(September 2013) ANTI-BIOMASS CAMPAIGN CALL RECORDING & NOTES: “A Pediatrician's Perspective on Air Pollution and Children"

Anti-Biomass Incineration Campaign - National Conference Call Notes

Thursday, September 5, 2013 at 3pm EST

Topic: “A Pediatrician's Perspective on Air Pollution and Children" - We discuss the human health impacts of biomass incineration and other forms of industrial air pollution, with a focus on our nation's most vulnerable population: our children.

Guest speaker: Dr. Norma Kreilein, MD, Fellow of the American Academy of Pediatrics 


A Pediatrician's Perspective on Air Pollution and Children - September 2013


Facilitator: Josh Schlossberg (Energy Justice Network, VT)

Notes: Samantha Chirillo (Energy Justice Network, OR)

On the Call: Mercedes Brugh (IN), Josh Schlossberg (VT), Toby Thaler (WA), Chris Zinda (OR), Samantha (OR), Paul, Larry Edwards (AK), Norma Kreilein (IN), Roger (IN), Mike Ewall (DC), Anonymous Lurker


See the video (3-4 minutes) that Dr. Norma Kreilein references on the call -



See the Congressional briefing Sept. 25, 2012, including Norma's presentation - 



Norma Kreilein (Jasper, IN): Original talk was 45 minutes for the Congressional briefing. Could have spent all day explaining what's relevant medically. 

Josh Schlossberg (Energy Justice Network, VT): Let's start. Press *6 to mute. Starting recording. Thanks for joining us, this network call is the 1st Thur of each month, time varies. See a link to the video in the email I sent earlier today and Norma's Congressional briefing Powerpoint presentation at saveamericasforests.org

Norma:  I'm a pediatrician. Degrees from Notre Dame and Indiana State University. I've practiced in IN for 20 years and have seen what happens to bodies over time, the limitations to medicine. Ohio River area has always been quagmire of allergies and asthma - Ohio River fever. Rural area relatively. Became involved in biomass. Thought the town leaders were on the same page, but turned out they were not monitoring, restricting pollution in the area. A lot of studies equating inflammation with disease. Medical diagnosis is like a 911 address. We try to be specific but not all diagnoses are specific. Diagnosis does not explain the reason.  Process that leads to heart attack or cancer is usually an inflammatory process. Pediatric board recertification required every 7-10 years. Inflammation wearing and tearing at the body + more pollution = undertow. This has lead me to oppose the biomass facility not built yet here. Much of the pollution is coal, wood furniture. City decided to make her life hell, moved practice 28 miles east. Ironically then commuted past coal plant (see slide) - the Petersburg Coal Plant. Indiana claims to meet air quality standards. Patients soaking in this all night long. How can we be complying? Closest monitor is 20 miles east. Often agency places monitors to prove what it wants to prove . . .

Samantha dropped off call momentarily, then got back on . . .

Our state says it complies, but no way that compliance when monitoring at 20 miles is legitimate. Baby coughing on the slide (photo at briefing). Can give them oral steroids which is cheap but has bad side effects or nebulizer which is expensive ($200). Doctors and drugs are not cheap for treating health effects of incineration. Am. Lung Assoc. opposes biomass incineration. I do because it triggers inflammation - a primary immune  response and responsible for disease. If you turn it off, you turn off the rest of the disease process. Drugs for rheumatoid arthritis and Crohn's disease advertised on TV - can cause immune deficiency diseases. Inflammation is a primary immune response to a trigger. When trigger lingers, so does this response. Infectious disease and pollution both trigger inflammation - a cascade, not a tightly regulated feedback loop. Heart rate only goes as high as oxygen can feed it - a regulated feedback loop in the body. Inflammatory response can continue like a domino effect without any feedback loop whatsoever. Will persist til the trigger is removed. The body makes antibodies to flu virus, body make antibodies, inflammation happens, then virus and response goes away. Chronic infection produces chronic inflammatory response, much like pollution does. Some people who do not fight infection and have a large inflammatory response - these people have large allergic responses. Air pollution causes disease by triggering inflammation. Pollution is an inflammatory trigger. Disease risk and damage is related to pollution level, worse with ongoing exposure, also depends on genetic makeup of the person. Lungs are often the recipients of pollutions, pollutants enter circulation via the lungs, inflammatory cells are recruited to the lungs, becomes a chronic disease. Many different diseases emerge from inflammatory pathway, often dose-related to air pollution. These include:

