a basic reproductive right
John Peterson Myers
Planned Parenthood Political Academy
12 July 2000
you for inviting me today to address such an extraordinary group
of community activists from around the country.
me begin with a story. I was in far western China a few weeks ago,
at the edge of the Tibetan plateau. I was there to look at some
work the W. Alton Jones
Foundation has begun supporting to develop new sources of energy
for rural communities. We hope to free mothers from the need to
use kitchen fuels like coal and firewood that often lead to blindness
after long-term indoor use.
had hiked into a remote village, 6 hours over a trail that climbed
over a 14,000' pass. No roads led into this village. The scenery
it. 22,000' jagged peaks in the background, covered with snow and
ice. The village nestled in a U-shaped valley cut by ancient glaciers.
Beautiful forests along the hillsides and a grassy meadow in the
grazed, bedecked with bells that clanged with every slow step.
A stream cut through the meadow.
in the middle, by the stream, was a Buddhist monk swirled in
the purple garb of his sect.
a scene. Mountains. Forests. Valley. Yaks clanging. And in the foreground
a purple monk. He stood stock still, it seemed, for 20 minutes,
his hands raised together in front of his chest, thumbs on top,
elbows by his side. He was staring fiercely at his thumbs. A tea
kettle hung from his left elbow.
I walked closer I could see that his thumbs were moving slightly
up and down, as if he were working prayer beads. Finally I got close
enough to see what he was holding so intently.
world is changing very fast, and all is not what it seems at first
rural China I went to Denmark. In far western China I had been a
giant. In Denmark I was a midget, surrounded by large, virile men
and tall, lithe women.
was in Copenhagen for a scientific meeting during which I learned
something quite unexpected about those virile men. They were not
all they seemed.
is within a range at which fertility impairments are expected. As
a biologist, I can tell you that even if we don't know all the details
of what is happening, even if there is some uncertainty and imprecision,
a population composed of men of whom 40% have biologically-based
fertility impairments is not a normal population.
data are consistent with reports
from other countries indicating that over the past 50 years some
places in the world have experienced large declines in sperm count.
fertility patterns are changing in women, also. For example, before
1921, there had been only 20 cases of endometriosis
reported in the medical literature. Endometriosis can dramatically
reduce a woman's ability to bear children. Now we know that at least
5.5 million women in the US and Canada are affected. It is appearing
with ever greater frequency in younger women. Endometriosis can
be a difficult condition to detect. Some of the increase, perhaps
a lot of this increase, has been due to increasing efficiencies
of detection. But not all. Public health experts believe that the
real rate of endometriosis has increased substantially since World
are two scientific hints of a future in which men and women who
wish to have children but can't will become increasingly common.
They are hints that a new front will open up in the global fight
over reproductive rights.
right to choose is the right to make your own choices about when
to have children. Here to fore, it has been assumed, for the most
part, that when you want to, you can. I believe this assumption
is no longer a safe one, for an increasing number of people in the
are likely to be multiple causes for this. Some have to do with
life style choices, simple biologically realities that flow from
the choice many women are making in this country to wait until later
in life to conceive. But this is not the whole picture, as suggested
by the high frequency of fertility impairments in young Danish men
and increasing commonness of endometriosis in younger women.
scientific meeting I attended in Denmark was about a new field in
biology and toxicology that has emerged during the last 10 years.
It has grown out of a series of disparate discoveries indicating
that widespread contamination can interfere not only with the ability
to reproduce, but also with the quality of life that might be expected
for a child that grows to maturity after exposure in the womb.
just their experience as a child, but life-long impacts on intelligence,
should state at the outset, and will remind you as several points
through my comments that the science on this issues is incomplete.
