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Your Environment. Your Health.

2017

Environmental health outreach in Puerto Rico

Santiago Perez explained plans to dredge and restore the Cano de Martin Pena.
Santiago Perez explained plans to dredge and restore the Cano de Martin Pena.
(Photo courtesy of Jed Bullock)
In Catano, from left, Francine Sanchez, AmeriCorps grant director, and Katrina Wiegand, AmeriCorps volunteer, discussed the programs with Rosen and others on the tour.
In Catano, from left, Francine Sanchez, AmeriCorps grant director, and Katrina Wiegand, AmeriCorps volunteer, discussed the programs with Rosen and others on the tour. (Photo courtesy of John Schelp)
“This was Dr Birnbaum’s 20th community forum and participants were passionate and engaged,” said John Schelp. “San Juan was one of the longest discussion sessions we’ve seen.”
“This was Dr Birnbaum’s 20th community forum and participants were passionate and engaged,” said John Schelp. “San Juan was one of the longest discussion sessions we’ve seen.” (Photo courtesy of John Schelp)

NIEHS sponsored a week of educational, collaboration, and outreach activities in San Juan, Puerto Rico in late March, led by NIEHS and National Toxicology Program Director Linda Birnbaum, Ph.D.

Events included a tour of neighborhoods affected by increased flooding, a large town hall meeting on environmental health challenges on the island, and a workshop to explore technologies for training workers who handle hazardous materials, known as hazmat training.

Neighbors respond to flooding, education, other needs

Rutgers University, an NIEHS Worker Training Program (WTP) grantee, organized site visits along with their partner Universidad Metropolitana (UMET). On March 28, NIEHS staff and grantees visited three communities in San Juan, Puerto Rico — Catano, Cano de Martin Pena, and Cantera to learn firsthand about local environmental health issues.

Rosa Hilda Ramos explained that Catano faces 65 nearby industries with air emissions and water discharges; diesel exhaust from transportation; coal-fired power plants; and heavy metal contamination in soils and sediments. She said local children experience high rates of asthma.

In Cano de Martin Pena, Estrella Santiago Perez, environmental affairs manager of the Corporacion del Proyecto ENLACE del Cano Martin Pena, told of families living along the Cano, who experience frequent flooding during rain events and have no connection to the sanitary sewer system.

The Cano is a natural tidal channel in the heart of the San Juan Bay Estuary — the only tropical estuary protected as part of the National Estuary Program. Santiago Perez shared aerial photographs showing how the width of the Cano has gradulally narrowed, due to sediment, debris buildup, and neglect.

Ecosystem restoration plans for Cano would return a healthy waterway to approximately 27,000 residents of these communities. With Luis Cintron, a community leader in Cantera, tour participants got to see how some of the canal area will look after dredging, rebuilding the wetlands, and creating buffers.

The tour ended at the Casa Educativa de Cantera, an afterschool program for children. "The smiles on the faces of children in Cantera give us great hope that our continued research and training can make a real difference in reducing environmental hazards for these communities," Birnbaum said. Environmental education and citizen engagement are hallmarks of the eight communities located along the Cano.

Passionate community gathers for forum

More than 100 residents, academics, and agency representatives participated in a community forum at UMET that same evening. Carlos Padin, Ph.D., chancellor of UMET, moderated the presentations and discussion.

Birnbaum and local environmental health experts responded to community questions about coal ash disposal, Zika virus and other infectious diseases, electromagnetic fields, and a range of other public health concerns. Other panelists were Wilma Rivera Diaz, Dr.P.H., environmental health director of the Puerto Rico Department of Health; Osvaldo Rosario, Ph.D., from the University of Puerto Rico (UPR); Carmen Guerrero, U.S. Environmental Protection Agency Caribbean Division Director; and Carmen Milagros Velez Vega, Ph.D., from UPR.

