A Bodacious Valentine’s Day

Be still my heart
 (Photo credit: EraPhernalia Vintage)

Yesterday, in honor of V-day, I had the pleasure of attending a ground-breaking panel on boobies. Because this is 2013, when the subject of breasts arises, so to speak, the topic of breast cancer isn’t far behind.

The purpose of the gathering was to announce publication of an important new report that — really for the first time — sets out an agenda for prevention of breast cancer and points to the significance of environmental factors like chemicals, instead of focusing almost exclusively on treatment. The 200+ page report was the result of two years of work by a group of academics, advocates and government scientists called the Interagency Breast Cancer and Environmental Research Coordinating Committee. (Oddly, the link to the report is not working on the government Website. The New York Times coverage is here. Update: Link fixed!)

In 2012, more than 200,000 women and 2,000 men will be diagnosed with breast cancer, and 40,00 women will die from it. A large majority of breast cancer cases — some 85 percent — occur in women with no family history of breast cancer. We know that some environmentally widespread chemicals — including PFOAs, dioxin, the pesticide Atrazine, DDT, flame retardants, and hormone disruptors like Bisphenol-A (BPA) — are linked to breast cancer.

We also know — most recently from shocking and sad reporting by the Center for Public Interest (CPI) of a published, peer reviewed study of plastics auto suppliers and other workers in Ontario that there is very strong evidence linking acute exposures to plastics and chemicals to cancer rates: women working in the auto supplier and canning jobs had cancer rates of 5 times the control group.

Here’s CPI’s summary of the report’s list of chemical exposures related to breasts:

At least 216 chemicals, including endocrine-disrupting substances like bisphenol A, have been associated with mammary gland tumors in animals. Endocrine-disrupting chemicals, or EDCs, are used to make plastics and pesticides and found in products such as furniture, metal food cans and cosmetics.

Ergo, it would nothing short of dunderheaded to talk about preventing cancer without looking at environmental factors in the mix, alongside genetic, diet and other risk factors. We badly need the kind of paradigm shift the report tees up, as well as the focused attention on environmental risks from regulators and researchers that it recommends.

The arrow on this mammogram points to a small ...

The arrow on this mammogram points to a small cancerous lesion. (Photo credit: Wikipedia)

In honor of the holiday, let’s get back to knockers for a sec. On the panel, author and reporter Florence Williams returned our attention to the physical facts by pointing out a number of novel features that uniquely describe the twin wonders on a woman’s chest.

She pointed out that breasts are among the fattiest organs in the body and that many chemicals are drawn (like men) to these fatty tissues, that breasts are filled with hormone receptors, and that they change over the course of women’s lives as biologically needed. Williams called them, rightly, a “sentinel organ,” noting that what happens to our breasts is an early signal for our overall environment and health. (I picked up a copy of Williams’ book, “Breasts: A Natural and Unnatural History,” and am excited to read it because she tests the level of flame retardants in her own breast milk, among other unpleasant but informative discoveries.)

Jeanne Rizzo, head of the Breast Cancer Fund, spoke next and highlighted the fact that we know that there are critical stages — called windows of susceptibility — that impact life-time risk for breast cancer, beginning in utero, and that due to the emerging science of epi-genetics, it’s now clear that genes and the environment interact throughout our lives in a complex dance of possibilities. Her wonderful op-ed is also well worth a read. (It’s for this reason that I do think a focus on reducing environmental risks for pregnant women and young children is important, and that consumers need help in this area.)

Linda Birnbaum, the Director of the National Institute of Environmental Health Sciences (NIEHS) of the National Institutes of Health (NIH), and National Toxicology Program (NTP) was also powerful. I was particularly struck by her description of an ongoing “sister study” pairing women who are diagnosed with breast cancer with their sisters who have not been.

As she pointed out, we may have been over-emphasizing genetic factors when we see diseases linked in families, because although it’s true that they share genes, siblings also tend to share environmental influences. This study will attempt to distinguish genetic factors from the other shared conditions, including chemical exposure levels, thus helpfully sorting out what we can fix, given sufficient political will, from what we really can’t.

