    [Senate Hearing 111-1231]
    [From the U.S. Government Publishing Office]

                                                           S. Hrg. 111-1231

      HEARING ON THE GOVERNMENT ACCOUNTABILITY OFFICE'S INVESTIGATION OF
                   EPA'S EFFORTS TO PROTECT CHILDREN'S HEALTH

    =======================================================================

                                    HEARING

                                   before the

                                  COMMITTEE ON
                          ENVIRONMENT AND PUBLIC WORKS
                              UNITED STATES SENATE

                         ONE HUNDRED ELEVENTH CONGRESS

                                 SECOND SESSION

                                   __________

                                 MARCH 17, 2010

                                   __________

      Printed for the use of the Committee on Environment and Public Works

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                   COMMITTEE ON ENVIRONMENT AND PUBLIC WORKS

                         ONE HUNDRED ELEVENTH CONGRESS
                                 SECOND SESSION

                      BARBARA BOXER, California, Chairman
    MAX BAUCUS, Montana                  JAMES M. INHOFE, Oklahoma
    THOMAS R. CARPER, Delaware           GEORGE V. VOINOVICH, Ohio
    FRANK R. LAUTENBERG, New Jersey      DAVID VITTER, Louisiana
    BENJAMIN L. CARDIN, Maryland         JOHN BARRASSO, Wyoming
    BERNARD SANDERS, Vermont             MIKE CRAPO, Idaho
    AMY KLOBUCHAR, Minnesota             CHRISTOPHER S. BOND, Missouri
    SHELDON WHITEHOUSE, Rhode Island     LAMAR ALEXANDER, Tennessee
    TOM UDALL, New Mexico
    JEFF MERKLEY, Oregon
    KIRSTEN GILLIBRAND, New York
    ARLEN SPECTER, Pennsylvania

                        Bettina Poirier, Staff Director
                     Ruth Van Mark, Minority Staff Director

                                C O N T E N T S

                                  ----------
                                                                       Page

                                 MARCH 17, 2010
                               OPENING STATEMENTS

    Klobuchar, Hon. Amy, U.S. Senator from the State of Minnesota....     1
    Nelson, Hon. Bill, U.S. Senator from the State of Florida........     3
    Cardin, Hon. Benjamin L., U.S. Senator from the State of Maryland    10
    Lautenberg, Hon. Frank R., U.S. Senator from the State of New
      Jersey.........................................................    11
    Boxer, Hon. Barbara, U.S. Senator from the State of California,
      prepared statement.............................................   120
    Inhofe, Hon. James M., U.S. Senator from the State of Oklahoma,
      prepared statement.............................................   121
    Baucus, Hon. Max, U.S. Senator from the State of Montana,
      prepared statement.............................................   122

                                   WITNESSES

    Grevatt, Peter, Ph.D., Director, Office of Children's Health
      Protection and Environmental Education, U.S. Environmental
      Protection Agency..............................................    12
        Prepared statement...........................................    15
        Responses to additional questions from:
            Senator Boxer............................................    33
            Senator Vitter...........................................    39
    Stephenson, John B., Director, Natural Resources and Environment,
      U.S. Government Accountability Office..........................    47
        Prepared statement...........................................    49
        Responses to additional questions from:
            Senator Boxer............................................    61
            Senator Vitter...........................................    64
    Solomon, Gina M., M.D., M.P.H., Senior Scientist, Natural
      Resources Defense Council; Associate Director, Pediatric
      Environmental Health Specialty Unit; Associate Clinical
      Professor of Medicine, University of California, San Francisco.    72
        Prepared statement...........................................    74
        Responses to additional questions from Senator Boxer.........    83
        Response to an additional question from Senator Vitter.......    87
    Bearer, Cynthia, M.D., Ph.D., FAAP, Division Chief, Neonatology,
      University of Maryland School of Medicine; Children's
      Environmental Health Network Board Chair.......................    90
        Prepared statement...........................................    92
        Responses to additional questions from Senator Boxer.........    98
        Response to an additional question from Senator Vitter.......   100
    Schettler, Ted, M.D., M.P.H., Science Director, Science and
      Environmental Health Network...................................   101
        Prepared statement...........................................   103

      HEARING ON THE GOVERNMENT ACCOUNTABILITY OFFICE'S INVESTIGATION OF
                   EPA'S EFFORTS TO PROTECT CHILDREN'S HEALTH

                                  ----------

                           WEDNESDAY, MARCH 17, 2010

                                           U.S. Senate,
                     Committee on Environment and Public Works,
                                                        Washington, DC.
        The full Committee met, pursuant to notice, at 10:30 a.m.
    in room 406, Dirksen Senate Office Building, Hon. Amy Klobuchar
    (acting Chairman of the full Committee) presiding.
        Present: Senators Klobuchar, Lautenberg, Cardin, and Udall.
        Also present: Senator Nelson.

               OPENING STATEMENT OF HON. AMY KLOBUCHAR,
                U.S. SENATOR FROM THE STATE OF MINNESOTA

        Senator Klobuchar. I think we are ready to begin this
    hearing and convene this hearing.
        I want to thank everyone for waiting. Senator Boxer is on
    her way. We had votes, as you know, so we appreciate everyone's
    patience. I know that Senator Boxer will be joining us, and I
    know that Senator Nelson is also. We are very honored to have
    him here with us.
        I am the Chair of the Subcommittee on Children's Health,
    and as the mother of a 14-year-old, I am particularly
    interested in doing all that we can to protect and improve the
    health of our kids, especially when it comes to the
    environment. Every one of us has a stake in making sure kids
    grow up happy and healthy.
        This is important not only for the well-being of our kids
    but also for our country. I know parents have an increasingly
    difficult job in today's world. The economic pressures, the
    time demands, and the many outside influences that affect our
    kids, all of these and more make it an especially challenging
    time for America's families.
        Since I have entered the Senate I have made children's
    health one of my top priorities. Part of that was because I got
    involved when a little kid, a 4-year-old, swallowed a charm
    that he got with a pair of tennis shoes, and he ended up dying.
    He did not die from choking. He did not die from somehow that
    charm blocking his airways. He died because there was lead in
    that charm. When they tested it, it was 100 percent lead, and
    the lead in that charm went into his bloodstream, and he died
    over a period of days.
        When you hear stories like that you know that things are
    not all right for the kids in this country. And that is why I
    worked with Senator Pryor and others, and Senator Nelson on the
    Commerce Committee, to pass what the Wall Street Journal called
    the most sweeping consumer legislation in 16 years with the
    Children's Products Bill that we passed.
        I have also worked with Senator Crapo on our formaldehyde
    bill. We now have many, many authors, I think nearly 20
    authors, and it is heading to the floor. It went through the
    Committee. Again, formaldehyde in wood products is something
    that is not a partisan issue.
        We are also looking at the effects of outdoor pollutants.
    With nearly 9 million kids in the United States affected by
    asthma, it is the leading serious chronic illness among our
    children. Outdoor air pollution worsens existing asthma.
        Kids are already at greater risk from outdoor air pollution
    than healthy adults since kids have smaller airways than adults
    which are blocked easier, causing children to breathe more
    rapidly. According to the EPA, 66 percent of kids live in
    countries that exceed allowable levels of at least one of the
    principal air pollutants that cause or aggravate asthma. That
    not only affects our children's health, but it contributes to
    $3.2 billion in medical costs per year. And that was actually
    66 percent of kids that live in counties that exceed rates.
        We are also working in the Agriculture Committee to
    increase nutrition standards. That bill is actually being
    introduced today by Senator Lincoln and is something that will
    also be important as we go ahead for our children.
        But more work must be done. I joined with Senator Boxer in
    requesting the GAO report that we will be hearing about today
    because we wanted to learn more about what EPA is doing to
    focus efforts on children's environmental health. With the
    increased prevalence of asthma, obesity, and chemical toxins,
    the agency should be focused on what steps we can take to
    prevent the spread and incidence of these risks but also
    researching long-term strategies to help improve the overall
    health of our children.
        To develop an effective, focused strategy EPA must be
    working with other agencies, like the Department of Health and
    Human Services, to coordinate this effort. At one time, we had
    this coordination. In 1997 the President's Task Force on
    Children's Environmental Health and Safety Risks was authorized
    by Executive Order to provide this guidance and interagency
    coordination on children's environmental health. This task
    force ensured that agencies were working together on efforts to
    improve health and provided the type of commitment we need to
    ensure long-term goals to combat environmental risk.
        That is why I am proud to introduce legislation, along with
    Senator Boxer, that would finally reestablish this task force.
    As a former prosecutor I know that the first responsibility of
    government is to protect our citizens. So we must do everything
    we can to make sure our Government is doing all that it can to
    protect our youngest citizens from environmental harm.
        Ensuring that agencies are coordinating their efforts not
    only means that we can develop an effective strategy to improve
    the health of our kids, but it means that our Government can
    ensure that we are using taxpayer dollars effectively and not
    duplicating programs or working at cross purposes.
        I look forward to hearing from out panelists about the
    GAO's findings and efforts to address the environmental health
    issues that are affecting our children. They are the most
    vulnerable among us, and it is our responsibility to protect
    them.
        Our first witness, or more than that, expert, testifying
    today, I am pleased to see Senator Nelson here. He has been
    very active on this issue. I know that because I am on the
    Commerce Committee. And I thank him for coming today.
        Senator Nelson.