In an absolute, pure scientific sense, there is not certainty, but
in my opinion and in the opinionand indeed in the opinion
of the Royal Society, Britain's equivalent to our National Academy
of Sciences in a report
issued last monthenough is known to recommend that strong
measures be taken now to reduce exposures.
what's the story?
are four pieces to the story.
we are all
contaminated, every person in this room, by several hundred
compounds that were not part of human body chemistry just 3 generations
ago. Some of those contaminants are most likely benign, some are
known to be harmful, but for the vast majority, we don't know. The
two generations of people born since world war two are walking,
global experiments in toxicology.
we have learned through research with animals that some of these
compounds intefere with the
hormonal signals that guide development in the womb. The developing
embryo and fetus depends upon getting the right natural hormonal
signals at the right time in development. They determine what that
individual will become-things as basic as sex, the number of digits,
the shape of the uterus if it is a girl, whether all the pieces
of the reproductive tract are functional, whether the immune system
works and whether the brain is wired properly.
that mimic or interfere with these natural signals can derail development,
send it off on the wrong track, subtley or grossly depending upon
the timing and the magnitude of the interference.
we have seen a dramatic change
in scientific understanding about the level of contamination
necessary to cause an effect through this hormonal interference.
now know that there has been a paradigm shift in thinking about
health impacts of contamination. The old way was too narrow, too
limited, and that many-indeed perhaps the most important effects-would
be utterly missed by standard approaches.
old paradigm focused on acute toxicity. How do high levels of contamination
affect health? How do they cause cancer? How do they kill directly?
How do they overcome the body's defenses, like a massive invading
army overwhelming the defenders simply by brute force and large
new paradigm realized that there were other ways that contamination
could work, work like a terrorist. Instead of an army, a small number
of molecules could hijack the hormonal control of development and
could cause intense, life long damage, undermining the immune system,
eroding intelligence, diminishing reproductive capacity.
terrorist attack on fetal development works because the imposters
can work at very low levels of contamination. sometimes at levels
tens of thousands of times lower than the brute force approach considered
by traditional toxicology. They don't need to overwhelm the system
or kill it, they just need to insinuate themselves into the natural
control process and add to it or subtract from it.
me give you a few examples of the sorts of impacts that have been
discovered in animal studies, both in the laboratory and in wildlife.
in fact have been the focus of a fierce battle involving government,
industry and environmental health proponents because, believe it
or not, phthalates can be an important constituent of items designed
to put in babies mouths, despite the facts that phthalates leach
out of soft plastics, that they can proven toxic effects in animal
experiments, and that the health consequences of long-term exposure
to infants are unknown.
US fought this caution. Through the US Trade Representative's office
the government applied diplomatic pressure to dissuade Europe from
acting. Ultimately consumer activism from US organizations led toy
to begin taking phthalate-containing toys off the market voluntarily.
first three pieces to this storythe ubiquity of contamination,
the reality of hormone disruption and the new recognition of the
potential importance of low level contaminationare now well
established scientifically through measurement and experiment.
fourth piece is not. The fourth piece is a question. Given all of
that, what is happening out here in the real world to real people?
now know that significant numbers of people are now exposed at levels
that cause problems in the laboratory.
know that people are experiencing syndromes analogous to these same
we can't say with certainty, however, is whether what we see in
people is being caused by contamination intefering with the mechanisms
known to work in the lab.
me give you some examples.
puberty: Some data suggest that young girls in the US are reaching
puberty earlier than before. This is not known for certain. It turns
out that good studies documenting the age of puberty 50 years ago
simply aren't available as a baseline. Accepting those early studies
limitations, a paper released in 1997 suggests a downward
shift in the age of puberty for American girls, and documents
some strikingly early signs of pubic hair and breast development--measureable
percentages beneath the age of 3 and significant numbers by the
age of 8 and 9. These results and other reports are leading pediatricians
to reconsider what should be "normal" to expect.
while we don't know for certain that there has been a change, what
we do know is that it is quite easy to affect the age of puberty
in animals with modest exposures to hormone disruptors in the womb.
Estrogenic exposure causes puberty to occur earlier
in females. Anti-androgenic delays
puberty in males.
is a birth defect of the penis. It is reliably
produced in laboratory animals using certain anti-androgenic
hormone disruptors like diethylhexyl phthalate (DEHP) and vinclozolin.
