| 
State
University of New York and the Akwesasne Community
PCBs in Breast Milk in the Akwesasne Mohawk
Body Burden Monitoring
|
Problem |
The
environment around a particular section of the St. Lawrence
River has been contaminated with PCBs from industrial operations
on the river. PCB contamination has affected the health
and well being of the Akwesasne Mohawk people living in
the region. |
| Objective
|
To
look at the relationship between fish consumption and PCB
breast milk contamination among nursing Mohawk women at
Akwesasne. |
|
Monitoring Type |
Body
Burden |
|
Community Involvement |
Every
aspect of the study from its design to execution has involved
the community. |
| Notable
Feature |
The
community-science partnership is, by far, the most notable
feature of this study. There is a section about this partnership
in the case study and an article is available on the internet
for a more in-depth look. |
Background:
Contamination of a Vital Waterway
The
Akwesasne Mohawk Nation lies adjacent to the St. Lawrence River
at the terminus of the Great Lakes. The waters that drain from
Lake Ontario to the St. Lawrence River carry a myriad of wastes
discharged from U.S. and Canadian industries and municipalities
located within the Great Lakes drainage basin including airborne
contaminants from throughout the world transported and deposited
into the basin . These waste materials have contaminated the
waters and aquatic organisms traditionally used by the Native
Americans for food and ceremonial purposes forcing changes in
life styles and traditions. These changes have occurred within
a relatively short period and can be directly linked to the
rapid industrialization that occurred during the post-war period
of the 1940s.
During
the 1950s, segments of the St. Lawrence River were dredged and
a vast network of locks and dams were created to provide international
shipping access to the Great Lakes. Hydro-generating power plants
were constructed attracting energy intensive industries including
three aluminum manufacturing facilities located on the U.S.
side of the river near Massena, N.Y.. Over the next 25 years,
the ALCOA, Reynolds and General Motors manufacturing facilities
discharged a variety of organic and inorganic compounds, including
a host of halogenated aromatic compounds. These fat-soluble
substances readily accumulated in the local fish and wildlife
and in members of the Akwesasne Mohawk Nation including young
women of child-bearing age. Nursing mothers who ate locally
caught fish had breast milk containing high levels of these
compounds, posing a threat to nursing infants.
All
three companies used polychlorinated biphenyls (PCBs), human-made
chemicals that were ideal for industrial purposes. PCBs were
eventually banned by the EPA in 1978 as the chemical was found
to be toxic to both human health and the environment. PCBs at
these three plants were released to the environment through
industrial wastewater discharges, spills, and illegal dumping
into the Racquette, Grasse, and St. Lawrence Rivers. In addition,
emissions of pollutants such as fluoride, polycyclic aromatic
hydrocarbons (PAHs) and other toxic substances from ALCOA. [and
Reynolds contaminated the air in and around Akwesasne. Mercury
and the pesticide mirex were discharged by Domtar, a pulp and
paper mill located on the Canadian side of the river.
Within
five to ten years of the construction of the hydroelectric project,
Mohawks began noticing impacts to their environment. By the
early 1970s, cattle began showing signs of fluorosis, brittle
teeth and bones, birth defects, low milk production and shortened
life spans. After consulting with health researchers, the Mohawk
community became concerned about possible linkages between these
health outcomes and exposure to PCBs through fish consumption.
By the mid-1980s, the Mohawk community had issued a fishing
advisory limiting fish consumption in the community and warning
women of childbearing age, infants, and children under the age
of fifteen to eat no fish from the St. Lawrence River due to
PCB contamination of the fishery.
An
Akwesasne Midwife Sounds the Alarm
During
the mid-1980s, an Akwesasne midwife, Mrs. Katsi Cook brought
concerns about local industrial contamination to the attention
of a New York State Department of Environmental Conservation
wildlife pathologist, Ward Stone. Stone collected and analyzed
local fish and wildlife and determined that they were highly
contaminated with polychlorinated biphenyls (PCBs) and other
organic contaminants used by the local industries. Subsequent
health investigations conducted during the late 1980s and early
to mid 1990s and funded by General Motors and the National Institute
of Environmental Health Sciences (NIEHS) determined that young
Mohawk mother's breast milk contained elevated concentrations
of PCBs and that these compounds were being transferred to their
nursing infants. By the late 1980s, the amount of PCBs found
in fish and wildlife at Akwesasne was astounding. Snapping turtles
(the Haudenosaunee/Akwesasne consider the turtle to be the foundation
of the earth), frogs, shrews, and fish were all found to be
contaminated, some with levels that would cause them to qualify
as hazardous waste.
The
Study: Researchers and Community Collaborate
New
York State Department of Health and NIEHS developed a study
to look at the relationship between fish consumption and PCB
breast milk contamination among nursing Mohawk women at Akwesasne,
along the St. Lawrence River. Principal investigators were David
Carpenter and Dr. Edward Fitzgerald, along with Dr. Ronald Scrudato,
who worked on PCB analysis in areas affecting the Mohawk community
in New York State.
