One of the most exciting reports I have ever read, Reducing Environmental Cancer Risk – What We Can Do Now, was released this week by the President’s Cancer Panel, along with significant coverage by Nicholas Kristof in The NY Times, Lyndsey Layton in The Washington Post and Liz Szabo in USA Today.

This signals a pivotal change in how we approach cancer (and, I hope, how we approach other illnesses that have increased in our lifetimes). The report acknowledges that we face “grievous harm” from chemicals that surround us every day and that we have “grossly underestimated” the amount of illness caused by these exposures – illness “that could have been prevented through appropriate national action.”

Why is this so exciting? By recognizing the importance of chemical and environmental causes of disease, we open the door to achievable environmental solutions. We can run in the right direction as we race toward prevention – not just race toward a cure. This report is about cancer – but the same issues apply to asthma, autism, learning disabilities, allergies, and more.

And it starts with kids. The report highlights the game-changing Environmental Working Group studies on umbilical cord blood that I helped EWG develop and release, where we found 180 carcinogens in babies (and 217 chemicals that were toxic to the brain or nervous system), even before the babies were born – chemicals that could set a trajectory for disease much later in life.

Parents can take simple steps right now to lower their children’s risk, from the cleaners you use in your home, to the plastics you use around food and beverages (watch our for BPA and phthalates!), to the sunscreens you put on your family’s skin.

In particular, the report highlights the value of organic food. There are ten foods (eleven, if you count wine) that I see as most important to choose organic.

And we can work together to change our chemical laws, under which the government has only assessed about 200 chemicals for safety out of the 80,000 chemicals on the market.

It’s a new era in our fight against cancer. It’s a new era for health.

Each day 3,000 kids start smoking.  One third of them will die from their addiction.

Most preschool children today view smoking as an unhealthy, negative behavior.  Somewhere around the time of kindergarten, however, this often begins to change.  They begin to think of positive aspects of smoking – that it is cool, that it can help you calm down, that it’s grown up, etc.  Many kids become quite ambivalent about smoking at this age.  Your greatest opportunity to prevent smoking lies between about the ages of 6 and 12.

When my son, Kevin, was a participant in the California State Scholastic Chess Championships.  During the lunch break, we grabbed a quick bite to eat.  Over lunch, another of my children (who shall remain nameless) picked up a straw, placed it still-wrapped in the mouth and began to pretend to smoke a cigarette – feeling very grown-up.  Quickly I checked to make sure no one in the restaurant recognized us (just kidding!).  Actually, we used it as an opportunity to talk again about all the people who are killed by cigarettes, and why smoking is not a game.

During this age, children need to hear you reinforce the consequences of smoking often, particularly the short-term consequences.  Get your kids talking about what they think about cigarettes.  Their ideas will guide your teaching.

Children also need to hear the truth about smoking from their schools.  Check to see that your children’s schools have smoking curricula.  The Center for Disease Control (CDC) and the National Cancer Institute (NCI) have free guidelines for curricula available, outlining what should be covered, how it should be communicated, and when these lessons are most important.  School-age children often look up to their teachers a great deal.  If the teachers’ lounge smells like smoke, children will notice the smell on their teachers.  When kids hear one thing from their teachers and see (or smell) another, the message is badly undermined.  If teachers who smoke wish they could quit (and a great many smokers do), it could be helpful to tell the children this, giving them a vivid example of the addictive powers of nicotine.

A teacher could even ask the class to encourage her in a stint at trying to quit – the class could function as a kind of support group.  If the teacher succeeded in quitting, the message to kids would be that they can be powerful health-promoters.  If the teacher failed, the message to kids would be that cigarettes are indeed terribly addictive.  In that case, she could promise to try again in a few months.

Avoid pretend smoking and candy cigarettes.  Some of the packages of candy cigarettes available look amazingly like the real thing.  If some other industry had their product copied, lawsuits would quickly ensue.  But not in this case!  The tobacco companies are glad to have kids imagine and model smoking behaviors.  Bubble gum is also available in packaging that looks like a tin of smokeless tobacco.

Help your child to notice the marketing campaign that is actively trying to deceive children and adults.  If your child sees a tobacco ad full of smiling, active people in a magazine, ask what the tobacco industry is trying to trick you into thinking about cigarettes (that smoking makes you happy and athletic).  Ask what the truth is (that smoking discolors the teeth, gives you bad breath, causes cancer in the mouth and throat, and decreases your athletic ability).  Kids can really get into this game, and it helps make them wiser.

