effects of methylmercury and the degree to which co-exposure to docosahexaenoic acid (DHA) may obscure these effects in a sample of Inuit children in Arctic Québec.
IQ was estimated in 282 school-age children from whom umbilical cord blood samples had been obtained and analyzed for mercury and other environmental exposures.
Prenatal mercury was related to poorer estimated IQ after adjustment for potential confounding variables. The entry of DHA into the model significantly strengthened the association with mercury, supporting the hypothesis that beneficial effects from DHA intake can obscure adverse effects of mercury exposure. Children with cord mercury ≥ 7.5 μg/L were four times as likely to have an IQ score below 80, the clinical cut-off for borderline intellectual disability. Co-exposure to PCBs did not alter the association of mercury with IQ.
To our knowledge, this is the first study to document an association of prenatal mercury exposure with poorer performance on a school-age assessment of IQ, a measure whose relevance for occupational success in adulthood is well established. This association was seen at levels in the range within which many U.S. children of Asian American background are exposed.

Full Article:  click here

5 March 2015

Trading away Health: Reflections on an HIA of a trade agreement”

Guest post by Fiona Haigh:
The HIA team at CHETRE has been working with a group of Australian academics and non-government organisations to carry out a health impact assessment (HIA) on the Trans Pacific Partnership Agreement (TPP) negotiations. The report has attracted a lot of attention and in general has been a different experience from the typical HIAs that we are involved in. We thought it would be interesting to share with the HIA community a few reflections on our experience.
We weren’t commissioned to do this HIA- a small group of us thought it would be a good and interesting thing to do and we somehow managed with some support from CHETRE and the Public Health Association of Australia keep it going. The support from CHETRE enabled us to bring in Katie Hirono to do a lot of the work on it and we were supported by a group of experts and advocacy groups who contributed their expertise and advice. There were some technical challenges to do with trying to do an HIA on something that is being kept secret. We had to base our assessment on leaked documents on wikileaks and advice from academics working in the area and policy experts. We also faced the challenge of trying to predict likely future public health policies that could be impacted on by the trade agreement (since it won’t affect current policies). We approached this by working with policy experts to identify likely future public health policies in our scoped areas of focus that would be impacted on by the TPP.
We also walked the talk of taking a participatory approach, which meant sharing power with the technical advisory group and the advocacy groups that we worked with throughout the process. We feel that this has worked really well- it meant that we focused on issues they identified as important and we have produced a report that they have been able to immediately use for their advocacy. Without them I’m pretty sure this report would not be having the impact it has had so far. The report is being talked about on the front pages of major newspapers, there have been multiple radio interviews, a social media campaign led by CHOICE (the main consumer advocacy group in Australia), lots of tweets and perhaps most satisfying of all we’ve been labeled scaremongers in a press release from the minister for trade and investment - we must be doing something right!

3 March 2015

Health Impact Assessment of the Proposed Trans-Pacific Partnership Agreement

An HIA of the Trans-Pacific Partnership Agreement (TPP) has just been released, authored by Katie Hirono, Fiona Haigh, Deborah Gleeson, Patrick Harris and Anne Marie Thow.

From the media release:

Report finds medicine affordability, public health policies at risk in Trans Pacific Partnership
A report released today by a large team of academics and non-government health organisations reveals that the Trans-Pacific Partnership Agreement (TPP) poses risks to the health of Australians in areas such as provision of affordable medicines, tobacco and alcohol policies and nutrition labelling. Many public health organisations have been tracking the progress of the TPP negotiations over the past several years and have expressed concerns about the potential impacts and lack of transparency. 
“The TPP includes provisions that don’t just affect trade. They affect the way the Government regulates public health,” said Michael Moore, Chief Executive Officer (CEO) of the Public Health Association of Australia (PHAA). “In many areas – such as nutrition labelling - it’s already a struggle to implement effective policies that promote health. If certain provisions are adopted in the TPP, this will be another hurdle for organisations seeking positive public health outcomes.”
The report also argues that: “The TPP risks increasing the cost of the Pharmaceutical Benefits Scheme (PBS), which is likely to flow on to the Australian public in terms of increased co-payments (out-of-pocket expenses) for medicines”. An increase in co-payments risks declining public health and increasing hospitalisations, particularly for people who are already disadvantaged.
A team of researchers from UNSW Australia, Sydney University and La Trobe University conducted the health impact assessment based on leaked documents from the trade negotiations.
“In the absence of publicly available current drafts of the trade agreement, it is difficult to predict what the impacts of the TPP will be,” said Dr Deborah Gleeson, one of the report’s authors. “In the study, we traced the potential impacts based on proposals that have been - or are being - discussed in the negotiations. But the only way to properly assess the risks is to allow a comprehensive health impact assessment to be conducted on the final agreement before it gets signed by Cabinet.”
The report offers a set of recommendations to the Department of Foreign Affairs and Trade to reduce the likelihood that the TPP will negatively impact health in Australia. Such recommendations include excluding an investor-state dispute settlement (ISDS) mechanism, and including strong wording to ensure that public health takes priority where there is a conflict with trade concerns. The report also recommends that Government change its approach to conducting trade agreements, for example by publishing draft texts and negotiating positions on issues of public interest.
Trade negotiators are meeting next week in Hawaii. The Minister for Trade and Investment, Andrew Robb, has said he anticipates the negotiations will wrap up within the next few months.
“It’s vitally important that health is given high priority in the final stages of the negotiations,” said Lynn Kemp, Director, Centre for Health Equity Training, Research and Evaluation. “We urge the Australian Government to consider these issues seriously.”
The HIA report can be accessed here.