                OPENING STATEMENT OF HON. BILL NELSON,
                 U.S. SENATOR FROM THE STATE OF FLORIDA

        Senator Nelson. Thank you, Madam Chair.
        Madam Chair, may I just talk to you and submit my comments
    for the record along with a number of letters from the people
    in the area affected?
        Senator Klobuchar. Without objection. Your comments will be
    put in the record.
        Senator Nelson. Madam Chairman, we have an area west of
    West Palm Beach in Palm Beach County, Florida, called the
    Acreage. It is a residential area that has a rural character.
    There have been a number of children diagnosed with cancerous
    tumors, and all live within a radius of a couple of miles of
    each other.
        Naturally, the consternation of not knowing if this is a
    cancer cluster has disrupted the lives of thousands of people
    who live in this area because now, with the fact that it might
    be a cancer cluster, you know what has happened to the value of
    homes, and you know what has happened to the ability to sell
    your home if someone has to move, with the fact that some
    people are so fearful that this is a cancer cluster have moved
    out and are renting elsewhere in the city, in the county, while
    still maintaining the mortgage on their home in this particular
    area.
        This is an upscale area. It is on well water, and in this
    part of Florida these are shallow wells, and they are on septic
    tanks. So, the question is, what is the cause?
        So, a year ago, when this came to my attention, I went to
    the Florida Department of Health. A part of them is the County
    Health Department. They are the ones to try to determine if
    this is a health hazard. And for almost a year now they have
    been studying this, and they cannot come up with any
    conclusions.
        And so I am asking this Committee--and thank the Good Lord
    that you have got a Committee that is concerned that there
    might be these cancer clusters around the country--I am asking
    this Committee to bring the full weight of the expertise of the
    Federal Government to assist the first responders, which are
    the State Departments of Health, in determining if these are
    cancer clusters and if so, what we can do about it. And that
    means reaching out to the expertise of the EPA, the
    Environmental Protection Agency, as well as the Department of
    HHS and all of its myriad agencies including the CDC, the NCI,
    the NIH, et cetera.
        Now, that is what we need, because these people are in a
    terrible situation, fearful for their health, but at the same
    time, because of no conclusions, paying a terrible price in not
    being able to move on with their lives.
        In the testimony that I have submitted, and some of the
    letters that I have submitted, I have chronicled the specific
    cases of children that had these brain tumors. Now, is this
    something from the soil? Is this something from the shallow
    wells of the water? Is it particularly because children are the
    ones that get out and play in the dirt and crawl around on the
    floor and play in the puddles? We do not know. And we need to
    help bring about a resolution of information and conclusions.
        Thank you, Madam Chair.
        [The prepared statement of Senator Nelson follows:]

                        Statement of Hon. Bill Nelson,
                     U.S. Senator from the State of Florida

        Chairman Boxer, Ranking Member Inhofe and members of the
    Committee, thank you for the opportunity to testify before you
    today. Chairman Boxer, thank you for your continued leadership
    and actions to protect our Nation's children.
        While the Committee examines the role of the Environmental
    Protection Agency and children's health I'd like to bring your
    attention to a community in Palm Beach, Florida, called the
    Acreage.
        This town of about 50,000 has been shaken by fears of a
    cancer cluster. In February a study by the State health
    department found higher than normal incidences of brain and
    central nervous system cancer in girls and young women. Some
    residents have lost a loved one, others aren't sure if their
    homes are safe to live in, and if they try to leave, they worry
    they won't even be able to sell their homes.
        Despite a year-long investigation, we still don't know
    what's causing these cancers, and people cannot get their lives
    back to normal until they have answers.
        Last summer I asked the EPA and Centers for Disease Control
    to get involved and help the State and local health department
    in its investigation.
        The Federal Government should take a larger and more
    proactive role in these complex and highly technical
    investigations because it has the expertise to lend a hand with
    detailed and sophisticated analysis.
        EPA's mission is to protect human health and the
    environment. In order to fulfill that role and to help
    communities like the Acreage that are desperate for answers,
    the first step would be bringing the EPA and various agencies
    within the Department of Health and Human Services together to
    lay out a plan for what a Federal role should be in the
    investigation of cancer clusters.
        I also believe the agencies, led by EPA and HHS, should
    prepare rapid response teams that will advise and assist not
    only the State and local health departments but help with
    communicating what's going on to the community. Here's why we
    need to act, and we need to do it immediately.
        Jenna McCann died just 2 months before her 5th birthday
    because of a rare, aggressive form of brain cancer. A few years
    later her family learned of two other young girls with the same
    type of rare brain cancer who also lived in the Acreage.
        Her mother, Kaye McCann, wrote to me, ``How can a cancer
    that is so rare . . . affect 3 children living within just a
    few miles of each other in just a few years' time? I don't know
    what the answer is, but I know this area needs help.''
        Another mother, Jennifer Dunsford, was in the hospital
    waiting room while her 5-year-old son had to undergo brain
    surgery, and she started talking with another family in the
    waiting room. As it turned out, they also live in the Acreage.
    Their daughter had just had surgery because she also had brain
    cancer.
        Later that same year, Jennifer found out there were two
    more children who lived in the Acreage who were diagnosed with
    brain cancer.
        She was the resident in the Acreage who initiated the
    request for a study and who has even gone on the Dr. Oz show to
    tell people about what's happening in Florida and the need for
    more testing and for immediate help to find answers.
        There are more stories like this, and with the consent of
    the Chairman I'd like to enter them into the hearing record.
        Hearing stories like these is heartbreaking, and we've got
    to do something about it. I look forward to working with you on
    this.

        [The referenced information follows:]

      [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Senator Klobuchar. Thank you very much, Senator Nelson. We
    really appreciate that, and hopefully we can get to the bottom
    of this.
        Senator Cardin.

             OPENING STATEMENT OF HON. BENJAMIN L. CARDIN,
                U.S. SENATOR FROM THE STATE OF MARYLAND

        Senator Cardin. Well, Senator Klobuchar, Chairman
    Klobuchar, thank you very much for conducting this hearing on
    the Government Accountability Office's investigation of EPA's
    effort to protect children's health.
        Let me use a little bit of my time in opening statement to
    introduce a witness that will be on our second panel, Dr.
    Cynthia Bearer. We welcome you to the Committee from the
    University of Maryland Medical Center in Baltimore City. She is
    the Cobey Professor of Neonatology and Chief of the University
    of Maryland Medical Center Hospital for Children Division of
    Neonatology.
        Dr. Bearer is here today on behalf of the Children's
    Environmental Health Network for which she serves as the Board
    Chairman. The Network is the national organization whose
    mission it is to protect children from environmental health
    hazards and to work to build a healthier environment for kids
    to grow in.
        We certainly welcome you here, and we look forward to your
    testimony. I apologize. I will be running in and out because of
    other duties today. But thank you for appearing before our
    Committee.
        Let me just point out generally, Madam Chair, if I might,
    the importance of this subject. We know that children are more
    vulnerable to the environmental risks. We know that their
    bodies cannot detoxify at the same efficiency as older bodies
    can. We also know, as Senator Nelson pointed out, children are
    closer to the ground. Therefore, they are crawling around and
    are more vulnerable to the environmental risk factors.
        We also know that they eat and breathe more per body weight
    than adults do. So, in 1993 the National Academy of Science
    came to the conclusion that children are not little adults and
    therefore are more vulnerable to these environmental risks.
        I was pleased in 1997 that the EPA established the Office
    of Children's Health as well as the advisory committee to
    implement and oversee a national plan to protect our children
    from environmental exposures. A major undertaking of the EPA is
    participation in the National Children's Study authorized by
    Congress in 2000. The National Children's Study examines the
    effects of environmental influences on the health of 100,000
    children across the United States, following them from before
    birth to age 21.
        Health disparities are also affected by environmental
    factors with environmental health risks affecting minority and
    low income children disproportionately because of the
    demographic trends in the United States, according to the
    Interagency Forum of Child and Family Statistics. To this end
    it is particularly important to conduct research on children
    that will include racial and ethnic majorities, minorities,
    excuse me.
        There is one finding, Madam Chair, that I know, that
    provoked, I think, this hearing, and that is EPA has not
    updated its National Agenda regarding protecting children's
    health in over 10 years and that the recent 2009 goals do not
    include the Office of Children's Health as a target area for
    improvement.
        This hearing is very important. Our children are our most
    precious assets. We say it over and over again; we want to do
    everything we can to protect them. They do not have the same
    advocacy as the adult community has. And yet, as Senator Nelson
    pointed out in his specific example, they are extremely
    vulnerable to environmental risk.
        The Environmental Protection Agency must have a focus on
    what we do to protect our children from these environmental
    risks. The study is an important part that they are
    participating with on other, with other agencies. It is also
    important that we update the strategies on a regular basis. I
    think this hearing is an appropriate oversight for our
    Committee, and I thank the Chair for conducting it.
        And with that I would yield back the balance of my time.
        Senator Klobuchar. Thank you very much, Senator Cardin.
        Senator Lautenberg.

            OPENING STATEMENT OF HON. FRANK R. LAUTENBERG,
               U.S. SENATOR FROM THE STATE OF NEW JERSEY

        Senator Lautenberg. Thanks, Madam Chairman, for having this
    hearing.
        Each of us who has a grandchild is immediately an expert on
    children's health, and the concerns that we have for them rise
    to the top of our agenda. I am fortunate enough to have four
    kids and am grandfather of 11 between my wife and me. This
    subject is a crucial one for us.
        I see in my own family, I have a grandson who is 16 who has
    got asthma and a granddaughter who is 11 who has diabetes. We,
    in order to help them, I am determined, and I think we all are,
    to make sure that we do everything for grandchildren across our
    country.
        That is why in 1997 President Clinton issued an Executive
    Order to protect infants and children from environmental health
    risks, and the Administrator of the EPA created the Office of
    Children's Health. That office developed into a powerful force
    that consistently fought for the well-being of our Nation's
    children. The nature of children's health was a top priority of
    EPA research budgets and policies.
        The office also made sure that children's health was a
    priority factor when the agency created cancer guidelines,
    environmental toxin guidelines, in its data base on chemical
    risks.
        Unfortunately, the progress made to safeguard children's
    health ground to a halt during the Bush administration as
    today's report from the Government Accountability Office makes
    clear. The EPA seemed to develop collective amnesia, lost focus
    on children's health issues, and the Office of Children's
    Health withered on the vine.
        In fact, the Administrator of the EPA office showed such
    little interest in the office that it went without a permanent
    director for 6 years. And as today's GAO report concludes, the
    Office of Children's Health, and here I quote, declined in the
    absence of direct and meaningful support from the EPA's
    Administrator.
        The good news is that things have turned around with
    Administrator Lisa Jackson at the helm of EPA. She has
    recommitted the Agency to protecting children from
    environmental dangers, moved quickly to appoint Peter Grevatt--
    we welcome him here--as the new Director of the Office of
    Children's Health, and made him a key advisor on her team.
        Soon after his appointment Director Grevatt issued a
    roadmap with five clear priorities to protect children's
    health. And I was pleased that he made the reform of toxics,
    the Toxic Substance Control Act, known as TSCA, a top priority.
    Right now TSCA is not up to the task of protecting our kids
    from toxic chemicals, and it has got to be overhauled so we can
    figure out what chemicals children are exposed to and what
    exactly we need to do to protect them.
        Children, as was said, are not simply small adults. They
    are extremely vulnerable to the acute dangers of toxic
    chemicals. And according to a report by the Safer Chemicals,
    Healthy Families Coalition as much as 5 percent of cancers, 10
    percent of neural behavioral disorders and 30 percent of asthma
    cases in children are associated with toxic chemicals.
        I do not know whether a report--the Op Ed piece by Nicholas
    Kristof, written in the New York Times, where he raised the
    question of toxics and autism. It got a lot of attention, and
    we are going to be focused in that area, thank goodness.
        So, we are here today because more work has to be done when
    it comes to children's health. Unfortunately, I, too, am called
    to other places. Madam Chairman, this is an important Committee
    and an important hearing, and I am sure that we will establish
    a good record from which we can work.
        Thank you very much. And thank you to the witnesses.
        Senator Klobuchar. Thank you very much, Senator.
        And now we are going to move to our first panel. If you
    could come forward, I will introduce you.
        OK, well thank you for being here today. We have two
    panelists for our first panel. The first is Dr. Peter Grevatt,
    who is the Director of the Office of Children's Health
    Protection with the EPA, and the second is John Stephenson, who
    is the Director of Natural Resources and Environment with the
    Government Accountability Office or, as we know them, the GAO.
        So, we will start with Director Grevatt.