This got me thinking about obesity as another confounding factor in the research. We all know — and it was reiterated by panelists — that obesity is major risk factor for breast cancer, heart disease, and basically every other major health problem. Yet we also know that mice exposed to a teensy amount of BPA get much fatter than other mice. As Nicholas Kristof noted:

Among chemicals identified as obesogens are materials in plastics, canned food, agricultural chemicals, foam cushions and jet fuel.

They’re everywhere, in other words. Yet the national report on obesity a big government panel issued last year barely mentioned the issue, instead focusing its major recommendations entirely on nutrition and exercise. Ditto with the President’s “Let’s Move” action plan.

Now, I’m not disputing that healthy foods and regular activity likely play an important role in obesity. But, as Jeanne Rizzo said the founder of the Breast Fund Center asked about breast cancer, I would still ask why we are so much fatter now than we used to be, and why Americans, who have far more chemicals in their diet and environment, are so much heavier than Europeans, when we eat basically the same types of foods.

The staggering rate of increase in obesity should be another indicator. A recent report found that adult obesity rates could exceed 60 percent in 13 states by 2030, and that:

If states’ obesity rates continue on their current trajectories, the number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension, and arthritis could increase 10 times between 2010 and 2020—and double again by 2030.

Then there’s the stunning increase in childhood incidence of Type 2 diabetes. From a September 2012 article in the Times:

Before the 1990s, this form of diabetes was hardly ever seen in children….There were about 3,600 new cases a year from 2002 to 2005, the latest years for which data is available.

What has changed from before the 1990s until now? As a child of the 1970s and ’80s, I can tell you: our diets were no paragon of health. We ate junk food, nutrient-poor school lunches, and canned green beans, white rice and pork chops for dinner. We binged on Halloween candy while playing Atari for hours. But this disease was for the full decade of my adolescent decadence still virtually unknown in kids. In fact, we know a lot more about healthy eating and healthier foods are much more widely available today, yet we’re still in deep trouble.

Researchers are basically at a loss to explain the obesity increase, as in this comically uninformative paper where they more or less throw in the towel. Could it be, instead, that the ubiquitous chemicals, drugs and fillers in food and industrial agriculture, along with the plastics that package virtually all of our foods, are at least in part to blame? That cheap calories from a degraded and ever-more industrialized food supply — eaten by people across the socioeconomic spectrum — come at a very high cost? What are those fat mice trying to tell us?

As in the breast cancer sister study, when we treat obesity as an inert risk factor — “don’t get fat, you!” — we are missing an opportunity to shift the paradigm to environmental health factors and instead substituting a far less helpful blame-the-victim mentality.

We should not fail to acknowledge obesogens may be a confounding factor in the data — that the same people who are obese are more likely to get breast cancer because the cause of both conditions could be related to the same chemical exposures (or chemical-epigenetic interactions that reflect a sensitivity to environmental influences). If it turns out this is right, and chemicals are a major factor in all of these kinds of health conditions, then the solutions are also shared, and the public health costs of inaction virtually incalculable.

Please don’t misunderstand me. I care deeply about preventing breast cancer, having seen its terrible toll on close family friends. And I am so excited for the publication of this major report that talks clearly and for the first time about the impact of chemicals on cancer rates, though I wish there was a least a small section on consumer can-dos, to counteract the doom and gloom.

But we also must be uncompromising as we outline the possible damage from toxins, and push this powerful new paradigm to its logical conclusions. To meaningfully address a host of public health threats, we will need one day soon to take the full measure of what our ongoing, uncontrolled experimentation with biology-altering chemicals has actually accomplished, in both our bodies and our brave, sentinel breasts.

Breast cancer. Image made by Itayba

Breast cancer. Image made by Itayba (Photo credit: Wikipedia)

My Troubles with Teflon

Jokes about abusive relationships are, by definition, Not Funny. They are also tasteless and a tad tawdry, much like my former relationship with my darling Teflon.

I now remember, with a little wince, how I spent years worrying over my Teflon, examining its placid, emotionless face for scratches and dings, using only the gentlest soaps and utensils, in the vain hope of somehow keeping it pristine and untroubled.

I babied it, frankly, fussing at those around me to treat it similarly with a ginger hand, somehow believing that if only the surface would remain unscathed, things would be all right.

Now I wonder, from the other side of things, why was I so scared? Why couldn’t I just leave it behind me? Was I perturbed by the thought of less perfectly formed eggs? Of spending precious time scrubbing that brownish cooked-egg scrum from the corners of some other, lesser, pan??