In addition to emphasizing the health dangers of tobacco, children at this age need to be taught a vital skill – how to say “no.”  Throughout the school years, peer opinions and behavior gain increasing sway.  Sometimes children will start to smoke if they don’t want to, just because they’re afraid to refuse a friend.  Teaching refusal skills to your school-age child is well worth the investment.  A great way to do this is to practice.  If your child is able to say that cigarettes are harmful, ask “What would you say if your best friend offered you a cigarette?”  Let your child try out several answers.  Kids who have practiced and who have ready responses will be more free to make their own choices regarding tobacco, sex, alcohol, drugs, and nutrition.

Parents are often surprised when I tell them that a great number of the products we use in our homes are not necessarily evaluated and declared safe by a government entity. The paints that cover your walls, the stain-resistant fabric that covers your furniture, the very carpet under your feet… these things can contain toxic chemicals that could be harmful to you and your family.

This fall I filmed a short video for Healthy Child Healthy World (I’m proud to be a member of their advisory board) that talks about how you can be a knowledgeable, diligent advocate for products that are good for your family and for the planet. Kids have the most to gain. According to the EPA, carcinogens average 10 times more potent for your kids than for an adult – and in some cases 65 times more potent – or even more – at the same dose that adults get. And kids get typically get higher doses. Adults may eat about 1/40th of their body weight each day; kids may eat 1/10th of theirs. Pound for pound, kids eat more than we do, drink more than we do, and inhale more fumes than we do.

Many of the biggest health concerns for our children are on the rise: asthma, ADHD, allergies, cancer in babies, diabetes, etc.. All of these are linked to environmental exposures. When you’re making decisions about the products in your home, cast a knowledgeable eye from the ground up. Think about the carpet and the pad underneath, the paint on your walls, the antibacterial cleansers you use throughout the home – even the personal care products you use on your body. The choices you make today are opportunities that could give your kids a better chance for the best of health throughout their lives.

When I addressed the assembled crowd at the World Congress, I started by showing them this picture of hundreds of thousands of Koreans, some pushing strollers with young children, coming together as part of a month-long candlelight vigil to ask for healthy, safe food. They were upset about the safety of imported of American beef. Whatever one thinks about the specifics of their concerns, their causes, or their politics, it’s moving to see so many people focused on healthy food for themselves and their families.

I then described for the crowd in Modena one of the biggest mistakes of my profession – prescribing the synthetic hormone DES to up to 10 million pregnant women in an attempt to prevent miscarriages. It was approved by our FDA for this purpose, and used in at least thirty countries around the world. The hormone didn’t prevent miscarriages, but it did cause cancer in some of their daughters – vaginal cancers in girls as young as 14. Because of this it stopped being prescribed to pregnant women in 1971. Later we learned that the DES made many of these young women less fertile. We also learned later that DES caused the CDC calls a modest increase in breast cancer in the women who took the DES themselves – about a 20 to 30 percent increase, taking their lifetime risk from 1 in 8 up to a risk of 1 in 6. Hundreds of thousands of real women developed breast cancer who would not have developed it otherwise.

We now know that even the grandsons of women who took DES while pregnant are twenty times more likely to be born with hypospadius (where the opening at the tip of the penis isn’t at the tip, but somewhere along the shaft). To keep this in perspective, 98% of the grandsons are fine – but having 2% with hypospadius is twenty times more common than in the general population.

Giving DES to pregnant women was a tragic mistake.

Most people don’t know that DES was also given to our cattle. By the mid-1950’s, about 2/3 of the beef cattle was given in DES. Hundreds of millions of Americans were getting small amounts of DES every day – without adequate testing. And when DES was stopped for pregnant women, it continued to be used in our cattle for the rest of the decade.

Today different synthetic hormones are used. The answers aren’t in yet about whether they are safe for us (and especially for pregnant women and for young children).

A couple of preliminary studies show some evidence of decreased fertility and increased breast cancer, but the results are far from conclusive.