        STATEMENT OF PETER GREVATT, PH.D., DIRECTOR, OFFICE OF
    CHILDREN'S HEALTH PROTECTION AND ENVIRONMENTAL EDUCATION, U.S.
                    ENVIRONMENTAL PROTECTION AGENCY

        Mr. Grevatt. Good morning, Madam Chairman and members of
    the Committee.
        My name is Peter Grevatt, and I am the Director of the
    Office of Children's Health Protection and Environmental
    Education at the U.S. Environmental Protection Agency. Thank
    you for the opportunity to appear before this Committee to
    discuss EPA's efforts to improve children's health.
        Children face greater threats from environmental pollutants
    than adults due to differences in their physiology, activity
    patterns and development. And not all children are the same. We
    continue to see disparities in exposures and health outcomes
    among the poor, African American, Latino, Native American and
    other ethnic minorities.
        Children's health is a driving force behind Administrator
    Jackson's priorities. In February, in a memo to EPA's senior
    managers, she reaffirmed EPA's commitment to considering the
    health of pregnant women, infants and children in all human
    health related activities and to the use of EPA's policy on
    evaluating health risks to children and the best available
    research and data to guide our children's health protection
    efforts.
        In the memo Administrator Jackson describes EPA's
    children's health agenda and identifies my office, the Office
    of Children's Health Protection, as having the lead in ensuring
    that the agency is successful in its efforts to protect
    children's health.
        EPA agrees that the GAO report reflects the progress of the
    agency's children's health protection efforts, accurately
    portrays the agencies challenges in addressing children's
    environmental health, and sets forth sound recommendations on
    steps that could be taken to better incorporate protection of
    children's health as an integral part of EPA's everyday
    business.
        EPA is implementing a comprehensive strategy to ensure
    protection of children's environmental health which embodies
    the five key priorities I previously discussed for children's
    environmental health at EPA.
        EPA will use the best science to ensure that regulations
    provide for protection of children's environmental health by
    actively addressing the potential for unique childhood
    vulnerability and exposure. Our goal is to reduce negative
    environmental health impacts on children through rulemaking,
    policy, enforcement and research that focus on prenatal and
    childhood vulnerabilities.
        For example EPA is confronting the harmful effects of
    criteria air pollutants on the health of children. We have
    decided to reconsider the 2008 National Smog Standards to
    ensure that they are scientifically sound and protective of
    human health. We will bring the best science to bear in our
    decisions.
        The Children's Environmental Health Centers, established in
    1998 by EPA and the National Institute of Environmental Health
    Sciences, examined the interactions between key environmental
    exposures in a range of child health outcomes such as growth
    and development, asthma and autism, with the goals of
    preventing and reducing childhood diseases and translating the
    findings to the effected communities and the broader public.
        Assuring the safety of chemicals in our products and our
    environment is critical to ensure the health of children. EPA
    will establish standards, policies and guidance to help
    eliminate harmful prenatal and childhood exposures to
    pesticides and other toxic chemicals.
        And last year Administrator Jackson announced principles
    for modernizing the Toxic Substances Control Act, or TSCA. We
    are hopeful that TSCA will be updated by Congress so that we
    are better able to take action on chemicals that pose a
    concern, particularly those that affect children.
        Separately, we are shifting EPA's focus to address high
    concern chemicals and filling data gaps on widely produced
    chemicals. At the end of 2009 we released our first ever
    Chemical Action Plans for four groups of substances, and more
    plans are in the pipelines for 2010.
        EPA also recognizes that children may be more vulnerable to
    pesticide exposure. We are planning to further strengthen
    assessment of pesticide health risks. By modifying our risk
    assessment approach we hope to continue to minimize the adverse
    health consequences of pesticide exposures. We are also working
    closely with partners such as the Department of Housing and
    Urban Development and the Centers for Disease Control and
    Protection--and Prevention, excuse me--to protect children from
    pesticides in residences and in schools.
        We will coordinate national and international community
    based programs to eliminate threats to children's health. EPA
    is collaborating with the Department of Health and Human
    Services, Department of Education and a diverse group of
    stakeholders through our Children's Health Protection Advisory
    Committee to provide tools to communities to build a new
    generation of healthy green schools and help ensure that
    existing schools are in good condition and are properly
    maintained.
        EPA, HHS and the Department of Housing and Urban
    Development are also collaborating to respond to the Surgeon
    General's call to action on healthy homes by taking advantages
    of opportunities to leverage Federal resources to provide
    States, tribes and local communities with the necessary tools
    to help improve home environments, particularly in underserved
    communities.
        EPA and HHS are also joining with other Federal departments
    and agencies to work toward reestablishing the President's Task
    Force on Environmental Health Risks and Safety Risks to
    Children. And with this group we will collaborate to address
    the most critical children's environmental health issues facing
    the Nation.
        EPA is also working with other Federal agencies to address
    environmental factors that contribute to the pervasive problem
    of obesity in children through our participation in the Task
    Force on Childhood Obesity.
        As part of our efforts in all of these areas, we will
    utilize our Children's Health Protection Advisory Committee to
    help ensure that we are developing effective strategies to
    address the most significant threats to children's
    environmental health.
        Thank you, Chairman Boxer, and Chairman Klobuchar and
    Members of this Committee, for the opportunity to talk to you
    today. As evident by our strategy and actions Administrator
    Jackson and I share your commitment to children's environmental
    health, and we appreciate your ongoing interest in our efforts.
        Thank you again for inviting me to give testimony, and I
    look forward to answering any questions you may have.
        [The prepared statement of Mr. Grevatt follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

            Senator Klobuchar. Thank you, Dr. Grevatt.
        Mr. Stephenson.

     STATEMENT OF JOHN B. STEPHENSON, DIRECTOR, NATURAL RESOURCES
         AND ENVIRONMENT, U.S. GOVERNMENT ACCOUNTABILITY OFFICE