It was only when I learned about its sordid past, its ugly history of broken lives in a small town in West Virginia, that I knew that one of us had to change, and that one of us was me.

My problem was not really the Teflon itself, but the bad company it keeps – the PFOAs (perfluorooctanoic acid) used to make it stick evenly to a pan.

To be clear, PFOAs (or precursor chemicals called “fluorotelomers” that break down into PFOAs in the environment) are also used in Gore-tex, Stainmaster, and carpets. And popcorn microwave bag linings, and the inside of some fast food containers.

Think really slick stuff. PFOAs are one slippery character, biologically speaking, as well. They’ve been found in animals in the Arctic, and – charmingly – form some of the strongest chemical bonds chemists have ever seen.

The best part? They bio-accumulate in humans and animals, persisting, basically, well, scientists don’t really know how long, but likely approaching something like, uh, forever.

How bad are PFOAs?

On this question, as with so many others, the government is not of much help. The Environmental Protection Agency, in an early draft of a risk assessment, labeled it a “likely human carcinogen” in 2005.

The agency has since stalled on the question. The agency’s Web site now says both that “EPA is still in the process of evaluating this information and has not made any definitive conclusions regarding potential risks, including cancer, at this time,” and that the agency, in “January 2006…asked eight companies in the industry to commit to reducing PFOA from facility emissions and product content by 95 percent no later than 2010, and to work toward eliminating PFOA from emissions and product content no later than 2015.” My translation: it may cause cancer. Please take a decade to stop using it.

Clearer, and helpful as usual, is Wikipedia:

[PFOA] is a toxicant and carcinogen in animals. PFOA has been detected in the blood of more than 98% of the general US population in the low and sub-parts per billion range, and levels are higher in chemical plant employees and surrounding subpopulations. 

 The floodwall of Parkersburg, West Virginia, a...

For evidence of this, look to “Teflon Town” – Parkersburg, West Virginia, the only place in the U.S. where PFOA is manufactured. Just today, one of the largest research studies on chemicals ever attempted announced a conclusion, after looking at the problem for over four years, that PFOAs are causally linked to prostate and testicular cancer.

For some of its residents, who fought an Erin Brockovich-level struggle against the hegemony of DuPont, this is welcome knowledge, but really not news.

PFOA had been leaching into drinking water in nearby Little Hocking, Ohio. After it was dumped near the property and stream of farmers Jim and Della Tennant in the 1990s, here’s what Della told NPR happened to her cows:

“It had the most terrifying bawl, and every time it would open its mouth and bawl, blood would gush from its mouth…And whenever you think about feeding all those animals to your children, all the time they were growing up, it’s something that puts a lump in your throat you can’t take away.”

The Tennants settled their dumping claim with DuPont in 2001. But that left the drinking water issue.

As movingly described in Chapter 4 of “Slow Death by Rubber Duck,” Parkersburg citizens received a mysterious letter around the same time of the Tennants’ settlement, stating that PFOA levels in the water were safe – based on the considered judgment of PFOA-maker DuPont.

Oddly, they weren’t reassured. They subsequently waged an unpopular campaign to bring the issues involving one of the town’s largest employers into the light, bringing suit against DuPont, and winning a novel settlement.

The EPA also sued DuPont, for failing to disclose that workers at the plant had PFOA in their blood, proving that the company knew it starting at least as early as 1981. DuPont was fined a record $16.5 million in 2005.

That lawsuit also turned up disturbing evidence that DuPont knew of health risks from PFOA way back in 1961, when rats exposed to PFOA had enlarged livers even after relatively low dose-exposures.

Most revoltingly, in 1981, when DuPont conducted a study of female workers to see if birth defects were present among their children, it found that two workers out of eight had children possessing similar defects in the eye and facial area. Although these findings were like the birth defects found in their study of rats, the company merely transferred the workers, halted the study, and buried the results.

The citizen lawsuit also got results, including a $71 million health and education project, a water treatment facility, and a landmark agreement to let a $20 million Science Panel conduct a detailed study of the health of town residents, to evaluate the link between PFOA exposure and health harms.

If the panel does find a link, DuPont must pay up to $235 million to cover medical costs for those harmed. (Although this sounds like a lot, as Smith and Lourie point out, it’s really chump change when considered against the $3 billion in profits the company made in, for example, 2007.)