An
additional goal of the study was to conduct the work in a manner
addressing concerns about privacy and data ownership. Mohawk
women were reluctant to participate in a study of their breast
milk, without fundamentally restructuring their relationship
with investigators from the New York State Department of Health.
Rather than allowing outside experts to conduct a study in which
community members would be passive participants, Mohawk women
insisted on a more equal relationship in which they would assist
in study design as well as own and control the analytic data.
The study and results have been published in peer-reviewed journals
and community members are among the authors.
Conducting
the Study
From
1986 to 1992, 97 Mohawk women were interviewed and donated at
least 50 ml of breast milk. The comparison population consisted
of 154 Caucasians. After adjustment for potential confounders,
Mohawk mothers who gave birth in 1986-1989 had a geometric mean
milk total PCB concentration of 0.602 ppm (fat basis), compared
with 0.375 ppm for the control group (p = 0.009). These Mohawk
women also had significantly higher mean concentrations of nine
PCB congeners. Beginning in 1990, there were no significant
differences between the Mohawk women and comparison groups.
The reduction in breast milk PCB concentrations parallels a
corresponding decrease in local fish consumption and may be
the result of the advisories issued since 1990 recommending
against the consumption of local fish by pregnant and nursing
Mohawk women.
In
1988, another study, a Health Risk Assessment Study was performed
as part of a negotiated settlement with General Motors. The
study focused primarily on Mohawk infants and mothers living
in the Akwesasne Mohawk Nation in northern New York State. Dr.
Fitzgerald directed the epidemiological study of health effects
and exposure to PCBs, polychlorodibenzofurans (PCDDs), polychlorodibenzofuran
(PCDFs),and polyaromatic hydrocarbons (PAHs) on these mothers
and children. Dietary, residential and occupational exposures
were assessed through interviews and environmental monitoring.
Body burdens were estimated through serum, breast milk, and
urine analysis; and cytochrome P-450 liver enzyme activity was
measured through the use of a highly sensitive caffeine breath
test. These methods are now being used at other National Priority
List (NPL) sites with similar contaminants. Using PCB congener-specific
analysis for both body burden and environmental sample measurements,
researchers found that the PCB congeners in the environmental
samples were also present in the breast milk of Mohawk women.
Results of these studies have shown that the mothers have been
exposed to PCBs by eating local fish and this contamination
was passed to their infants by breast milk.
Various
measures were employed in these studies to protect privacy.
The main strategy was to assign a code to each study participant,
and the relationship between the code and identity was not released.
When entering and analyzing data, only the participant code
was used. Very few people had access to the relationship between
code and identity.
Outcomes
of the Study
Health:
Breast milk PCB levels declined in the last three years of the
six-year study, perhaps as a result of more consistent attention
to advisories recommending against consumption of local fish
by pregnant and nursing Mohawk women.
Cleanup:
General Motors Corp. reports that the decade-old cleanup of
hazardous waste sites at its Massena, N.Y. plant will probably
take two more years to complete instead of one. GM initially
set its goals too high when it said the cleanup of PCB-laden
soils and sediments in the plant's lagoons and landfills would
be completed by the end of 2003. The 12-acre GM industrial toxic
waste site is part of the company's 270-acre industrial complex,
bordered by the St. Lawrence River, the Raquette River and the
St. Regis Mohawk reservation in northern New York. While the
company made progress in the summer of 2003 excavating hazardous
materials from its waste lagoon and the Raquette River, GM officials
said they need the EPA to decide how the final phases of the
project should be conducted.
Taking
Action: The Akwesasne Task Force on the Environment
The
Mohawk community of Akwesasne had a history of negative experiences
working with researchers prior to working with Dr. Carpenter
and colleagues. All of this started to change in the mid-1980s
when an organization within the Mohawk community, the Akwesasne
Task Force on the Environment (ATFE), decided to become actively
involved with research projects done at Akwesasne. The ATFE
is a community-based organization founded to conserve, preserve,
protect, and restore the environment and natural and cultural
resources within the territory of Akwesasne, and is comprised
of community members who reside in all regions of Akwesasne.
Developing
Research Guidelines
In
1995, ATFE established a research advisory committee (RAC) to
provide a more formal voice for the community and to respond
to the increasing number of research projects being proposed
by scientists. The RAC reviews and comments on all studies to
be conducted in the Akwesasne region. The RAC developed a set
of guidelines, the Protocol for Review of Environmental and
Scientific Research Proposals, to standardize community review
of the many proposed research projects in the region. This Protocol
was developed from the problems encountered and community research
processes refined during the course of the past decade.
The
three main principles included in the guidelines are taken from
the Mohawk language, and translations have been made to the
closest possible interpretation of their true meanings. The
principles are peace, good mind, and strength, and it is the
emerging behaviors that flow from these three main guiding principles
that serve as the criteria of the research process. From peace
comes respect, from a good mind comes equity, and from strength
comes empowerment. When respect, equity, and empowerment are
achieved by all parties involved, a good research process will
result.