        Mr. Stephenson. Thank you, Madam Chairman.
        I am pleased to be here today to discuss EPA's and the
    Federal Government's progress over the last 10-plus years in
    addressing children's environmental health issues. My testimony
    summarizes our full report to the Committee on these issues
    being released today.
        The scientific evidence about children's exposure to
    dangerous chemicals and the health effects of these chemicals
    continues to mount. For example 66 percent of children live in
    counties that exceed allowable levels of at least one of the
    principal air pollutants that cause aggravated asthma--a
    significant problem for children, one that costs $3.2 billion
    in medical costs annually.
        EPA and the Federal Government took several bold steps in
    the late 1990s to make children's environmental health a
    priority. In 1996 EPA issued a National Agenda to protect
    children's health from environmental threats. In April 1997 the
    President signed Executive Order 13045 that mandated a
    concerted Federal effort to address children's environmental
    health and safety risks and established an Interagency Task
    Force to recommend strategies to the President for protecting
    children.
        Also in 1997 EPA created the Office of Children's Health
    Protection and formed the Children's Health Protection Advisory
    Committee. However, this early momentum waned through the last
    decade. Our report, while acknowledging some successes such as
    the increased margins of safety for pesticides and the creation
    of the National Children's Study, concludes that EPA's past
    efforts to institutionalize children's health through its
    National Agenda and Strategic Plan have not been sustained.
        But EPA has not effectively engaged its Office of
    Children's Health or proactively used its Children's Health
    Advisory Committee, and the agency's Interagency Task Force,
    which is largely responsible for the Federal Government's early
    momentum on children's health issues, was allowed to expire in
    2005.
        We are encouraged that Administrator Jackson is attempting
    to refocus attention on children's environmental health issues
    and believe that the strategy just discussed by Dr. Grevatt is
    a step in the right direction. However, we believe that to
    ensure progress EPA needs to implement changes in concrete and
    actionable ways to institutionalize its approach to children's
    environmental health issues.
        To this end our report makes specific recommendations to
    EPA to include: No. 1, updating and reissuing a National Agenda
    to articulate current environmental health priorities and
    emerging issues; No. 2, identifying and tracking rulemaking and
    other actions to ensure that children's health issues are fully
    considered; No. 3, ensuring that each new Strategic Plan
    expressly articulates children specific goals, objectives and
    targets; No. 4, reevaluating the mission of the Office of
    Children's Health and ensuring that it has the resources and
    organizational placement to carry out its mission; and No. 5,
    more proactively using the Children's Health Protection
    Advisory Committee.
        We are pleased that EPA agreed with our recommendations but
    believe they must be successfully implemented if EPA is to
    incorporate protection of children's health as an integral part
    of its everyday business.
        Finally, Madam Chairman, notwithstanding the actions that
    EPA can take on its own, leadership from outside the agency and
    across the Government will also be needed to protect children
    from current and emerging environmental threats.
        The President's Task Force on Children's Environmental
    Health that expired in 2005 was comprised of nine cabinet
    officials and seven White House office directors and was co-
    chaired by the Administrator of EPA and the Secretary of Health
    and Human Services. We believe that this task force provided
    the high level infrastructure needed to coordinate Federal
    research and strategies for addressing children's environmental
    health concerns through nationwide initiatives like the
    National Children's Study, a study that is examining the role
    of environmental factors on health and diseases in children
    from pre-birth to age 21.
        The Task Force documented this and other accomplishments
    and reported to the President, and in our review significantly
    enhanced the Nation's ability to understand, analyze and
    respond to environmental health risks to children. Nearly every
    children's health expert we talked to told us that the Task
    Force could help the Federal Government respond to national
    health and safety concerns such as recalls of toys and other
    children's products.
        Our report recommends that the Task Force be reestablished.
    We are pleased that you are introducing legislation to do so,
    and we see this as a critical step for the Government to regain
    its momentum in comprehensively addressing children's health
    issues.
        That concludes a summary of my statement, and I, too, will
    be happy to answer questions.
        [The prepared statement of Mr. Stephenson follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Senator Klobuchar. Thank you very much, Mr. Stephenson.
    Thank you for acknowledging the legislation that we are
    introducing. What do you see are some of the advantages of
    going beyond EPA and coordinating with other agencies as we
    want to do with this legislation?
        Mr. Stephenson. Well, at least those 10 agencies that were
    on the Task Force certainly have roles in protecting children.
    The Consumer Product Safety Commission would be instrumental in
    things such as the toy recall. It could benefit from EPA's
    scientific assessments of chemicals that are typically used in
    toys. So, it just created leadership across the Government and
    provided great momentum for addressing this issue that has kind
    of waned since it expired in 2005.
        Senator Klobuchar. I was thinking about that when we had
    the latest toy issue with the cadmium in the jewelry, and how,
    when we had a previous hearing I asked about that, and the
    studies that were going on at EPA and just having that kind of
    coordination. It might not have been as much of a surprise as
    it appeared to be when suddenly there was this new problem that
    none of us had foreseen because we were so focused on the lead.
        Mr. Stephenson. Yes, too, we think that the regular reports
    to the President on this subject help keep the public informed
    about what the Government is doing to protect children as well.
        Senator Klobuchar. I would just think that coordination
    might result in better legislation as you look at things, not
    just as a specific thing that comes to one agency, but overall.
        How can we create accountability and ensure that the EPA is
    following through on its stated goal to make children a
    priority at the agency since you guys are all about
    accountability?
        Mr. Stephenson. Well, as Senator Lautenberg mentioned the
    National Agenda that guides EPA's efforts in this area has not
    be updated for 10 years. I think EPA is getting there, but it
    is not documented yet.
        We think that such a document with clear research
    priorities, chemical risk assessment priorities and the like
    are critical to guide the agency, and we think that informs the
    public about what EPA is doing to protect children as well. And
    it sends a message across the program offices and regions at
    EPA as well to the fact that this is an important agenda of the
    Administrator. We think that the regular reports that they
    provided to the Administrator were also instrumental in keeping
    the momentum going.
        There are many things that we think need to be done. In the
    rulemaking process, we recommended better tracking mechanisms
    to show how children's health issues are considered in
    rulemaking and standard setting and other actions that EPA
    takes. So, there is a whole variety of things specified in our
    report that we think will go a long way toward
    institutionalizing the addressing of children's health issues
    at the agency.
        Senator Klobuchar. Thank you.
        Mr. Grevatt, what will the agency do to address the
    findings that are in the GAO report?
        Mr. Grevatt. We have already taken steps to begin
    addressing a number of the findings, and I appreciate very
    much--as we indicated in our comments to your draft report--
    that the recommendations are sound. And so, for example, as I
    mentioned in my testimony, we are already working with other
    Federal agencies toward the reestablishment of the Interagency
    Task Force on Children's Environmental Health and Safety, which
    we see as a critical step to helping the Nation to be able to
    address these key issues.
        The agency has improved its tracking system for regulations
    to help--to better capture children's health issues, and I have
    significantly increased the focus of the office on rules and
    regulations that are being developed by the agency through my
    interaction with the Administrator and also with the senior
    career folks across the agency. I think we have an opportunity
    to increase the sort of reporting that you were talking about,
    the critical nature of that.
        We have--I have requested and have received an increase in
    resources to my office this year and in 2010 of five full-time
    equivalent employees being increased in the office, and then
    the President's budget for 2011 includes a request for an
    additional 13 employees between my office and the regions to
    focus on healthy school environments.
        Senator Klobuchar. And when you talk about healthy school
    environments, what do you mean by that?
        Mr. Grevatt. I mean to address the issues in schools that
    we think that can both impact children's health in those
    schools as well as children's academic performance in those
    schools. So, things like making sure the schools are dealing
    with moisture problems to prevent mold in the school
    environments to help reduce the possibility of children
    experiencing attacks in the school environment, making sure
    that when pesticides and cleaning products are used in school
    they are used safely so as to not inadvertently affect the
    children who are in those school environments, making sure
    there is adequate air exchange so that kids can be alert in
    their work and also protected from any kind of allergens other
    than mold that might cause asthma attacks in those school
    environments. So, those kinds of issues are all key to that
    work.
        Senator Klobuchar. OK, one specific question, and then I
    will turn it over to my colleague, Senator Udall, who has
    arrived.
        Dr. Grevatt, in your testimony you mentioned that EPA
    issued the Lead Renovation Repair and Painting Rule, which aims
    to provide broad protections against inadvertent lead poisoning
    by requiring contractors and construction professionals to be
    trained, certified and to use lead safe work practices during
    renovation, repair and painting in pre-1978 housing and
    childcare centers.
        There is broad agreement that these increased protections
    for children are necessary, but there is also some recent
    concern among consumer health organizations and people who do
    this type of work that there are not yet enough certified
    contractors to meet EPA's requirement when this rule could take
    effect.
        I understand that EPA has less than 200 accredited trainers
    and less than 14,000 certified renovators nationwide. We are
    not quite at the 200,000 that we need to make this work. I did
    write a letter today to Administrator Jackson expressing
    concerns about implementing this rule next month, that we
    simply might not be ready yet, and it could not have the
    desired effect that we want, to reduce the lead and at the same
    time, because of the lack of the contractors--the trained
    contractors--could hinder the home energy efficiency upgrades.
        Do you know what is EPA's position is on this? That was a
    long question.
        Mr. Grevatt. It was a long question but a very important
    one. It is a tremendously important rule implementation;
    effecting implementation of that rule is tremendously important
    to protect children's health in home environments and other
    environments where they spend time. The Administrator is well
    aware of this issue, and I was speaking with the Deputy
    Administrator about it yesterday, looking toward increasing
    opportunities and awareness of the contractors of the need to
    be trained for implementation of the rule.
        And I think there are a number of factors at play here. We
    think that we have enough trainers now to reach out to a large
    group of contractors across the country, but we think there is
    still an issue with increasing the awareness among the
    contracting community. It requires them to spend roughly a day
    in a training course with 2 hours of hands-on training, and we
    are not getting the response from the contractor community that
    we need as yet.
        So, we are talking about specific ways of outreach in the
    near term, the very near term, to try to increase participation
    in the training and get those numbers up where they need to be.
        Senator Klobuchar. Yes, and I would suggest, just because
    we are working so hard with our stimulus and jobs package that,
    you know, perhaps some delay will be necessary with the
    immediate outreach and a different date because I am just
    concerned about these numbers so far. But that is something
    that I know you will be discussing at the EPA.
        Mr. Grevatt. That is right. Thank you.
        Senator Klobuchar. OK. Thank you.
        Senator Udall, I see you are wearing green. I forgot to.
        Senator Udall. Thank you, Madam Chair. I am wearing green.
    Somehow, I managed to remember this morning.
        Senator Klobuchar. You are very organized. You must be part
    of a coordinated green interagency task force.
        Senator Udall. No, I happened to see Senator Leahy last
    night in black tie on the floor, and I said, what is going on
    there, and they said he is going to the dinner.
        Senator Klobuchar. Oh, and then that made you remember. You
    did good. It is sort of an interagency theme. OK. There you go.
        [Laugher.]
        Senator Udall. Anyway, Madam Chair, thank you very much,
    and thank you for focusing on this issue. I know you have a
    real passion for children's issues and children's health, and I
    look forward to really working with you on this Committee to
    achieve some good goals.
        This question is for both Mr. Stephenson and Mr. Grevatt.
    The EPA's National Agenda to protect children's health from
    environmental threats came out in 1996. That same year Congress
    reauthorized the Safe Water Drinking Act with a focus on cost-
    benefit analysis. Since 1996 the EPA has issued few new
    drinking water standards.
        Under the previous Administration EPA decided not to
    regulate perchlorate, an ingredient for explosives that harms
    the thyroids of pregnant women. What are the challenges of
    incorporating the special health effects of children in the
    Safe Water Drinking Act? Either one of you, jump in there.
        Mr. Stephenson. I will defer to Dr. Grevatt on that.
        Mr. Grevatt. OK. Thank you very much. A very important
    issue, perchlorate in particular, but more broadly, addressing
    contaminants in drinking water. And we are--I think you are
    aware that within the last year EPA reevaluated the health
    risks related to perchlorate and issued an updated risk
    assessment for perchlorate for public review. And at this point
    the Administrator is considering what decision to make
    specifically with regard to possibly regulating perchlorate as
    a contaminant in drinking water.
        But more broadly the Safe Drinking Water Act, in addition
    to requiring a cost-benefit analysis, does require
    consideration of vulnerable populations for drinking water
    contaminants, including children. And we will be working very
    closely with the Drinking Water Office as well as other offices
    across the agency and their own regulatory actions to make sure
    that children's health vulnerabilities are considered through
    any rulemaking activities that will address drinking water
    contaminants.
        Mr. Stephenson. The only thing I would add is that we do
    have some ongoing work on perchlorate right now as an emerging
    contaminant in drinking water, and I believe this Committee is
    one of the requesters for that report, which will be out later
    this year. It does not single out children's health issues, but
    it will talk about the problems that EPA has and the length of
    time that it takes to do chemical risk assessments in general.
    Perchlorate, for example, has been studied for over a decade
    now. And we may have some specific recommendations on the issue
    of chemical risk assessment coming out of that report.
        Senator Udall. Thank you.
        Mr. Stephenson, you recently testified at our Committee
    regarding efforts to reform the Toxic Substances Control Act,
    which is clearly out of date, at best, and possibly fatally
    flawed. The question for both of you is which of the proposed
    reforms to this law have the most potential to provide an extra
    buffer zone of protection for children: biomonitoring, risk
    screening of chemicals, increased data for producers, or
    increased authority to restrict chemicals? Or does this require
    a comprehensive approach?
        Mr. Stephenson. All of the above, a comprehensive approach.
    The biomonitoring data will tell you what chemical exists in
    the blood, but it does not tell you the causes or the likely
    health effects of that data. But biomonitoring is an important
    element to help prioritize which risk assessments are needed.
    We have not looked at all the various proposals to amend TSCA
    but have been studying the issue for 5 or 6 years and are
    definitely in support of amending TSCA and giving it more teeth
    and strength for the Agency and requiring more by the chemical
    industry in regards to proving that its chemicals are safe
    before they are introduced into commerce.
        Mr. Grevatt. And thank you. If I may, I agree with Mr.
    Stephenson's comments on that. I think any one of the factors
    that you mentioned there would help, but without the full suite
    of those I think it would be very difficult for us to move
    forward in the way that we need to on TSCA implementation. And
    the Administrator, Administrator Jackson, issued recently her
    key themes that she thought were important in TSCA reform, and
    we are very supportive of moving forward in this area.
        Senator Udall. Thank you.
        There is a continuing push by business and industrial
    interests to include more and more cost-benefit analysis in
    environmental regulation. How is that effort compatible with
    children's environmental health, which may not be as easily
    quantified?
        Mr. Grevatt. I am sorry, but I am not sure if that is a
    question for me or for both of us.
        Senator Udall. Jump in if you both want. You have, I am
    running out of time, so----
        Mr. Grevatt. OK. Thank you very much. I think that it is
    important for us to focus on cost-benefit analysis related to
    children's environmental health, but the emphasis I would put
    there is doing a better job of understanding the costs
    associated with childhood impacts and the benefits associated
    with taking actions to prevent those impacts. So in particular
    I think there is more work that we could be doing there to
    better capture the benefits of steps that we take to protect
    kids from environmental contaminants.
        Mr. Stephenson. I think this is a place where you can use
    the Children's Health Advisory Committee as well. There are
    several new members, including a new Chairperson, resulting in
    about half of the Committee being new. They are convening the
    new Committee later this month. EPA can ask them to use their
    expertise, which includes industry representation, academic
    representation, and special interests to address questions
    regarding the compatibility of cost-benefit analysis with
    environmental regulations related to children's health. That is
    why they are there. So, I think they can help EPA better
    determine how to consider children's health issues in that
    manner.
        Senator Udall. I thank both of the witness and the Chair.
    Thank you for your courtesy for letting me run over a little
    bit. I am sorry I cannot stay for the whole hearing. I think
    this is a very, very important subject.
        Senator Klobuchar. Thank you very much, Senator Udall.
        One last question, Dr. Grevatt. As you know there is
    finally some movement afoot to do something on childhood
    obesity. It has been dormant. And as our recesses have gotten
    shorter, and our attention, I think, has gotten shorter, our
    kids' waistlines have gotten larger. And we just have not been
    devoting the attention we need to it. As you know a third of
    kids that now graduate from high school are obese or overweight
    and a fourth are obese going into elementary school.
        The Child Nutrition Act, as I mentioned, is being
    introduced today. That is one thing. And as we go into some of
    the education work that will be done this summer I think we
    should be looking at recess and gym time as a piece of that. We
    have our Complete Streets Bill here where we are trying to move
    on community planning and things that more is done to
    incentivize and encourage walking. But I just wondered what EPA
    is doing as part of this effort.
        I just see it as huge money for taxpayers. You know, we are
    financing--for very good reasons and necessary reasons--not
    just school lunches and breakfasts but also Pre-K, the
    Childcare Program, 3 million of these kids are getting food
    every day. And one of the most amazing things to me, I
    introduced a bill on this this week with Senator Harkin; it is
    now being included in the Child Nutrition Standard.
        I just want to make sure you know this. They are really not
    just standards at all for these childcare meals. And yet we are
    paying for it, the taxpayers are. One out of three kids, a
    recent study showed that kids in these childcare programs do
    not even have a fruit or a vegetable all day and that the most
    common vegetable is french fries. And if you think about what
    we are giving these kids, it is just not right. And so this is
    something that I really believe has to be changed.
        I have seen it in my daughter's own schools. The difference
    between being in a sort of a different demographic with parents
    with more money, these kids are bringing carrots and celery in
    their lunches, and then at the other school she was in for 3
    years with 90 percent free and reduced lunch, these kids are,
    you know, choosing the Twinkie line and the french fries
    instead of the yogurt in these a la cart lines. And it seems to
    me the kids we are hurting most are the kids who are the most
    vulnerable and who need the most help during the school day.
    And it has to change.
        So, I just wondered what EPA, what you are doing in this
    regard, as part of this big focus of the First Lady's, which I
    truly appreciate.
        Mr. Grevatt. Senator, thank you very much, and I appreciate
    your leadership on this critical issue. And childhood obesity
    certainly has the potential to lead to the current generation
    of children being the first generation in American history who
    may have a shorter life expectancy than their parents. So, this
    is a critical issue for us to address.
        As a part of the Interagency Task Force on Childhood
    Obesity, EPA is an active participant. All the key players are
    there focusing on physical activity, focusing on the built
    environment, focusing on food availability and food nutrition
    guidelines, school lunches, and a variety of other issues that
    intersect with obesity in some ways that may not be obvious,
    including the intersection between childhood asthma and
    childhood obesity and the intersection between some chemical
    factors that may lead to infant obesity.
        So, EPA is an active player in this area. And I think you
    are aware that the President's memorandum on childhood obesity
    that established the Task Force gave us a 90-day timeframe to
    produce a report, a comprehensive report from across the
    Federal Government, on key steps that will be taken to address
    childhood obesity and eliminate childhood obesity within a
    generation. EPA is an active participant in that effort, and we
    will remain so.
        Senator Klobuchar. OK. Very good.
        Well, thank you very much. This has been informative. I
    especially liked the question part. I mean, the testimony was
    not bad, but you know.
        [Laughter.]
        Senator Klobuchar. I think we got some very useful
    information on the focus here, and I thank both of you. And now
    we will bring up the second panel. Thank you.
        Very good. We are pleased to have the second panel here.
    Our first witness will be Gina Solomon, a doctor who is the
    Associate Director of the University of California in San
    Francisco Pediatric Environmental Health Specialty Unit and the
    Center for Occupational and Environmental Health at the
    University of California at Berkeley. Second, we have Cynthia
    Bearer, also a doctor, who is the Chief of Neonatology at the
    University of Maryland School of Medicine. And then, finally,
    we have Dr. Ted Schettler, who is the Science Director for the
    Science and Environmental Health Network. Thank you all for
    being here.
        Dr. Solomon.