So, after years of study, and a record number of blood samples from town residents (totaling some 70,000), the second set of conclusions are in. The first set of findings found a “probable link” between PFOA exposure and dangerous high blood pressure among pregnant women. It also found no link between PFOA exposure and birth defects and adult-onset diabetes, and some types of cancers.

Today’s announcement from the Science Panel was as follows:

The only two cancers where the Panel found a reasonably consistent and strong relationship between past exposure and cancer were testicular cancer and kidney cancer. Both…are rare. In the Science Panel data there were 19 confirmed cases of testicular cancer and 113 confirmed cases of kidney cancer. After dividing the population into four categories…the kidney cancer rate in the upper categories of the population was 20%, 40%, and 60% higher for the 2nd, 3rd, and 4th quartile compared to those with the lowest exposure. For testicular cancer the corresponding numbers were 80%, 120%, and 170% higher for the upper quartiles compared to the lowest.

The panel will wrap up its work by June of this year.

So, what to make of all this? After all, at least eight manufacturers claim to be phasing out PFOAs (though they are replacing them, at least in some cases, with chemically-similar substances).

Depressingly, cooking pans may not be the biggest source of contamination for PFOAs, as long as you always cook on low heat and never leave the pan empty (which I know we did, as I remember scolding my husband over it at least once, because I evidently privileged the health of my abusive Teflon boyfriend over him).

The Teflon itself starts to off-gas at around 390°F, and at close to 500°F, you actually get a dangerous breakdown of the pan. While this sounds super-hot, a study in 2003 by the Environmental Working Group found that pans can actually get well over 700°F in 3 to 5 minutes. And there’s the issue of the non-stick coating under the burner area on the stove, or under the broiler. Fumes from over-heated pans can kill birds, and also have negative health effects for humans. So there’s that.

Basically, although avoiding PFOAs is evidently impossible even if you move to the Arctic, we do the following:

1)    We chucked our non-stick everything. Like Tribbles, non-stick coatings were slyly hiding everywhere – the rice cooker, sandwich press, muffin tins, as well as frying pans. I recognize that DuPont says that there is little exposure from this cookware (uh, ok), but I don’t want to have to worry about off-gassing, heating points, and the like, and the story about Parkersburg really ticks me off, more or less on principle.

We found a rice cooker, which we use all the time, with a stainless steel bowl on Amazon. We use enameled cast iron for every day, and regular cast iron when we have a big frying job. (Except for with tomatoes or acidic foods, as the iron leaches too much.) I don’t miss non-stick, really. Plenty of oil and a little extra scrubbin’ pretty much makes it work.

2)    For carpets, furniture, and the like, we don’t use or have applied any stainmaster treatments. (I actively regret, but have not bothered to replace, the small loveseat purchased in the mid-90s with the stain-resistant shellack.) When I buy carpets, I look for organic untreated wool in colors that show fewer stains. Cheap carpets, I assume, are full of PFOAs and other ick.

for microwave ovens, popped state.

3)    We avoid stain-resistant clothing and Gore-Tex. And microwave popcorn, which tastes like buttery Gore-Tex anyway.

4)    I turned back the allegedly “green and non-toxic” carpet cleaning guy, after he got to my house, because he couldn’t tell me what was in the murky blue liquid. Who knows? He certainly didn’t. I’ll just have to vacuum more.

5)    We use green cleaners. Which I’m sure helps with a number of chemical hazards.

6)   Because these kinds of chemicals are used, willy-nilly, to keep greasy fast food from sticking to containers, there’s yet another health-related reason not to eat, or let Maya eat, fast food.

Still, we know it’s all around us and in our blood along with most Americans. As Rick Smith and Bruce Lourie write (at 73), in comparison to, say, Love Canal and other local eco-tragedies:

The story of Parkersburg may be the first environmental-disaster story in which a [corporation in a] small town is also responsible for contaminating the entire world and almost every living thing in it.

Yikes. That’s one hell of a bad relationship.

Two BPA-free Weekend Breakfasts

Yup, still ticked off about the FDA’s truly egregious decision to allow food companies to continue experimenting on all of us with BPA in our food. A post is a-brewing on that particular bit of ludicrousness.