  • With aerial photos, Santiago Perez explained how the Cano narrowed because of years of neglect, as well as sediment and debris buildup.
    With aerial photos, Santiago Perez explained how the Cano narrowed because of years of neglect, as well as sediment and debris buildup. (Photo courtesy of Jed Bullock)
  • At the UPR Medical Campus, which hosts the PROTECT, CRECE, and ZIP labs where samples are processed and sent on for further analysis, Birnbaum spoke with researchers about their work.
    At the UPR Medical Campus, which hosts the PROTECT, CRECE, and ZIP labs where samples are processed and sent on for further analysis, Birnbaum spoke with researchers about their work. (Photo courtesy of Jed Bullock)
  • This community garden provides fresh, healthy food for residents of the Cantera neighborhood in San Juan, Puerto Rico.
    This community garden provides fresh, healthy food for residents of the Cantera neighborhood in San Juan, Puerto Rico. (Photo courtesy of Jed Bullock)
  • From left, Birnbaum, with Sharon Beard and Carolina Medina from WTP, visited the library and community center in the low-income community of Cantera. Created by parents and staffed by AmeriCorps volunteers, it hosts an afterschool program and environmental science camp.
    From left, Birnbaum, with Sharon Beard and Carolina Medina from WTP, visited the library and community center in the low-income community of Cantera. Created by parents and staffed by AmeriCorps volunteers, it hosts an afterschool program and environmental science camp. (Photo courtesy of Jed Bullock)
  • Birnbaum and other members of the tour visited with students in the afterschool center at Casa Educativa de Cantera.
    Birnbaum and other members of the tour visited with students in the afterschool center at Casa Educativa de Cantera. (Photo courtesy of John Schelp)
  • Panelists at the community forum were, from left, Rivera, Rosario Guerro, Birnbaum, and Velez Vega. Moderator Padin is not shown.
    Panelists at the community forum were, from left, Rivera, Rosario Guerro, Birnbaum, and Velez Vega. Moderator Padin is not shown. (Photo courtesy of John Schelp)
  • From right, Ramos, Birnbaum, Carlos Morales, from UMET, and two Cantano residents at the community forum.
    From right, Ramos, Birnbaum, Carlos Morales, from UMET, and two Cantano residents at the community forum. (Photo courtesy of Chip Hughes)

In her comments, Birnbaum reflected on the day's tour. "We visited several areas of devastation, and we ended on an uplifting note, at a community center with engaged parents and students," she said.

According to John Schelp, NIEHS special assistant for community engagement and outreach, those who came to the forum were equally engaged. "This was Dr. Birnbaum's 20th community forum, and the question-and-answer session was one of the longest that we've seen."

(Joseph “Chip” Hughes directs the NIEHS WTP.)

Breast Cancer Forum at City of Hope (CA)

A focus on breast cancer drew upwards of 100 people to the latest NIEHS community forum. Sponsored locally by the City of Hope Medical Center, participants in the Nov. 16 event in Duarte, California came from across the Los Angeles basin.

NIEHS and National Toxicology Program Director Linda Birnbaum, Ph.D., holds several such forums each year to hear from local residents about their environmental health concerns. This one was held in conjunction with a meeting of the Breast Cancer and the Environment Research Program grantees (BCERP; see sidebar).

Birnbaum described NIEHS-supported research related to environmental impacts on breast cancer. “All in all, we spent $28.4 million dollars on breast cancer last year,” she said. “In fact, we’re second only to the National Cancer Institute in breast cancer funding.”

Birnbaum speaking with community members

Birnbaum stayed after the event to speak with community members on a more personal level.
(Photo courtesy of John Schelp)

Opportunity for two-way exchange

Birnbaum also emphasized the two-way exchange that is the goal of these events. “These community forums highlight the research we support. The forums [also] provide an opportunity for my institute and other public health groups to hear the public’s concerns about environmental health,” she said.

Congresswoman Judy Chu, Ph.D., planned to attend, but stayed in Washington, D.C. for a congressional vote. She provided remarks by video. Besides Birnbaum, four other panelists participated.