     STATEMENT OF GINA M. SOLOMON, M.D., M.P.H., SENIOR SCIENTIST,
        NATURAL RESOURCES DEFENSE COUNCIL; ASSOCIATE DIRECTOR,
       PEDIATRIC ENVIRONMENTAL HEALTH SPECIALTY UNIT; ASSOCIATE
     CLINICAL PROFESSOR OF MEDICINE, UNIVERSITY OF CALIFORNIA, SAN
                               FRANCISCO

        Dr. Solomon. Good morning, Madam Chair and members of the
    Committee.
        [Laughter.]
        Senator Klobuchar. They come and go. We have actually had
    very good attendance. I am excited.
        Dr. Solomon. I think that it is a great testament to this
    topic, and I am very glad to be here to testify today.
        I am a physician. I am also a Senior Scientist at the
    Natural Resources Defense Council, an Associate Clinical
    Professor of Medicine at UCSF, and I do work with the UCSF
    Pediatric Environmental Health Specialty Unit.
        One of the most frequent questions that I hear from my
    patients is: What can I do to protect myself and my family from
    chemical contaminants in our air, water and food? And I always
    find it difficult to answer that question because most hazards
    to children and families are not things that individuals can
    really protect themselves from, even with advice from their
    physician. Really it is the responsibility of Government
    agencies such as the EPA to ensure that our air and our water
    are safe for pregnant women and children.
        Decades of scientific evidence have accumulated
    demonstrating that children are more susceptible to
    contaminants in their environment. And in the 1990s the
    President and the EPA recognized that evidence and took
    important actions including Executive Order 13045, which we
    have heard about, the National Agenda to Protect Children's
    Health, and the creation of the Office of Children's Health
    Protection.
        Congress recognized the overwhelming evidence on children's
    susceptibility when it passed child protective language in the
    Food Quality Protection Act. And for the first time EPA was
    actually required to incorporate an additional 10-fold margin
    of safety to protect children from pesticide residues on food
    and in particular was required to do that if there were data
    gaps.
        So, this approach would seem to be a model for how to
    protect children. But in the last 14 years since then a couple
    of problems have become apparent. One of those is that the law
    applied only to pesticides, and to this day there are no legal
    requirements that EPA actually protect children's health from
    other industrial chemicals including chemicals that are known
    to disproportionately affect fetuses and children such as
    bisphenol A, phthalates, brominated flame retardants, and even
    arsenic.
        And the second problem is that EPA failed to honor even the
    directive of the Food Quality Protection Act. I was on an NAS
    committee which reported in 2006 on EPA pesticide assessments.
    They looked at 59 pesticides with assessments posted on EPA's
    Web site and EPA failed to apply the child protective factor
    for 48 of the 59 and only applied the full 10-fold factor to
    five chemicals despite the presence of widespread data gaps on
    many of these chemicals.
        In more recent years there have been problems at EPA with
    their approach to protecting children from carcinogens, and
    that is diametrically different to the situation in California
    where California considers children to be more sensitive to all
    carcinogens unless shown otherwise. Instead EPA currently
    limits child protective considerations to chemicals with a
    mutagenic mode of action, and in their framework document sets
    such a high standard of proof for mutagenic mode of action that
    it is basically unachievable for most carcinogens, and the net
    result is the child protective factor is not likely to apply to
    the vast majority of cancer causing substances. I am encouraged
    to hear that EPA may revisit this policy because it clearly
    needs to be changed.
        The biggest threat to children's health, however, in my
    opinion, may not be from the chemicals we already know about,
    the carcinogens we already know about, but from what we do not
    know because we are dealing with the unfortunate reality that
    most of the chemicals in our air and our water and even our
    children's toys, as you well know, have not really been tested
    or have not been tested at all for their toxicity.
        So I am not just talking here about testing for effects on
    infant development but in fact for all kinds of health effects:
    genetic damage, neurologic damage, hormonal effects, and
    allergic reactions.
        Basic safety assessments of all chemicals, not just
    pesticides, are needed in order to protect children. Only with
    broader chemical policy reform will parents be able to sleep
    soundly at night knowing that their children are safe.
        Thank you very much.
        [The prepared statement of Dr. Solomon follows:]

          [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Senator Klobuchar. Thank you, Dr. Solomon.
        Dr. Bearer.