Results from the lab suggested to the US Centers for Disease Control
that it would be worthwhile to examine changes in hypospadias rates
in the US. The resulting study
showed a doubling of hypospadias since 1970.
trend data are firmer than that for the age of puberty, the animal
studies are equally strong, and the only way for hypospadias to
occur is for development to be disrupted in the womb. But, there
is no firm evidence demonstrating, with scientific certainty, that
human hypospadias is caused by endocrine disrupting synthetic chemicals.
should point out that there also are no studies that have been
done that could prove or disprove that possibility with certainty.
We are left with human trends consistent with animal experiments
combined with certain knowledge that humans are exposed to the same
count. The best
available data and the most sophisticated analysis to date indicates
that on average sperm counts have declined by 40% over the past
5 decades. More detailed analysis clearly shows large declines in
sperm counts in some places. Most recently reports have come in
from China and India indicating large recent declines.
with hypospadias and date of puberty, laboratory work shows clearly
that contaminants found in the human womb cause sperm count declines
when fetal animals are exposed experimentally. This combination
of evidence plausibly implicates endocrine disruption in the womb
as a possible cause for low sperm counts measured today in many
different geographic regions. There is, however, no scientific certainty.
has proven to be a highly controversial subject largely because
the historical data on what sperm count used to be are so patchy
and even the modern data are of such varying quality. Unfortunately,
the data showing no decline, particularly from the United States,
are almost invariably from studies using statistical sampling procedures
that are biased (an
example). These studies have been useful to industry attempting
to defuse concern over sperm count, but misleading scientifically.
resistance. Contamination's impact on the immune system is beginning
to get serious attention with striking results. Let me briefly describe
a study done
by the US National Cancer Institute and the US Centers for disease
control on non-Hodgkin's Lymphoma (NHL). NHL is one of the cancers
whose incidence has been increasing steadily over the past 30 years.
It had been thought that exposure to Epstein Barr Virus (EBV) was
a risk factor for NHL. This study by the National Cancer Institute
and the Centers for Disease Control reveals it is far more complicated,
and also raises a much broader issue. They found that exposure to
EBV alone is a negligible risk factor for NHL. Independent of EBV
exposure, exposure to PCBs increases the risk to NHL by about a
factor of 4.5. But if you are exposed to both EPV and PCBs, your
risk of NHL rises over 20-fold.
believe that the effect of contamination on disease resistance is
the sleeping giant of this issue. Contamination affects the immune
system, undermining the body's ability to resist disease. With a
weakened immune system, people fall prey to diseases they normally
would have been able to resist. Traditional public health statistics
would attribute their illness or death to the disease agent, not
to contamination. This would lead to a vast underestimation of the
importance of contamination in human disease.
the necessary science is not in on immune system impacts. Enough
is available to know that it is a serious problem. I believe that
within a few years we will have a new paradigm for the interaction
between disease agents and chemical contamination. In essence, it
will be that you can't understand the epidemiological impact of
a disease agent, without knowing its contamination context.
and behavior. I will mention one result. Dr. Elizabeth Guillette
found striking impacts on the ability of children to respond to
a simple instruction based on their level of exposure to pesticides.
She asked them to draw a picture of a person:
has just been published by Greater Boston Physicians for Social
Responsibility on contaminants that are developmental neurotoxicants.]
Looking at this diversity of evidencefrom animals, from people,
on sperm, hypospadias, behavior, etc.what
emerges is a mosaic of data all of which converges on the likelihood
that these contaminants are affecting people in the real world,
but it falls short of providing us definitive proof with scientific
this scientific case is not over. But I have concluded that enough
evidence is available from a diversity of sources to conclude that
exposures must be cut back sharply. We have an experiment underway
in the bodies of people and the wombs of mothers all over the world,
one whose results may not be evident with scientific certainty until
long after it is too late.
me mention to important proofs of the enormity of this experiment.
The first is an analysis
carried out by Environmental Defense showing how little experimental
toxicology has actually been done to test the safety of most chemicals
in widespread use today.
the 3,000 high production volume chemicals produced in quantities
of over 1,000,000 pounds per year in the US, how many have not
been tested for specific health endpoints.