My point in the talk: This testing should be done BEFORE feeding hormones to hundreds of millions of people. Grass-fed organic beef has stood the test of time. It’s produced without the use of synthetic hormones, antibiotics, genetically modified feed, or feed raised with chemical pesticides. I’m not saying that everyone should eat meat, but I am saying that I prefer organic meat for those who do — especially for pregnant women and young children.

As a father, I have a desire to teach, provide for and protect my children. For me, one way to do all three of these is to choose organic foods for my family. I now know this as a physician, but I first learned it as a father and a husband.

That’s often the way it is. Medical textbooks don’t contain all the answers. Intuition and personal experiences often pave the way for later scientific understanding.

Today there is a strong, mounting body of science that is illuminating the benefits of growing crops organically. There is also evidence showing the harm of certain chemicals used in foods. And where we just don’t know the effects of new chemicals, we can proceed with precaution and protection for our children and their world. But I didn’t always feel this way.

When my first son was born, I was still in medical school. His knowledge of food came from what we fed him and what he saw us eat. Children learn more from what we do than from what we say. As a busy medical student, intern and then resident, I ate a typical rushed American diet: convenience foods, fast foods, junk foods. I ate some fruit most days and even less in the way of vegetables.

I was more interested in nutrition than my peers and went out of my way to take additional nutrition courses to supplement the meager offerings in the core curriculum. Still, I knew little. And what I did know was pushed aside by habit and a busy schedule.

By the time my youngest son came along, I was an established pediatrician. I had learned a lot about many aspects of health and wellness. I knew that there were benefits to foods grown organically, but I didn’t believe this deeply enough for it to become a priority in my family’s life. Then everything changed…

Crashing Insight When my youngest was a baby, my wife, Cheryl, was radiant and full of life. We were enjoying parenting and working together. Life was great!

Then Cheryl was diagnosed with stage III, high-risk, inflammatory breast cancer. The prognosis was grim. She was not expected to live to see the New Year. I grappled with the question “Where does breast cancer come from?” Like so many women with breast cancer, Cheryl had no history of the disease in her family. But she grew up on a farm.

It turns out that even though farmers in the United States are healthier than the general population in many ways, they have higher rates than the American public at large for several cancers, including leukemias, lymphomas, myelomas, brain cancers, and cancers of the lip, stomach, skin and prostate. But it’s not just the farmers themselves who get sick. Their children also have higher rates of reproductive tumors, leukemias and brain cancers—kidney and bone cancers, too.

As a girl, Cheryl could hear the pesticide sprayers rumble as she lay in her bed. She drank water from a well on the farm, a water source we later learned had been contaminated with pesticides. She bathed in this water. Her family cooked with it.

Several lines of reasoning suggest that agricultural pesticides used on farms are partly responsible for the increased cancer rates we see in farm families . The structure and function of these chemicals, their effects on animals and what we are learning about their effects on people are all reasons for concern.

The first studies I read about pesticides and breast cancer were a startling wake-up call for me . If these chemicals are hurting people and animals on the farm, how might they be harming the rest of us? Why wait for science to answer this question? The enormity of what we still don’t know about their effects demands thoughtful choices.

Against all odds, Cheryl survived her cancer. Did her early toxic pesticide exposure cause her cancer? I don’t know for sure, but I do know that I don’t want our children and other children put at this risk.

A Father’s Protection Most children today don’t grow up on farms. Does choosing organic food make a difference for them? Researchers at the Department of Environmental Health in the School of Public Health and Community Medicine at the University of Washington started tackling this question by measuring pesticide levels in urine samples from preschool children in suburban Seattle. They divided the children into two groups: those who were fed mostly conventional foods and those who were fed mostly organic foods.

The urine samples of children who ate what people call conventional diets had mean pesticide concentrations about nine times higher than did those of children who ate organic! The results indicated that these preschool kids had exceeded the safe pesticide exposure levels set by the EPA and that their health was at increased risk. By contrast, those children who ate organic foods were well below the EPA levels deemed to cause negligible risk. By feeding your family organic foods, you safeguard them from harm and help them build healthy bodies.

Choosing organic for my family is one way I protect it. Additionally, when we provide our children with organic foods, we are often giving them an even bigger edge—like organic blueberries instead of partially hydrogenated snacks or organic orange juice instead of high-fructose sodas. What a gift! What an important part of our responsibility!