    STATEMENT OF CYNTHIA BEARER, M.D., PH.D., FAAP, DIVISION CHIEF,
        NEONATOLOGY, UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE;
          CHILDREN'S ENVIRONMENTAL HEALTH NETWORK BOARD CHAIR

        Dr. Bearer. Thank you, Senator Klobuchar.
        I am a practicing neonatologist, which means that I take
    care of the sickest of the babies, the newborn babies. I am
    also a wife and mother, and my son, Matthew, is in the audience
    today.
        Senator Klobuchar. Welcome, Matthew. Where are you? I can
    tell you want me to call you out. You are lucky I did not make
    you stand.
        [Laughter.]
        Dr. Bearer. I am currently Professor and Division Chief of
    Neonatology at the University of Maryland, and I am here today,
    though, as the Chair of the Board of the Children's
    Environmental Health Network.
        The Network commends Senators Boxer and Inhofe for holding
    this hearing and to you for running it today and for their
    ongoing interest in environmental risks to children.
        I ask that my full statement be submitted for the record.
        The Network's mission is to promote a healthy environment
    and to protect the fetus and child from environmental health
    hazards. I urge the Committee to embrace its role in ensuring
    that all children grow up in healthy environments. I will
    discuss three overarching tenets.
        My first tenet is that the basic scientific facts of
    pediatric environmental health need to be incorporated into the
    policies and programs in this Committee's jurisdiction.
    Children, as we heard this morning, are not just little adults.
    They have unique vulnerabilities and susceptibilities. Because
    their systems are developing an exposure that causes little or
    no damage to adults may lead to irreversible damage to children
    and the adults they become.
        Children are exposed every day to a mix of chemicals, most
    of them untested for their effects on developing systems, as
    Dr. Solomon just noted. Policymakers could--and must--do a
    better job of assessing the role that environmental toxicants
    have on affecting the current and future health of developing
    human beings. The predominant and worrisome assumption is that
    potential hazards are innocent until proven guilty.
        One example is bisphenol A, or BPA, which is widely used in
    consumer products. Only recently have scientific studies shown
    that BPA causes harm. These studies have come long after
    massive population exposure has already occurred, with more
    than 90 percent of our citizens having BPA in their bodies. As
    a result of these reports BPA is being phased out of products
    used in the neonatal intensive care unit at the University of
    Maryland Hospital for Children.
        BPA is just one chemical that is ubiquitous in our
    environment and in our bodies. Parents understandably ask, how
    did we allow these substances to get into our children's bodies
    when we know so little about them? I do not know how to answer
    them.
        Most industrial chemicals are regulated through the Toxic
    Substance Control Act, or TSCA, which was enacted in 1976.
    However, EPA comprehensively regulates very few chemicals under
    TSCA. We need to protect the health of children through our
    chemical regulatory decisions.
        My second tenet is that children's health and healthy
    children must be an ongoing priority for this and every
    Administration. A series of forward looking policies were
    adopted in the 1990s. Over time their original successes have
    stalled. Previously, leadership of an Interagency Task Force by
    the EPA Administrator and the Secretary of DHHS galvanized
    efforts across the Government. We need such a catalyst again in
    order to regain momentum.
        The Network believes that key components of the 1997
    Executive Order on Children's Environmental Health, such as the
    Interagency Task Force that it created, should be put into
    statute. Such legislation must also ensure that other key
    agencies handling childcare and related issues, most notably
    the Department of Education, are actively engaged.
        I want to highlight the importance of the EPA's Office of
    Children's Health Protection in this process. The Network feels
    that it must have a robust presence within EPA in steering
    policy and science initiatives for the good of protecting
    children. Their advisory committee, the CHPAC, plays a critical
    role in providing advice and feedback to the EPA.
        My third tenet is that protection of children's
    environmental health must occur indoors. One focus on interior
    environments such as homes, childcare centers and schools is
    necessary. For example little is known about the environmental
    health status of our childcare centers where 60 percent of
    children from 1 month to 5 years of age spend more than 40
    hours per week. Most people do not know that there is no agency
    authorized to intervene to protect children from environmental
    hazards in daycares, pre-schools or schools.
        The Occupational Safety and Health Administration does not
    protect pre-school or school children. Thus every day we
    require or children to spend hours in environments that are not
    required to be healthy and where they and their parents have no
    options, alternatives or recourse.
        The Network also commends the EPA for its existing healthy
    school activities. We are especially supportive of the proposed
    Clean, Green and Healthy Schools Initiative. If we work to
    ensure that the many environments that make up our children's
    world are healthy and promote well-being we will improve the
    health of our children and the adults they will become.
        Thank you for the opportunity to testify. I would be happy
    to answer any questions.
        [The prepared statement of Dr. Bearer follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Senator Klobuchar. Thank you very much, Dr. Bearer.
        Dr. Schettler.

      STATEMENT OF TED SCHETTLER, M.D., M.P.H., SCIENCE DIRECTOR,
                SCIENCE AND ENVIRONMENTAL HEALTH NETWORK

        Dr. Schettler. Thank you very much, Madam Chair, and thank
    you for the opportunity to testify here today.
        I am Ted Schettler, and I am the Science Director of the
    Science and Environmental Health Network. I am a physician, and
    I also have training in public health and environmental
    medicine.
        We have heard from a number of people today that developing
    children are uniquely vulnerable to environmental exposures. I
    would like to add to that that early life exposures can also
    increase the risk of chronic degenerative diseases in adulthood
    so that while we are protecting our children, we are also
    lowering the risk of disease later in life.
        We have also heard that during the 1990s it appeared that
    EPA was taking steps to address many of the unique aspects of
    children's environmental health, but since then some of these
    efforts have fallen short. I would like to just add two
    examples from my own experience to illustrate this.
        The first has to do with the potential for some commonly
    encountered chemicals to disrupt the function of hormones and
    other chemical messengers that are important during child
    development. These chemicals are called endocrine disrupters.
        During the 1980s and 1990s it became apparent that
    reproduction and development of many species of wildlife were
    being affected by exposures to these chemicals, and laboratory
    findings confirmed these outcomes. Many scientists then began
    to wonder whether the increasing incidence of cancer of the
    testes, prostate, breast, birth defects of the male
    reproductive tract, lower sperm counts, behavioral disorders
    and other abnormalities in humans might be explained in part by
    similar exposures.
        So, in 1996 the EPA created the Endocrine Disruptor
    Screening and Testing Advisory Committee in response to a
    congressional mandate, and the EPA was directed to develop a
    screening program to determine whether certain substances may
    have endocrine disrupting effects. This was supposed to be
    implemented by 1999. I served on that Advisory Committee, and
    we delivered consensus recommendations by the statutory
    deadline in 1998.
        Unfortunately, thereafter EPA missed deadline after
    deadline and became bogged down in an endless set of validation
    exercises that remain unfinished today. Meanwhile, thousands of
    chemicals in consumer products, food, water and air have not
    been tested for endocrine disrupting properties.
        Recently, the Endocrine Society, the American Medical
    Association and the American Chemical Society have called for
    reducing exposure to endocrine disruptors as well as more rapid
    advancement of the screening program. Sadly, the EPA is a
    decade late, and we are still waiting.
        My concerns about human exposures to commonly encountered
    chemicals are not limited, however, to endocrine disruptors. As
    we have also heard flaws in the Toxic Substances Control Act
    have allowed thousands of untested chemicals to remain in
    commerce with limited or no toxicity information.
        A second example is the failure of EPA to require adequate
    evaluation of the impact of pesticides and other chemicals on
    brain development. The agency has the authority to require
    those data from pesticide registrants but historically has been
    reluctant.
        In the 1990s, the EPA finally asked for developmental
    neurotoxicity testing of a group of pesticides called
    organophosphates, which are notoriously toxic to the brain. But
    if we thought that we were finally going to see more regular
    requirements for this information we were sadly disappointed in
    2007 when EPA registered the fumigant methyl iodide for use
    without it. This chemical is an extremely toxic chemical. It
    causes severe nervous system toxicity in adults who are
    accidentally exposed. Unfortunately, effects on the developing
    brain have never been studied.
        In my written testimony I have described why I and others
    believe we must be concerned. EPA's rationale for not requiring
    the data on this pesticide is based on an untested hypothesis
    for which there is little evidence.
        The Department of Pesticide Regulation in California
    carried out its own risk assessment of methyl iodide and set it
    out for external review by a scientific review committee. In
    its final report that committee not only expressed concern
    about the likelihood of human exposure when this chemical is
    used in agriculture but also said--and I am quoting--an equally
    important element in our review was the data that we would have
    wished to assess but that was insufficient or nonexistent
    altogether. The lacunae in our knowledge about methyl iodide
    are particularly wide and deep in relation to key aspects of
    its potential toxicity such as neurodevelopmental effects. That
    is the end of the quote.
        Wide and deep data gaps with respect to this chemical's
    effect on the developing brain. Yet the EPA registered it for
    use.
        So, in conclusion, some efforts to protect children's
    health that were taking hold seem to have slowed and even been
    abandoned. Developing children continue to be exposed to
    environmental chemicals without adequate safety assessment,
    many of these under the authority of the EPA. Meaningful TSCA
    reform and EPA's exercise of its existing authority are
    essential in order to protect developing children--and really
    people of all ages--from the impacts of exposure to hazardous
    chemicals.
        Thank you, Madam Chair.
        [The prepared statement of Dr. Schettler follows:]