In the meantime, living well is the best revenge. And so Maya and I hit the kitchen to make a couple breakfasts this weekend worth posting about.

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A Massive FDA Fail Frittata

This recipe delivers a rich mix of vegetables in the morning, and Maya ate it up.

Generous pat of (grass-fed, organic) butter

12 stalks or so of (organic) asparagus, broken into 1 inch sections

2 large handfuls of (organic) cauliflower florets

2 handfuls (organic) baby spinach

Basil, Thyme, Oregano, Rosemary, Salt & Pepper

5 (pasture-raised, organic) eggs

2 Tablespoons (grassfed, organic) whole milk

2 Tablespoons fresh herbs as you may have available (we used chives that survived the neglect in my backyard)

Melt the butter in a frying pan capable of going under the broiler (a non-stick pan is not necessary; nor is it a good idea). Toss the asparagus and cauliflower in the butter on medium high heat and let it sit until roasted on one side. Stir and add the spinach. Cook until wilted and most of the moisture is gone, stirring minimally to get a nice roast.

Add the dried herbs with two generous and firm shakes of each, as well as salt and pepper. Beat the eggs and milk and add to the pan. Lower the heat and let the eggs set on the bottom of the pan, until the sides are cooked but not the top. Add the cheese and fresh herbs, and place under the broiler on low for three minutes until bubbly and browned on top. Serve in wedges with a sense of injustice.

The FDA’s-So-Cheesy Bread

We ate it with some farmer’s market sausage, sliced and boiled beets, and fresh-made chevre. It makes a lot, so this is good for a crowd. I love the easy impressiveness of a quick bread.

3 cups (organic) unbleached all-purpose flour

4 tsps baking powder (ours was aluminum-free and double-acting; I haven’t looked into the aluminum issue, if you have, please tell me if aluminum-free is best and why)

1 tsp sugar

1 Tablespoon (organic, grassfed) butter

2 (organic, pastured) eggs

1/4 tsp sea salt

2 tsps prepared (dry) mustard

1 cup grated cheese (we used old gouda and a “green onion” grassfed cheddar — just keep an eye on the salt, as some cheeses will add a lot)

Preheat over to 425F. Dust a baking sheet (not non-stick if you have one) with flour, and sift flour, sugar, salt, mustard and baking powder. Combine with milk and 2 eggs, as well as 1/2 the cheese, stir until just combined. It may be helpful to use your hands to knead just a bit, which is great fun for a toddler (just clean well after the eggs!).

Shape dough into a circle on the baking pan and use your hands to cup the edges. Run a knife over the surface to create sections if desired. Sprinkle with the remaining cheese. Bake in the oven for 10 minutes, then bake 20 minutes more until risen and golden. Cool slightly.

Modified substantially from a recipe in “The Book of Breakfasts and Brunches,” by Kerenza Harries.

10 free (or nearly free) ways to reduce your family’s exposure to toxic chemicals

Credit: Darren Higgins

Some simple principles can help you take action to reduce toxic chemicals in your home:

1)   Use less stuff.  Do you really need those dryer sheets? Or the umpteenth “miracle” cream just taking up space in the medicine cabinet? Go back to basics by figuring out what you use need on a daily basis, and chuck the rest. Save your fancy makeup for the evening out. And whenever you can, pick fragrance free or go without the smelly stuff. (Most fragrances are loaded with pthalates. Mmmm.) Also, treat the plastic you own more carefully — never heat plastic in the dishwasher or microwave (pop food out of the container and handwash the sippy cups). I find that having to hand-wash stuff becomes its own reason not to buy more plastic!

2)   Repurpose items.  Rather than buying new furniture for the nursery. convert that dingy old dresser into a changing table. (Ask relatives what’s in their attic or look on Craigslist or at yard sales for what you need.) The off-gassing from materials, if any, will long be over, and you can often even find deals on solid wood. Spend your dollars on what will really matter, like wooden teethers and a decent and safe new crib. And some of the cutest baby clothes, once out-grown, can be packed away to be used as doll clothes one day.

3)   Replace as you go. Instead of tossing everything out at once, replace items as they run out or wear out with safer ones. When that non-stick pan begins to show wear, replace it with an enameled or a cast-iron pan instead.  When the coffee maker starts to sputter, think about replacing it with a French press to avoid heating plastics every time you brew a cup. And when all those plastic food containers show stains, substitute glass containers with BPA-free lids. Lastly, when you need a new vacuum, buy one with a HEPA filter to reduce both allergens and toxins in the dust.