autoimmune diseases - type 1 diabetes, lupus

neurodegenerative - Alzheimer's

metabolic - type 2 diabetes, 

cardiovascular - heart attacks, strokes

cancer - inflammation wears down the body, accelerates aging without repair

pediatric - kids spend more time outside, less body mass than adults, more exposure, still developing so pick up something like autism or ADD from chronic inflammation. Potential impact of pollutants is far greater than that of vaccinations, far greater than that of vaccinations will ever be. Exposure to large amounts of pollutants 24-7 versus micro amounts of vaccine occasionally. Pollutants are underreported. Child's cumulative lifetime exposure is a public health crisis. See citations - CA did study in which children had lung scarring permanent up to 20% from living next to freeways. Modern medicine in terms of trauma and infection - can put body back together again. But if you look at chronic diseases, medicine is not very effective. Only in past 20 years do we understand the role of pollution in chronic disease. 

The video Josh sent the link to shows the progression of airway disease. Inflammation means swelling around the airway, which constricts, more mucus, more swelling. Next slide - this causes damage, scarring over time in long run. In short run, damage to cilia. Cilia exposed to smoke do not beat effectively. Look like tornado hit - increased likelihood of getting virus, limited in airflow and ability to get oxygen in. Can't see but know as physician - look at patient, kids coughing, and try to imagine what's going on in lungs. 

Pollution is a huge factor in the development of asthma and clots causing stroke. Anytime you decrease airflow or blood flow, you dramatically effect how the body operates. Children have smaller blood vessels - any restriction or swelling is more significant in a child than an adult. The radius of the tube to the 4th power (^4). Steroids reduce mucus, more effective in nebulizer but $80-150 per month and systemic steroids affect the whole body. Cannot fix it when the trigger is ongoing. Can't address the brain and blood flow to brain and what happens chronically to circulatory system.  

Sulfur dioxide melts cilia together - mucus cannot move, stagnation breeds infection. Sinus infections, pneumonia, brochitis. Bacteria are inflammatory.More pollution, more mucus, more bacteria, more mucus, more particulate absorption, even more inflammation and less airflow, gets worse and worse. Pollution affects the developing placenta and fetus. More developmental anomalies when there's exposure to environmental toxics, like atrazine combined with coal pollution -- chromosomal and embryologic damage that does not repair over time. Can progressively end up with cancer from chronic inflammatory response.  Slide - guy has always had allergies and asthma, developed type 1 diabetes, can't take steroids, everything worse with diabetes, greater cost, his school in top 5% diabetes rate from USA Today. Next slide - biomass pollution includes ultrafine particulates - PM 2.5-10 - inhaled and get into circulatory system via lungs, go to brain via bloodstream along with heavy metals. Pollution is way more likely to impact autism and ADD than vaccines because it bypasses any filtering process the body usually has. Bottom of slide - DNA damage or blood brain barrier damage - extremely devastating. Quagmire where 26% of children in counties surrounding Evansville qualify for learning disability. Dose-related. Hits some harder than others. But ultimately worsens over time. 

Josh: Thanks, Norma. If you came on the call during Norma's talk, please give your name.

Mike Ewall (Energy Justice Network, D.C.) 

Laura from Minneapolis 

Jim Travers 

Laura (MN): Study talked about lower academic performance around incinerators. Seems like tests for learning disabilities could really sound some alarms for communities. 

Norma: In Indiana, the data is straight off the State's website - the Education Dept. But screaming about it has not helped. Haven't' been able to get anyone to take action.

Laura: Any racial disparity? 