       [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Senator Klobuchar. Thank you very much. And thank you for
    sort of bringing this down to the real world level and the kids
    that you deal with in your work. I was listening to this
    thinking of--I had not related this, but of my own experience
    when my daughter was born. She could not swallow for a year and
    a half, and no one could figure out what was wrong. We still do
    not know what was wrong. She somehow snapped out of it after
    being on a feeding tube, and I spent many weeks in the
    neonatology unit and things like that.
        When I look back on that time now, because she is an
    amazing kid and she has no permanent thing, there was nothing
    genetic, I always think about time is a gift. One, it gave me a
    sense of what parents with kids with disabilities go through.
    But two, it made me always wonder was I exposed to something
    when I was pregnant? What happened? How did this happen? And
    how did she suddenly snap out of it when it was not a permanent
    problem?
        I know a lot of parents dealing with kids with autism and
    other things that just daily wonder the same thing as we see
    these sudden increases in certain diseases and do not know what
    they are. That is one of the things that drive so many families
    to want to see that research and just feeling so alone out
    there, you know, surfing the Internet, coming up with theories
    that make no sense because they read them on a blog, when we
    should be looking at these scientifically, and we should be
    getting the data collected.
        So, I want to tell you how I know that I and so many
    families share that frustration that we are not getting the
    data, Dr. Schettler, that you are talking about.
        So my question, first of all, is how do you think, in the
    ideal world, this Interagency Task Force could work to try to
    better share things? And what do you think, as we look at, you
    know, difficult budget times for Government, what do you think
    the most cost effective way and where should our focus really
    be as we look at all the myriad of potential problems we have
    here?
        I know those are two big questions. The first would be how
    the Interagency Task Force could be better coordinated, and I
    guess the second would be how we could do this most cost
    efficiently and what our focus should be.
        I guess, Dr. Bearer, that I will begin with you because I
    mentioned you. You can all three answer it.
        Dr. Bearer. Thank you. I see the Interagency Task Force as
    being able to link across agencies various pockets of pediatric
    environmental health. For example the biomonitoring programs at
    CDC to be linked to EPA's list of priorities for chemicals that
    need to be studied, to the NIH where research dollars need to
    be spent in order to assess the toxicity of the chemicals.
        I also see it as a clearinghouse for research and
    initiatives of what is actually going on right now. There is no
    place where you can go to find out what research is actually
    being done. And I see the Interagency Task Force as being
    important in collecting and organizing and making publicly
    available what research is actually happening.
        Senator Klobuchar. Thank you.
        Dr. Solomon.
        Dr. Solomon. In addition to coordinating with agencies such
    as CDC for chemicals that are in food contact materials and in
    consumer products, such as known endocrine disrupters like
    bisphenol A and phthalates, we are finding that FDA and CPSC
    have very major regulatory roles and yet often do not have the
    same toxicologic approach or expertise in those chemical areas
    as EPA.
        And it is really important also to have consistency. We saw
    this as a problem when EPA and FDA were publicly disagreeing a
    number of years ago about levels of mercury that are safe for
    women of reproductive age, and very recently FDA, EPA and NIEHS
    sort of came together around bisphenol A, and they are trying
    to come to a common ground. So, it is very, very important to
    avoid conflicting standards or conflicting messages to the
    public as well.
        But I also think in terms of priorities, you know, all
    three of us mentioned chemical policy reform. It really is a
    huge, huge issue----
        Senator Klobuchar. You are talking about TSCA?
        Dr. Solomon. Yes, TSCA is the main issue area where we are
    dealing with both enormous data gaps that impair all of us as
    physicians from being able to provide information to patients
    and communities and also the problem that EPA does not have the
    authority it needs to take regulatory action even when there is
    evidence showing harm to developing organisms and children.
        Senator Klobuchar. When you think about all the new
    products and changes in our society and the fact that it has
    not been updated for so long, it clearly cries out for some
    changes.
        Dr. Solomon. Exactly. The science has moved forward; there
    is a lot of information from the National Academy of Sciences
    to go with, and that really is something that needs action
    soon.
        Senator Klobuchar. OK.
        Dr. Schettler.
        Dr. Schettler. I would agree with the need for coordination
    across the agencies and do not have more to add to that. It is
    important that we not sort of Balkanize this and fail to look
    at it comprehensively.
        With respect to the second question, the issue of cost
    effectiveness, I would agree first of all with the importance
    of TSCA reform, and some of the elements of that have to
    include that chemical manufacturers need to be responsible for
    evaluating the safety of their products. I mean, this should
    not fall on the public to do that after the fact. So, it should
    be, you know, pre-market testing is required. If you are going
    to stay on the market, we need safety data.
        But I also would like to add a little more to this idea of
    cost and benefits which came up in the first panel. We know
    that a lot of the childhood conditions that we are concerned
    about today are setting the stage for an overwhelming wave of
    disease and disability that is coming down, that is going to
    overwhelm us in the next several decades.
        As was pointed out in the first panel, childhood obesity
    itself is a risk factor for diabetes, cardiovascular disease,
    cognitive decline, dementia and Alzheimer's disease. And I am
    not certain what we are going to do about this. And at a time
    when we are talking about healthcare reform in this country we
    should be really looking at what is coming as we try to figure
    out primary preventive strategies to try to prevent this flood
    of chronic disease that is coming along.
        So when we are doing our cost-benefit analysis, let us look
    at the whole picture, and let us look at it over time and see
    how we are going to be dealing with that decades from now as
    well as in the shorter term. Thank you.
        Senator Klobuchar. Very good. Thank you.
        I just want to ask a few specific questions with some work
    that I am doing, legislation that we are working on. I
    mentioned formaldehyde. And there is a huge problem of some of
    these wood products coming over, primarily from overseas,
    because our own timber industry has agreed to some standards
    voluntarily. But yet we are seeing--there is the whole trailer
    issue down in Katrina and those things of formaldehyde in these
    woods.
        That is why Senator Crapo and I have a bill that basically
    follows the California Standards, Dr. Solomon. And I can tell
    you it was quite interesting to stand with our timber industry
    in Minnesota at a Home Depot where we were supporting this bill
    to take up the California standards nationally and having the
    industry people talking about how they wanted the California
    standards. You can bring that home with you.
        But because of the fact that these wood products are coming
    in with formaldehyde, and they are unfairly competing with our
    own American timber, that is actually in wood products that are
    actually abiding by these higher standards. I just wondered if
    any of you--and I do not expect all of you could comment on the
    formaldehyde issue with kids.
        Dr. Solomon. I am happy to comment because I have been in
    numerous of those FEMA trailers. I spent a lot of time in New
    Orleans after Katrina. I talked with families who lived in FEMA
    trailers for months or even years and heard first-hand from
    them about the symptoms that they were suffering from, ranging
    from increased rates of asthma to just constant nagging
    irritation of the upper airways and constant headaches. This
    would have been so preventable, so avoidable.
        I think that there is a broad concern about voluntary
    agreements that is raised by this issue because a voluntary
    agreement is good as long as everyone abides by it. But in this
    age of global commerce it is very hard to get the entire
    industry--especially internationally--on board.
        We are seeing that more recently with the flame retardants
    where there have been voluntary agreements with U.S.
    manufacturers of these polybrominated diphenylether flame
    retardants, PBDEs, to take them off the market. But I
    personally am very concerned that we are going to still be
    seeing them in imports from other countries. So this is why
    Congress needs to take action and why EPA also needs to take
    regulatory action and not count on voluntary agreements to
    protect the public.
        Senator Klobuchar. Right.
        Cadmium in jewelry, speaking of imports, anyone have any
    familiarity with that the effect on kids? No one? OK. That is
    all right. I think I have asked the EPA about this in the past,
    so I appreciate that.
        Other things that we have been working on are radon and the
    effect on children of that. We are putting together a bill in
    that area. And then, as you know, Senator Boxer has been a
    leader on perchlorate monitoring and the Right to Know Act and
    has done a lot in that area.
        So, there are a lot of specific things that we are working
    on that I cannot help but think cry out for action about having
    this Interagency Task Force where we are drawing these
    resources together, as you say, for research, which will really
    help us in Congress so that when we move ahead in one area, we
    are not just doing one little thing, maybe we should be doing
    three things at the same time. I think it will be very helpful
    if we could get that Task Force going.
        Is there anything anyone else would like to add today?
        Dr. Schettler. I would like to add one more comment. Thank
    you for the opportunity.
        As I listened to the discussion about perchlorate and about
    formaldehyde and air pollution I think it is important for us
    to keep in mind that we are not exposed to these various
    contaminants one at a time, but we are exposed to mixtures. And
    it occurs in a social and an economic environment which may
    cause either more or less vulnerability. This is all fairly
    well outlined in the National Academy of Sciences' report on
    science and decisions. But these are very real issues.
        So, people are not just exposed to perchlorate. In farming
    communities, for example, there is going to be nitrate in the
    water at the same time. There may be women who have inadequate
    iodine intake in their diet. Thirty percent of women in the
    United States are estimated to have suboptimal intakes of
    dietary iodine, making them more susceptible to the effects of
    perchlorate and nitrate in terms of being able to produce
    enough thyroid hormone for their baby to develop in utero. So,
    we need to think about these things collectively.
        Similarly, children who are exposed to formaldehyde and air
    pollution who also happen to be living in suboptimal
    socioeconomic environments are more likely to develop asthma as
    a result of those exposures because the social environment
    creates vulnerability.
        So, these do need to be looked at through sort of this
    interagency comprehensive approach that will recognize that
    there are vulnerable populations of people among the general
    population who do need to be protected.
        Thank you.
        Senator Klobuchar. All right. Thank you.
        Dr. Solomon. We usually do not do this at the end, but you
    know, you are up here, and it is just me, so add your final
    comments here.
        Dr. Solomon. Thank you for the opportunity for a final
    comment.
        I have served on a number of EPA advisory committees over
    the years, including the Drinking Water Committee, and have
    been frustrated at how long it takes from the time when there
    is enough scientific information to take action to when action
    actually occurs. And perchlorate is an excellent example of a
    chemical that has been under study for well over a decade and
    where there is extremely strong information about exactly what
    it does in the human body and enough data, even in humans, on
    which to take action. And yet this chemical has not been
    regulated yet.
        I have seen the same thing with numerous industrial
    chemicals. It was a decade ago that the Science Advisory Board
    reviewed the trichloroethylene risk assessment and recommended
    that it be finalized as soon as possible. But a decade has
    passed, and it is now undergoing another round of review.
        That is the type of pattern that tends to occur, and one of
    the things that will be important with TSCA reform will be to
    get out of that endless loop of repetitive, interminable risk
    assessments. We certainly also saw it with dioxin, another
    ongoing example.
        So, EPA really does need not only the authority but in fact
    the responsibility to take rapid action when there is
    information, scientific evidence, showing harm to children's
    health.
        Senator Klobuchar. OK. Thank you.
        Dr. Bearer. I would really like to say that I think the
    National Children's Study should go forward to generate some of
    this data because not only has Dr. Schettler noted that we are
    exposed to mixtures, but we are exposed over time. And with
    children that can be important for setting them up to future
    vulnerability following a previous chemical exposure.
        So, until we understand this complex play of determinants
    on our health but occurring over time in our children I do not
    think we will have a good idea of what is actually impacting
    our health.
        Senator Klobuchar. OK.
        Well thank you, all of you. This has been very
    enlightening, and I think you have seen a number of Senators
    that came by today who are similarly devoted to moving forward
    on this. I know the EPA is, and I appreciate the GAO work as
    well in looking at this and stepping back and looking at how we
    can do better.
        I wanted to note that Senator Boxer, I think she talked to
    me about this hearing five times in the last 24 hours. She
    really had wanted to be here and cares a lot about this. She
    has been a true leader on this issue. She even caught me in the
    hallway and said you are going to be 5 minutes late. She would
    be here, but as you know there is a lot going on right now in
    the U.S. Senate, and so she was needed elsewhere to work on
    some very time sensitive issues. I know she wanted to be
    specifically here to greet you, Dr. Solomon.
        I am going to put her statement on the record and also the
    GAO report on Environmental Threats to Children, as well as the
    EPA's 1996 National Agenda on Children's Health. So, without
    objection, those things will be included in the record.
        And we look forward to working with all of you this
    important issue as we go ahead.
        Thank you very much, and the hearing is adjourned.
        [Whereupon, at 12:05 p.m. the full Committee was
    adjourned.]
        [Additional statements submitted for the record follow:]