Whether or not cell phones cause cancer remains very controversial, but a renowned neurosurgeon has released a provocative paper reviewing over 100 scientific and medical studies, and concluded that the link between cell phone use and brain tumors on the same side of the head is now clear, and that tumors from cell phone use are now a bigger public health threat than cigarette smoking.

With cigarettes, there is a very long time lag between starting the habit and developing lung cancer. It’s not surprising that it took decades to discover the link.

Even though cell phones are now used by 3 billion people, they have not been very common for very long. Data in this study suggest that brain tumor rates may double after only 10 years of regular cell phone use, and continue to rise. Cell phones emit a plume of electromagnetic radiation that can penetrate our brains, a major electrical organ. Whether or not this proves to be the looming public health crisis the author predicts, I expect that any risk would be greatest for young children.

The protection surrounding a child’s brain is thinner, the penetration of the radiation is deeper, the brain tissue is more conductive, their brains are changing more rapidly, and they could have a longer lifetime of exposures. Studying chemical exposures, the EPA has found that physical carcinogens average about ten times more dangerous in young children than in adults. Within five years the extent of the risk should be very clear, one way or another. While these issues are being sorted out, it makes sense to me to minimize the time young children spend on the cell phone unless it is important. Keeping the phone at least 8 inches away from the head by using the speakerphone greatly reduces the radiation – but even an inch or two helps. Bluetooth ear pieces and regular unshielded headphones, though, aren’t recommended in this paper, because they can turn the head into an antenna for the phone signal. Shielded headsets or those with an air flow gap can greatly reduce radiation exposure to the head.

We shouldn’t assume that because radiation is invisible to the naked eye it is harmless. Nor assume that because a danger hasn’t been proven in the first decade of widespread child-use that the habit is safe. Nor should we panic. New brain tumors occur in about 15 out of 100,000 people in the general population each year. Doubling that rate would only raise it to 30 out of 100,000 people. The odds against a tumor for an individual cell phone user would still be more than 3000 to 1. On the other hand, with 3 billion users, cell phones could potentially cause about 500,000 new brain tumors a year after 10 years of use – a big public health issue. And the rate after using a cell phone for 40 years? I hope we never find out. I hope that if these risks are proven, safer technologies will be developed long before then.

Men and women born in 1970 – now in their mid-30s – already are being diagnosed with malignant melanoma, the deadliest form of skin cancer. Shockingly, these young adults are being diagnosed with melanoma at the same rate as the elderly who were born in 1930 and who didn’t start developing melanoma until their 50s, according to a March 2005 warning by the SunSmart campaign of Cancer Research UK.

Melanoma risk throughout life is directly linked to excess sun exposure during childhood. A childhood sunburn can double the risk of melanoma later in life. The ozone layer of the atmosphere absorbs 95 to 99 percent of the sun’s ultraviolet radiation before it strikes the surface of the earth. But NASA estimates that the ozone layer is being reduced by 4 to 6 percent every ten years, largely from manmade chlorine products such as chlorofluorocarbons (CFCs) and hydrochlorofluorocarbons (HCFCs).

The US is on a schedule to completely phase out production and import of these substances by 2030 – but they will continue to affect the ozone layer for another century or more. Because of changes in the ozone layer and changes in behavior, children born in the 70s got far more childhood ultraviolet exposure than those born in the 30s. Today’s children are at a higher risk still. They are three times more likely than their grandparents to ever develop malignant melanoma.

It’s more important than ever for kids to avoid excess sun exposure by such measures as heading for the shade at peak sun hours (~11am to ~3pm), using T-shirts, wide brimmed hats, and sunglasses for physical protection, and not letting sunscreens that only protect from some parts of the UV spectrum lull you into a false sense of sun security.

Tobacco contains many compounds capable of damaging DNA and causing cancer. When a woman smokes during pregnancy, tobacco compounds from Mom’s bloodstream slip across the placenta. They can be found both in fetal blood and in the amniotic fluid that bathes the baby inside and out. We’ve known for some time that smoking during pregnancy can be associated with many negative consequences, including infertility, ectopic pregnancies, bleeding and clotting problems, growth retardation, and SIDS.