4)   Enlist help. Tell friends and family that for the baby shower, holidays and birthdays you would like “green” gifts that help your family to detox your home. Help them pick suitable toys through a registry or just a note with a list of things you’d prefer they get for your child or home. They may even want your research so they can make their own positive changes! (Or they may grumble and say you’re nuts, but really, do you want all those loud, annoying plastic gizmos?) And make your friends and family leave their shoes near the door (or better yet, the garage), which really reduces tracked-in toxins and pesticides.

5)   Scrounge a bit. Keep tabs on your local parents’ list serv or check out yard sales, book sales, and thrift stores for nicer items and used books. A little quick action in response to a post from a parent selling a premium toy can save a lot of money! (Our oh-so-fancy wooden Svan highchair came used off our neighborhood listserv for less than half the price of a new one.) Check ebay and craigslist as well for deals on a particular item you covet.

6)   Prioritize. Can’t afford to go all-organic? Just pick the dirty dozen (a list of the most pesticide-heavy fruits and vegetables), plus milk and peanut butter, and buy those organically. (Dairy, berries, apples, peanuts and potatoes are the worst.) Or start with cleaning supplies, which can be made simply with baking soda and vinegar or other homespun recipes.  Skip convenience foods and more processed foods, which contain less nutrition, are far more likely to have harmful preservatives and additives, and are less likely to be organic. Buying food from the edges of the supermarket (vegetables, fruit, dairy, and breads) will save you money and keep you safer and healthier as well. Besides, cooking with children is great fun, and teaches measurements, flavors, and how to help mom.

7)   Air it out.  It’s free and easy to roll down the window in your car for a minute or two whenever you start driving, to air out the VOCs (or volatile organic compounds, as in paints) emitted by all the plastics in cars, as well as the flame retardants in your kiddo’s car seats. It’s also a good idea to open your windows at home when you can to let the house breathe a little, and to run cold water from your kitchen tap for 10 seconds before using it for cooking. (Don’t use hot tap water directly from the tap for cooking, as it can contain heavy metals from the pipes.) And skip the vinyl cover for strollers — it’s better to get a little wet than to have the baby breathing flame retardants, PVC and nasty pthalates.

8)   Think ahead. When you go bargain hunting, think about what your child will need over the next few years, not just today. In thrift stores, I look for clothes that are like-new and good labels that are two, or even three, sizes ahead of where Maya is today. She’ll get there all too soon! And for toys, I invest in really nice toys if they will facilitate open-ended play that will enable them to grow with her – wooden blocks, imagination starters like animals, and cardboarc puzzles that are images now and a puzzle later. Hand puppets and finger puppets are wonderful ways to learn about animals, and lead to fun. Dress-up clothes can come from thrift stores around Halloween, when the costumes are plentiful. And even baby rattles can be kept for the box of musical instruments, or you can buy shakers that double as gorgeous rattles for baby.

9)   Buy in bulk. Many areas now offer Community Supported Agriculture (CSAs) opportunities to buy directly from a local farm, usually for a season and often pay-ahead. This is terrific way to know much more about where your food comes from (and some have visiting days for kids). The food can be certified organic, or can be from a farm that uses farming practices that are very close to organic (or better) without certification, but do ask. Although you pay ahead of time, over the season,  costs may be lower than paying at the supermarket for premium meat, fruits and vegetables. The offerings are always seasonally appropriate, and will be very fresh. (To find CSAs near you, look here.)

10) Let it go. Small changes really do go a long way in reducing chemicals. But stress and anxiety are also not good for parents or kids. So if your efforts to reduce toxins are causing you late nights rather than peace of mind, pick your battles, make your choices, and let the rest go by.(Fifteen minutes of exercise or meditation also helps the body cope with hazards to our health.)We all just do what we can do to protect our children. That has to be enough.

And number 11 is: Stand with groups like Healthy Child, Healthy World in telling your member of Congress and the Senate leadership that you, as a parent, voter and citizen, support more reasonable standards for chemical safety. The best way to reduce exposure to toxic chemicals for every family, and every child, is to enact stronger rules in Congress.