                       Statement of Hon. Barbara Boxer,
                   U.S. Senator from the State of California

        Children are more vulnerable to toxic pollution than
    adults. Their bodies are developing rapidly--including their
    brains, hearts and lungs, their nervous and immune systems--so
    exposures to toxic chemicals at critical times in their
    development can have lifelong impacts.
        That's why I wrote the law that ensures that the EPA takes
    children and other vulnerable populations, such as pregnant
    women and the elderly, into account when setting drinking water
    standards, not just healthy adult men.
        And that is why I asked the Government Accountability
    Office (GAO) to investigate the EPA's role in protecting
    children's health and to give me a report card on how the
    Federal Government is doing in keeping our children safe from
    environmental dangers.
        As the GAO has said in its report, ``Children face
    disproportionate health risks from environmental contaminants
    such as pollution in air, lead paint in homes, pesticide
    residues on food, and treatment resistant microbes in drinking
    water. Such hazards contribute to asthma, cancer,
    neurodevelopmental disorders, and other diseases, and many of
    the Nation's 74 million children are exposed to them daily.''
        Senator Klobuchar joined me in this request as Chair of
    this Committee's Subcommittee on Children's Health. Today we
    are releasing GAO's final report, the culmination of an in-
    depth 2-year investigation. Based on GAO's report I am very
    concerned that EPA has not followed through on its initial
    commitment in the late 1990s to make children a priority with
    the creation of the Office of Children's Health and other steps
    designed to put kids first.
        The GAO report paints a clear picture:
        First, the GAO found that EPA has not focused attention on
    children's health in agency-wide priorities, strategies, and
    rulemakings.
        GAO also found that EPA has not fully utilized its Office
    of Children's Health Protection and other child-focused
    resources.
        At the same time, GAO concluded that opportunities exist
    for EPA to lead and coordinate national efforts to protect
    children from environmental threats. The current Administration
    has begun the task of returning the focus to children as a
    central mission of the agency. I applaud these efforts, but
    there is much more work to do.
        I am working on a bill with Senator Klobuchar that would
    authorize an interagency task force geared toward protecting
    children's health from environmental threats. This task force
    was originally put in place by President Clinton in an
    Executive Order, but the task force lapsed, and we want to make
    sure that the work of this important group is made permanent.
        I am also working with Senator Bill Nelson, who is here to
    testify today, on legislation to strengthen the EPA role in
    investigating cancer, birth defects, and other disease clusters
    that may be associated with environmental toxins.
        Communities that experience unusual increases in birth
    defects, cancers and other diseases, especially in children,
    should get more help from the Federal Government, including
    EPA, in getting to the root of the problem. In my home State we
    have a community in Kettleman City that is working with the
    State of California to investigate the reason for the level of
    birth defects, and Senator Nelson will talk about a community
    in Florida and their efforts to determine the cause of the
    childhood brain cancers being experienced there. Senator Nelson
    and I would like to make sure these communities and others like
    them around the country can get the help they need so they can
    get answers quickly.
        The goal of this oversight hearing today, as well as the
    legislative efforts we have underway, is very straightforward.
    Protecting children's health must be central to EPA's mission
    across the board, and the Agency must specifically remedy the
    deficiencies identified by the GAO when it comes to this
    critical issue. Our legislative efforts are designed to
    accomplish the same thing--to ensure the health and safety of
    children in communities across the country.

                      Statement of Hon. James M. Inhofe,
                    U.S. Senator from the State of Oklahoma

        I am a father and grandfather, so obviously protecting the
    health of children, born and unborn, is a personal priority.
    The best way to protect children's health is to use the best
    available science to properly assess risk. In some cases,
    children can be more susceptible, in other cases less
    susceptible, and in many cases equally susceptible to
    environmental exposures when compared to adults. On a body
    weight basis children can have greater exposure than adults,
    but not always. EPA takes these susceptibility differentials
    into account when assessing potential risks to children.
        This follow up GAO investigation into efforts to protect
    children's health suggests to us, among other things, that the
    Agency has not fully used the Office of Children's Health
    Protection and has not prioritized children's health
    considerations in light of advisory recommendations.
        However, what the report does not fully address is the fact
    that EPA must always balance recommendations on children's
    health with objective scientific standards, legal requirements,
    and practical realities. For instance we have been told that
    EPA should incorporate more of the recommendations of
    children's health advisory groups into Agency actions. But
    advisory groups do not have to base their recommendations on
    risk: they can base their opinion on the use of precaution.
    They do not have to balance economic impacts and resource
    limitations: Federal agencies do. And advisory groups almost
    never address whether the Federal Government should be or
    actually is authorized to regulate all issues suggested by
    their recommendations.
        So, while EPA always takes advisory recommendations very
    seriously the Agency must independently review advisory
    findings and balance these opinions with the other factors that
    direct rulemaking and guide policy management.
        Elements of GAO's report are instructive, and I look
    forward to hearing more. I especially agree with the report's
    favorable view of the National Children's Study. The National
    Children's Study will fortify the Government's commitment to
    the health and well-being of children--bringing together the
    top experts on children's health and the environment. The Study
    is the largest long-term study of environmental and genetic
    influences on children's health ever conducted in the United
    States. It will follow 100,000 children from before birth to
    age 21. Researchers will better understand how children's
    interactions with their environments affect their health and
    development.
        But in contrast to what some of the witnesses will say
    today I do not believe that EPA needs additional congressional
    authority to specifically protect children's health. Rather I
    believe that EPA has the existing authority and processes in
    place to build upon ongoing Federal efforts to properly protect
    children's health. That said, I look forward to hearing your
    perspectives and welcome you to the Committee.

                         Statement of Hon. Max Baucus,
                     U.S. Senator from the State of Montana

        Madam Chairman, I want to take a few moments to talk about
    the health of the children of Libby, Montana, and to engage EPA
    officials today on this important topic. Libby is a beautiful
    little town in northwestern Montana. Libby is also a place
    where EPA has found asbestos contamination so pervasive--and
    the conditions so severe--that it warranted the declaration of
    a ``public health emergency.'' The type of asbestos in Libby
    known as tremolite is particularly deadly. Tremolite fibers
    quickly find their way into victims' lungs and stay there. It's
    like a time bomb waiting to strike.
        The effect of asbestos poisoning on Libby residents has
    been severe. Hundreds of people have grown sick and died due to
    the pervasive presence of asbestos spewed from the vermiculite
    mining and milling operations of W.R. Grace. Today we know that
    291 people have died in Libby from asbestos exposure. That's
    291 deaths in a community of just over 2,600 people. Lincoln
    County, Montana, home to Libby, has the highest age adjusted
    death rate due to asbestosis in the entire Nation.
        I am in regular contact with the victims. Recently, I was
    written by a 55-year-old Libby resident, sick from asbestosis,
    with one concern--the long-term health of his grandchild:
        ``[A]t 55 and dying, I have been blessed, with a grandson,
    just 10 months old . . . I never knew I could love so much
    especially when I know my time is short. My grandson is the
    lifeline that is left from three generations of life/blood line
    that moved to a place so beautiful and God Given that no one
    would have guessed the monster that lie silent in the air and
    water and soil and lands in the lungs of all who breathe . . .
    what I take with me is knowing in my heart that Libby, Montana,
    killed my parents and killed me and killed my children. Libby
    will not kill my grandson.''
        We cannot allow this story to repeat itself. We cannot
    allow today's children to be told years from now, as this Libby
    resident was told, that their life is over. The asbestos in
    Libby has exacted an immeasurable toll on the parents of this
    generation. We cannot allow this to continue in our
    grandchildren.
        So, as the current generation of Libby residents--through
    no fault of their own--suffers the horrible effects of this
    deadly poison, I am continuing my long standing efforts to be
    sure that EPA is taking every step possible to ensure that the
    clean up of Libby moves forward expeditiously and is based on
    accurate risk assessments for the unique type of asbestos in
    Libby. Today my question is--is EPA doing enough to ensure that
    the children in Libby, Montana, are protected from asbestos
    exposure? It would be unforgivable and tragic to create another
    generation of victims in Libby by failing to take every
    imaginable step to prevent their exposure to this known
    asbestos contamination.
        The long-term health of the children of Libby should be our
    focus. We should act with an abundance of caution when making
    decisions that impact them. But ensuring their protection is
    not a one size fits all proposition. The existing EPA risk
    assessment procedures and existing science may not be adequate
    to address the special impacts of childhood exposures to
    asbestos. The multiple exposure pathways and the long-term
    consequences of cumulative exposures may need special focused
    attention. The comparisons of existing data on childhood
    exposures at other Superfund sites may not be applicable to the
    Libby. It is critical that the latest advancements in science,
    law and policy of children's health are integrated into the
    clean up decisions that directly impact the Libby community.
    EPA should redouble its efforts to address these special
    circumstances.
        Today's GAO report identifies opportunities for greater
    focus, direction, and high level commitment to children's
    health at EPA. The report is critical of EPA's failure to
    institutionalize children's health issues into the overall
    activities of the Agency. However the report does identify the
    potential to start to get things right with the appointment of
    a permanent, stable and long-term office Director.
        Therefore, today, the people of Libby want EPA's assurance
    that we are doing everything we can to protect the children of
    Libby. The people of Libby want EPA's assurance that the
    schools and playgrounds that we send our children to every day
    are safe. The people of Libby want EPA's assurance that its
    clean up assumptions and its policy of ``allowable'' and
    ``acceptable'' childhood exposure to asbestos will not create
    another generation of victims at Libby.
        This assurance cannot come only from the clean up managers
    at EPA. It needs to come from the person in the Agency whose
    job it is to be the advocate for children's health--that is
    you, Mr. Grevatt.
        I am asking you to join me in keeping the promise and
    fulfilling the long-term commitment that we have made to the
    people and particularly the children of Libby, Montana. We owe
    it to the next generation.
        I thank our distinguished panel, and I look forward to your
    response.

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