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Routine Newborn Screening for Heavy Metals

Routine Newborn Screening for Heavy Metals: NOW is the time in Pennsylvania!

Global Warming is real - but that hasn’t stopped millions of Americans from buying gas-guzzlers and driving them solo each day a few miles to work. Animal protein requires nearly 50 times the energy to produce per pound than vegetable protein – but Applebee’s still sells plenty of steaks. Why? The environmental damage caused thereby doesn’t seem personal.

Only when people see pollution directly impacting their own lives, and the lives of their families, does public awareness turn into public action. Recent events in Flint Michigan, where a change in water source caused massive lead exposure – and exposed feckless government responses – illustrate just how seriously the public will take pollution if it threatens its children. Huge sums will be spent to remediate Flint’s water supply.

One government program, a little-known but universal screen for inherited diseases – commonly called Newborn Metabolic Screening – however, is quite the opposite of `feckless.’ Representing the only time in the human life cycle when everyone has blood drawn, Newborn Metabolic Screening involves placing a few drops of blood obtained from a baby’s heel onto a filter paper card, which then is shipped to a reference laboratory. There the blood spots are analyzed for over 55 gene cally determined illnesses – sickle cell, cystic fibrosis, and hypothyroidism to name just a few.

Pioneered in the 1960s at the University of Pennsylvania, Newborn Metabolic Screening now is mandatory in all 50 States – and has spread worldwide. It saves thousands of lives each year.

After analysis, the filter paper cards are stored for a year in PA, in case further medical tests are needed, and then destroyed. Privacy concerns about the hypothetical creation of a 'government DNA database’ are thus addressed.

We propose to expand Newborn Screening so that PA newborns can also be checked for exposure to pollution – at first, specifically heavy metals such as lead and mercury. This would require obtaining a single extra blood spot - five currently are drawn - placing it on specially cleaned filter paper - and protecting that spot from contamination during transport to the lab. In essence, while the current filter paper card is simply air- dried, and thus easily contaminated, this newly designed and pre-cleaned spot will come with its own desiccant, and be housed within a resealable plas c bag. A pilot project involving 20,000 to 30,000 newborns screened for lead and other heavy metals over a year (representing approximately 1/5 of the infants born in PA) would allow, for the first me, an accurate population-wide public health assessment of the prevalence and geographic extent of heavy metal, and specifically lead poisoning, in Pennsylvania. Of note, current data – based on spotty screening of so-called `high-risk’ populations - suggests that many older urban areas in PA currently suffer from far higher rates of lead poisoning than Flint did, at it’s worst.

Since the newborn period is one in which exposure to pollutants such as lead is particularly damaging – and blood is being obtained, anyway, for the Newborn Metabolic Screen - it seems completely logical and imperative to expand such testing to include medically relevant potential environmental contaminations. While the current public health `crisis’ is lead poisoning, and identifying the aging housing and water supply infrastructure that contributes to it, there are countless examples of industries whose safety could be objectively assessed, and then continually monitored, by routine Newborn Environmental Screening.

For example, benzene – a known carcinogen and by-product of all hydrocarbon extraction – is flared off whenever a fracked well is opened, and supposedly never contaminates the water supply. Newborn Environmental Screening could find out if that is so. A raft of `endocrine disruptors’ and other potential environmental causes of such newly epidemic diseases such as autism and ADHD also could be detected.

But first, just as Newborn Medical Screening began with checking for just one disease – PKU – and, once established, grew organically, let us begin our drive to make Newborn Environmental Screening routine by focusing our efforts on non-controversial, non- theoretical threats to the health of our future generations.

Therefore, the Lehigh Valley Sierra Club requests PA State (as well as National Sierra Club) assistance via Letters of Support and vigorous lobbying efforts as we seek to open a new chapter in the storied history of Newborn Screening of Pennsylvania’s citizens. A pilot project to establish the feasibility of heavy-metal screening of newborns in PA would address a current well-known public health crisis while simultaneously helping establish an entirely new (and badly needed) branch of Environmental Science: Neonatal Environmental Medicine. PLEASE HELP!

Andrew Unger MD, FAAP, Chief, Pediatrics, Sacred Heart Hospital Lehigh Valley Sierra Club Ex-com

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