A landmark study in the March 9, 2005 Journal of the American Medical Association carries this a step farther and suggests that Mom’s smoking is directly toxic to her baby’s genes. The study was performed in Barcelona, Spain. Researchers analyzed the cells obtained during amniocentesis from smokers versus nonsmokers. All of the women were otherwise healthy. The smokers in the study were smoking at least 10 cigarettes a day, and had been for at least 10 years. The nonsmokers never smoked, their partners did not smoke, and they were not exposed to passive smoke at home or at work. Neither group drank any alcohol, coffee, or tea.

As you might imagine, it was difficult to find women who met the strict criteria. It took 175 interviews to find 25 smokers who fit the criteria, and 496 interviews to find the 25 nonsmokers. When the amniocentesis results were analyzed, the risk of identifiable chromosome damage was more than tripled in the women who smoked! The structural chromosome damage in the babies of smokers was not randomly distributed among the chromosomes, but clustered on chromosome 11, at band 23 of the long arm (11q23).

Damage at 11q23 can cause leukemia. Between 40 and 60 percent of infants with blood cancers such as leukemia (and up to 7 percent of adults with these cancers) are known to have had damage to 11q23, which may have happened before they were even born. This study is the first report of tobacco-associated direct genotoxic damage to fetal cells from mothers who smoke. More research is needed to clarify the relationship of cancer to tobacco before birth. I hope that large studies will soon consider whether babies whose fathers or mothers smoked during pregnancy will have an increased risk of cancer throughout their lives.

How and when sun damage occurs to children’s skin may surprise you. Many parents know that in the United States alone more than 1 million skin cancers are diagnosed in adults each year, resulting from damage to the skin during childhood. Many of these cancers are deadly melanomas. Over the last thirty years, the frequency of melanoma has more than doubled, even though sunscreen use has increased.

About 80 percent of our total lifetime sun exposure happens during childhood. But there are two key ages to pay extra attention. The first of these is the toddler years. Sunburns and damaging tans more than double during a child’s second summer, according to a study in the August 2004 Archives of Dermatology. The surprising bit is that this occurs even though total hours of sun exposure stays the same, and the use of sunscreen triples in the toddler years! How can this be? The use of other sun protection efforts dropped, including strategies such as hats and other sun-protective clothing, shade, and non-peak hours for sun exposure. Many parents think that sunscreen alone is enough.

Another key age to pay special attention is when your child is 9 to 12 years old. Sunburns are most common at that age when kids are off enjoying activities without their parents. About 2/3 of American children do not get adequate sun protection. Some gifts we give our kids thrill for the moment, but soon fade. They are often discarded or broken soon after we give them. But whether it’s preventing wrinkles or skin cancer, sun protection is a great way to give your children healthy skin and a healthy complexion for years to come – a gift they will appreciate more with each passing year.

Dr. Greene has been concerned about acrylamide since 2002 when The World Health Organization convened an emergency expert panel in to evaluate the potential health threats of acrylamide, a known toxic substance possibly created by heating starchy foods to high temperatures.

The initial study in Sweden that suggested starches produce acrylamide, conducted early in 2002, was viewed with skepticism. But the formation of acrylamide in this way has now been confirmed by independent studies in England, Norway, Switzerland, Germany, and the United States.

The WHO expert panel unanimously concluded that the results of these studies are valid. They also unanimously agreed there is a major concern that the levels of acrylamide found in some potato chips and French fries could cause cancer. The amount of acrylamide varies from brand to brand, and between cooking techniques. The Center for Science in the Public Interest has commissioned testing of levels in some US brands. The acrylamide in a large order of fast food fries was at least 300 times the amount allowed by the EPA in a glass of water. One brand studied contained 600 times the EPA amount.

Besides agreeing on their cancer concern, and on the validity of the studies done so far, the panel called for urgent new research to further define the scope of the risk and the extent of the problem. In the meantime, they are urging a balanced diet with lots of fruits and vegetables, while decreasing the amounts of fried foods. They said it is too early to specify which fried foods should be avoided.

Based on the evidence currently available, I would go further. In good conscience, I could not recommend that children eat French fries, potato chips, or corn chips until further research is in, or until the brand has been tested and found to have low levels. I recognize that French fries and potato chips are favorite items on kids. menus everywhere, but the benefits just do not justify the risks!

I would also like to see labeling on foods to indicate the presence and amount of acrylamide, so that people can make an informed choice about the risks for themselves and for their kids.