Norma: Possibly, most in S. Indiana are white. Have to have jobs even if they kill us. Worst pollution to jobs ratio. County with the 26% stat just voted to add a several billion $ fertilizer plant to produce < 20 jobs. Proponents claim that if disease is from air pollution, then rate should be going down because air pollution has been going down over past so many years.  But the data is faulty. We don't have real monitoring. Disease rate going up. Can't get people upset over it. Culture in which we live. Check state ed dept. 

Paul (IN): I live near Norma - we need more monitors, like EJN sent out about this past week. Correlation statistics suggest the need for more monitors in key areas. Not enough causation studies. Too much anecdotal evidence. We should be doing more studies.

Norma: There's potential in satellite technology in tracking particulates where monitors are politically difficult to get in place.  Has been used in Massachusetts to look at association between PM2.5 and premature birth. Double bind because places with worst pollution have least monitoring. 

? - Comment about sewage is pertinent. Sewage has come far over last 50 years. Years from same sort of awareness about air. What's in air will be in water, not filterable. Air and water share same environment. Where mercury is concerned, mercury in air will end up in soil and water.

Larry: Can satellite monitoring distinguish size classes?

Norma: Don't know. 

Chris: Are public health agencies involved in the process and how?

Norma: No - they focus on infectious disease, sewage. environmental pollution usually under separate departments which are not attuned to public health. Gov. of Indiana makes sure environment dept. takes care of environment, public health is something else. 

Chris: Permitting is poor, esp. in regard to PM2.5. Officials won't comment on PM2.5 in these processes. Are there resources for citizens to comment?  

Norma: As for coal power plants undergoing conversion - we had a fire last year but because of budget cuts it got approved without comments. No objection to it, but this is typical for indiana. No accountability. Until last 10-15 years, there appeared to be much progress. But not since takeover of industry over environmental guidelines. 

Chris: This is the pattern, with individual states doing enforcement, there is no consistency of environmental enforcement. States can claim they are compliant. EPA defers to states like OR, then washes its hands. Medical professionals have greater status than ordinary citizens though.

Norma - I'm in a minority as an advocate. Medical professionals usually don't live in a place long enough. ? disease among children increased 300% since ?

? - told not to talk about smoke stacks in IN. Pressure to keep quiet is pervasive in our culture. 

Mercedes - Where can we see the powerpoint? is there a video also?

Norma:  Briefing presentation is at www.saveamercasforests.org

Josh: Will send link to video along with recording and notes.

? - how do parents get their information?

Norma: We need to send the message that we can't have more jobs for poorer health. In the Hospital I was employed at the industrial undertow silences opposition out of fear of losing a job or fewer jobs. This is true of past 5-10 years. Polluting children to this degree to have jobs . . .

? - how about getting Propublica or Frontline involved?

Norma: Have not been able to get anyone to take this seriously at the national level.

Josh - Continuing to speak up will help. 

Norma - 20,000 doctors in Massachusetts voted that biomass is a human health risk. Can't get this many doctors to agree to anything. Just a matter of ? Doctors are less advocates than they used to be. They told me my business would suffer.

Jim Travers - Cement plant across from high school, 400 lb mercury/year. Paid close attention to fine particulates. Epidemiological studies scarce. Sick children make good business, opposition hurts business. Some of these plants are main economic engines in these areas. Would be great to have an animation of a cubic meter of air, what's in it, what it does. anything like backyard bucket brigade?

Norma: Producing this and getting it on national TV might wake people up. Ultrafines are related to surface area.

Jim: These pass through blood brain and placental barriers. Need to look at economics. EPA arbitrarily delayed regs. 

Norma: CAA alone has 40:1 payout on healthcare benefits. Past Gov Mitch Daniels called industry the "employment provision agency"? . . .?

Jim: Regs not stringent enough?

Norma: EPA has gotten overridden by last few administrations, ergs unglued by the executive branch.

Josh: Time to wrap up. thanks again to Norma and everyone. 1st Thur of every month. Role of wildfire in ecosystems next month. 


End of call.