The answer was stark. Most chemicals in widespread use in America
today have not been tested for safety. And while industry lawyers
might have us believe that the absence of data is proof of safety.
Nothing could be further from the truth. Absence of data is proof
of ignorance. It is proof of the vast experiment that has been unleashed
unwittingly on Americans, indeed global citizens.
of the most striking of these experiments is the ubiquitous use
of bisphenol A. BPA was first synthesized in the late 1930s during
the effort to create artificial estrogens. Not as powerful as diethylstilbestrol
(DES), which was invented during that same rush, BPA was put on
the shelf until someone discovered that when polymerized it formed
a very useful plastic, polycarbonate. As polycarbonate it has entered
consumer society in a myriad of forms, including plastic water bottles,
plastic baby bottles, coating for kids' teeth (to reduce the likelihood
of cavities) and the inside coating of food
cans (to minimize food interactions with the can). Only recently
with work by several different laboratories, notably those of Nicolas
Olea in Spain and Fred vom Saal in Missouri, have we learned that
bisphenol A is extraordinarly
potent at endocrine disruption and also that the quantities
of bisphenol A that leach out of these plastic products and processes
cause exposures to people at levels known to cause strong impacts
point here is that bisphenol A is out of the bag, everywhere, including
in the mouths of children, and we have no confirmation of safety.
Instead, we have indication of significant risk. But we have a system
that allows the contamination in an uncontrolled experiment in the
real world instead of insisting first upon a demonstration of reasonable
safety in the lab.
this country the regulatory apparatus is proceeding very slowly.
There's no question why. The paradigm shifts involved here create
an enormous challenge for the use and manufacturing of chemicals
as it is now practiced, and bless our political system, those with
vested interests and lots of money are using the money to protect
is where you all might come in.
said at the outset that a new dimension to the fight over reproductive
rights may be emerging. This is it. Our current approach to the
regulation of chemicals permits chemical trespass in the most intimate
environment of all, a mother's womb, with no information about safety.
It threatens to create a world in which impaired fertility is common
and in which, as a result, only the rich can afford the medical
interventions that allow them to reproduce. It threatens to create
a world in which children grow up at heightened risk of disease,
with intellectual impairments, and with their own fertility problems.
is not a just world.
the problem. We know enough about the science here to realize these
patterns of contamination create plausible risks, risks established
from a wide body of evidence. We don't understand it all, but what
we do know is very disturbing.
industry lawyers and their scientists can argue legitimately that
the level of proof is not certain. And that's true. Just like the
level of proof for tobacco and cancer wasn't certain, for decades
after reasonable people concluded that enough evidence was available
to finger cigarettes as agents of cancer. We're getting the same
worse, I can tell you that details of the science of hormone disruption
make it vastly more difficult, if not impossible, to obtain enough
certainty to satisfy industry's lawyers, as long as we live in a
society constrained by morals from conducting planned scientific
experiments on people. Epidemiology won't deliver a final verdict
for decades, if ever.
in the meantime, unless we act to reduce exposures, we condemn additional
generations to additional unplanned, uncontrolled experiments.
are experiments whose results we will not know until it's too late
to call them off.
the sort of experiment that would be rejected by any medical ethics
board in the world. Medical experiments on people begin with the
premise of prior informed consent.
I ask you. Who asked us? Who asked us for permission to perform
this experiment. Don't you have the right to make reproductive choices?
These contaminants interfere very directly with those rights.
we need is a dramatic change in the standards of proof for what
chemicals are allowed to be used in products and processes that
have led to that fact I mentioned at the outset, that each of us
carry several hundred novel chemicals in our blood.
need to be far more cautious about letting chemicals move from the
lab into the marketplace.
need to demand much more evidence that chemicals don't cause harm.
We need to acknowledge that there are some contaminants whose risks,
although still uncertain, are so large that we simply won't let
them be used or produced in commerce.
need to insist that experiments take place in the laboratory, not
in our children's bodies nor in the wombs of our mothers.