Researchers
and the community must generate respect for
each other by understanding the other's social, political, and
cultural structures. Communication must work both ways for a
good research agreement to be generated. Cultural sensitivity
training for the researchers and community awareness presentations
help to develop a mutual understanding of the research process.
Equity
is defined as a sharing of resources. Both the researchers and
the community must bring equity to the agreement. Money is only
one form of equity. Community knowledge, networks, personnel,
and political and social power are other forms of equity useful
to the project. Each of these commodities has value and must
be shared between the researchers and the community if a good
research agreement is to be formulated.
Empowerment
is defined as a sharing of power and is the result of a good
research agreement developed by both the community and the researcher.
Each participant must feel that his or her needs are being met
and that their credibility is increasing. Partnership and responsibility
continue to grow as more and more respect and equity enter the
agreement. Empowerment also means that authorship must be shared
between the community and the researcher. Although this is sometimes
difficult, the increase in empowerment and credibility is beneficial
to a good research agreement, which is the goal of the research
guidelines.
| The
following action steps are specific examples of likely expenditures
of time and funds for partnership and involve virtually
every step of the research process. |
 |
 |
Involve
the community in research planning at the earliest stages.
This planning would include choosing local health outcomes
and methods for assessing exposures and outcomes. |
 |
 |
Obtain
consent from the community leaders and representatives as
well as from individual participants. |
 |
 |
Hire
community members as field staff and train them to collect
data rather than hire already trained personnel from outside
the community. |
| |
 |
Keep
the lines of communication open and communication flowing
in both directions. |
| |
 |
Involve
community research partners in communication of research
results to the participants. |
| |
 |
Inform
the community, not just the study participants. |
| |
 |
Publish
the research results for the larger community without denigrating
the community in which the research was conducted. Share
the authorship and work cooperatively in the publication
of papers, press releases, and reports. |
Reflections
on the Study: A Community-Science Partnership
There
are many barriers to partnerships between communities and scientists.
However, if a researcher wishes to conduct research on important
environmental health issues that affect communities, a partnership
with the community must be formed. Partnership does not mean
abandoning scientific principles or abandoning community respect
and integrity. It does mean to conducting research differently
and budgeting for it appropriately. It means having more communication
than usual, more meetings, more travel, more joint decision-making
(and perhaps a slower decision- making process), more compromise
and trust, and some original solutions to issues of quality
control and confidentiality.
Perhaps
the most remarkable feature of this project is the manner in
which it was conducted. It is often cited as a model for a successful
partnership between researchers and the community. The success
of the partnership was the result of careful planning and clear
communication of expectations from both parties. An article
describing this partnership in detail can be found at:
http://ehp.niehs.nih.gov/members/1998/Suppl-3/833-840schell/schell-full.html.
This
project truly represents a milestone in community involvement
and partnership with academic researchers. The research methods
employed were quite sophisticated and provided valuable information
to the community. Also, the research associated with this geographic
area has continued for a long time, cleanup efforts have been
slow, and the companies involved have sometimes not been cooperative.
In these circumstances there is the danger that the focus will
shift away from the community focus toward more directly serving
the needs of the researchers. The Akwesasne community has been
able to avoid this pitfall because of the strong working relationship
forged with the SUNY researchers.
Contact
information or web links.
Ron
Scrudato, Director
The Environmental Research Center
319 Piez Hall, SUNY Oswego
Oswego, NY 13126
Phone: 315-341-3639 Fax: 315-341-5346
e-mail: scrudato@oswego.edu
website: http://www.albany.edu/sph/superfund/index2.html
David
Carpenter
State University of New York
One University Place
Rensselaer, NY 12144-3456
Phone: 518-525-2660 Fax: 518-525-2665
e-mail: carpent@albany.edu
website: www.albany.edu/sph/superfund/index2.html
Edward
F. Fitzgerald
Associate Professor
Assistant Director
Bureau of Environmental and Occupational Epidemiology
Center for Environmental Health
Flanigan Square, Rm 200
547 River Street
Troy, NY, 12180
Phone: (518) 402-7990
Fax: (518) 402-7969
E-mail: eff02@health.state.ny.us
Recommended
websites about the project (valid as of February
2003)
AKWESASNE
TASK FORCE ON THE ENVIRONMENT (ATFE)
http://www.albany.edu/sph/superfund/akwes.html
http://ehp.niehs.nih.gov/members/1998/Suppl-3/833-840schell/schell-full.html
(article on the project)
http://www.greatlakesdirectory.org

|
Dredges
are digging up nearly 100,000 pounds of river bottom contaminated
from the Reynolds Aluminum plant. A steel curtain was
installed to prevent contaminated sediment from floating
downriver.
Seth Harrison/The Journal News (7/2/2001). Along with
the Reynolds Aluminum plant, the General Motors Powertrain
facility was responsible for PCB contamination in the
St. Lawrence.
|
A
tanker sails up the St. Lawrence River through the Akwesasne
Indian Reservation.
Seth Harrison/The Journal News (7/2/2001). |
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