  • Peggy Reynolds, Ph.D. — program leader of the Environmental Research Group at the Cancer Prevention Institute of California.
  • Rosario Quintanilla — U.S. Food and Drug Administration public affairs specialist.
  • Christopher Sistrunk, Ph.D. — City of Hope community education and community outreach research specialist.
  • Kim Tankersley — breast cancer activist and representative of the Community Leadership Committee.
Community forum panelists and coordinators posing for a group photo

From left, panelists and coordinators included Amy Trentham-Dietz, Ph.D., from the University of Wisconsin; Reynolds; Quintanilla; Tankersley; Susan Neuhausen, Ph.D., from City of Hope; Sistrunk; Birnbaum; Rakoff; and Shiuan Chen, Ph.D., from City of Hope.
(Photo courtesy of John Schelp)

City of Hope

The City of Hope, which concentrates on research and treatment of cancer, is a BCERP grantee. Ikuko Bentsi-Barnes, Ph.D., who headed up the planning team for the forum, reflected on the value of having federal research representatives listen to local concerns.

“These forums are essential because they present information on exposures based on scientific evidence, demonstrate that it is important to have community involvement, and provide links to where the community can obtain additional information,” she said.

Birnbaum credited the work of the planning committee for much of the success of the free event. The group advertised in local newspapers, online, and reached out through community representatives.

Your commitment to educating the community about breast cancer and the environment is truly commendable - Congresswoman Judy Chu

Format welcomes all concerns

A community member speaks to the forum

A good turnout by a highly engaged audience made for a successful forum, according to organizers.
(Photo courtesy of John Schelp)

As with other NIEHS community forums, most of the time was reserved for the audience to voice concerns and ask questions. The discussion was moderated by Michele Rakoff, from the Breast Cancer Care and Research Fund. She brought deep experience working with local residents, as a partner on the City of Hope BCERP grant.

Audience members included breast cancer survivors, family members, and area residents who had questions about how chemicals in their environment might be involved in the disease. During the 90-minute meeting, the discussion ranged far and wide, according to John Schelp, NIEHS special assistant for community engagement and outreach.

“We heard about disparities in breast cancer risk as well as in mortality from the disease, challenges to families, questions from activists, and concerns about things like air pollution and plastics, among other topics,” Schelp said. The role of interactions between genes and the environment was also raised, along with the possibility that the environment may outweigh family connections in disease risk and prognosis.

Congressional recognition

Video remarks from Congresswoman Chu urged more exploration of disparities in breast cancer, especially among Asian and African American communities.

A representative from her office attended and presented a certificate to NIEHS, in recognition of achievements high standards of excellence. The text read in part, “Your commitment to educating the community about breast cancer and the environment is truly commendable. Your dedication has made a lasting and positive impact on society.” The document was signed by Chu, who represents the Pasadena area.

  • A shot overlooking Santa Anita
    The community forum took place near Santa Anita Canyon. Birnbaum noted that Pasadena and Durham share common ground as the only two cities to have hosted the Rose Bowl and Rose Parade.
    (Photo courtesy of John Schelp)
  • Elizabeth Andalon speaking with Birnbaum
    Elizabeth Andalon, right, staff member for Rep. Judy Chu, spoke with Birnbaum, left, and Chen after the forum.
    (Photo courtesy of John Schelp)
  • Local residents speak at forum
    Comments from local residents, researchers, breast cancer survivors, and family members focused on the role of the environment, even as the topics ranged beyond breast cancer to air pollution and plastics.
    (Photo courtesy of John Schelp)
  • Community members discussing comments at the forum
    Most of the hour-and-a-half event was reserved for discussion of comments made by audience members, including Kimlin Tam Ashing, Ph.D., founding director of the Center of Community Alliance for Research and Education at City of Hope Medical Center.
    (Photo courtesy of John Schelp)
  • Panelists responding to community speakers
    From left, panelists Tankersley, Sistrunk, Quintanilla, Reynolds, and Birnbaum used their varied expertise to respond to points raised by the community.
    (Photo courtesy of John Schelp)
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