Out In The Open

By Micah Buis '02

For many of us, searching for organic, free-range, or antibiotic-free food products has become almost commonplace during our weekly visits to the grocery. But, says Professor of Psychology and Director of the Program in Science, Technology, and Society (STS) Janet Gray, we’re not doing nearly as good a job trying to avoid many other chemicals in our everyday lives that could pose a risk to our health.

1 PRODUCE: Pesticides used on many crops also act as endocrine-disruptors, increasing risks for cancer as well as neurodevelopmental disorders.
2 PERSONAL CARE PRODUCTS: Many lotions and cosmetics contain phthalates and other chemicals that may be absorbed directly across the skin.
3 LANDSCAPING: Exposure to chemicals used on lawns, gardens, playgrounds, and athletic fields may increase risk for cancer and other diseases.
4 LONG-TERM EXPOSURE: Young children and teens may be particularly susceptible to long-term effects of exposure to chemicals because of the rapid changes their bodies are undergoing.
5 PLASTICS: Additives may leach out of the plastics when they are heated or when children chew on some toys.
6 GRILLED MEATS: Grilled meats, as well as cigarette smoke and automobile exhaust, all contain polycyclic aromatic carbons (PAHs), which are potential carcinogens.

Alkylphenols, for example, the chemicals that help make many cleaning products and detergents sudsy, do not biodegrade easily and are found in our water supply in high concentrations. The plastic in all those bottles of water we consume each day contains toxins that may have leached into the water. And the pesticides and herbicides we use to make our lawns, playing fields, and golf courses look so beautiful actually alter many of our own natural hormonally regulated systems.

Women, though, may be even more vulnerable because of their increased use of personal-care products—lotions, cosmetics, hair products—that contain parabens and phthalates, both linked to manipulation of estrogen levels in the body. The result of this overexposure? A possible increase in the risk of developing breast cancer. “Fewer than half of all breast cancer cases are caused by risk factors including lifestyle, inherited factors, and reproductive history. Risks in the environment, both inside and outside the home, have been implicated in the high rate of breast cancer,” says Gray.

So, will wearing nail polish or using eye cream give you breast cancer? No, probably not. But using these products in combination with the hundreds of other chemicals we regularly come in contact with each day just might. And using them steadily over a period of time could be especially dangerous—which means that young girls who begin heavy usage early on, when their breast tissue is still developing, might be particularly susceptible to the carcinogenic effects of these chemicals. (African-American girls specifically, because the hair-care products marketed directly to them often contain not only parabens and phthalates but also estrogen and placental hormones, stand an even greater risk of possible changes in breast development because of the increased level of estrogens and other hormones.) Steady exposure over time also means that those not just personally applying these products but working with them professionally on a daily basis—cosmetologists or manicurists, for example—are at greater risk, too.

Because advocacy groups have done a good job of showing how certain behaviors, such as smoking, drinking, or not having children, or genetic factors can impact the chance of developing breast cancer, “information about the relationship between environmental risks and breast cancer is often ignored,” says Gray. Part of the difficulty in getting people to focus on environmental risks is that the dangers might not seem so immediate. If we are ingesting or absorbing or inhaling small amounts of these harmful chemicals each day, and if the possible effects of that exposure might not surface for many years, “how do you reach people and get them to grapple with issues that are so long-term and complex?” asks Gray. “It may be especially difficult to get young children and teens to think about the long-term health consequences of engaging in common behaviors, especially ones that may seem to make their lives easier or more comfortable.” While Gray knows that we can’t change these issues overnight, she thinks “it is crucial to inform the public, especially young girls, who can alter habits now that could diminish their risk of developing breast cancer in the future.”

There is a growing literature that explores the correlation between certain environmental risks and breast cancer, but most of it exists either in the dense texts of scientific and academic journals or in the written “State of the Evidence” presented annually by the Breast Cancer Fund and Breast Cancer Action, two organizations that are committed to public education and action on these issues. Gray points out that these are wonderful resources, but most useful to those with some expertise and the time to wade through very thorough and complex findings.

So Gray, who for 25 years has studied the effects of the breast-cancer drug tamoxifen on the brain and has taught an STS course on the biopolitics of breast cancer, decided to produce a CD, Environmental Risks and Breast Cancer (ERBC), that would help synthesize the findings from over 200 sources into one accessible, engaging, multimedia resource—without “dumbing down” any critical information. “It’s attractive and accessible, but it’s serious science,” says Gray.

The idea of possibly creating a CD was suggested to Gray by a colleague, Dr. Devra Davis, director of the Center for Environmental Oncology at the University of Pittsburgh Cancer Institute (UPCI). Before committing to creating the CD, Gray offered a special STS seminar in Spring 2004 on environmental risks and breast cancer. She and the five students in the seminar divided up the existing literature and discussed and analyzed it during their meetings. Halfway through the semester the class agreed that they wanted to move forward with something larger and with more impact—produce a CD that would educate people and provide critical information on the risks they were learning so much about. Jessica Schifano ’05 was one who recognized a need for an educational CD. Although she didn’t have a direct interest in studying breast cancer when she first enrolled in the course, she “was very interested in exploring environmental health issues, especially the links between chemicals in our everyday lives and disease. Breast cancer is a disease that continues to strike more women at increasingly younger ages. Because of this I realized how important it was to learn more about the preventable causes of the disease and educate other women…and empower them to make choices to protect themselves from the disease.” Schifano went on to become one of the main content specialists for the CD, as did Molly Nadelson ’05, another of the original seminar participants.

Image of ERBC Screen
Image of ERBC Screen

Gray thought the CD was a great idea, but she’d “never done anything like this before.” Still, she was interested in how the project would “make her more comfortable with possibilities for innovation in the classroom—and a much broader educator.” In hindsight, though, she calls it the “craziest” thing she’s ever done as a teacher and a scientist.

Crazy because, as Gray says, “a monster had been created” that had a much larger scope than originally anticipated. The small five-student seminar wasn’t enough to capture the computer animation, web design, computer programming, voiceover, and production and administrative expertise that would be necessary for the sort of textually and visually sophisticated product Gray and her students hoped for and which would be most valuable to users.

In all, 11 students came on board, and administrators and staff from several Vassar departments offered help with everything from fundraising to modeling for some of the animated figures in the CD to beta-testing. “People really cared on many levels about this project,” says Gray. “We would meet for an hour and a half two times a week,” despite the fact that most of this was not done for academic credit or pay, “and put our steel armor on” as people offered critiques to the text and designs, making this the “most collaborative, collegial, consensual project” in which Gray had ever been involved.

Attempting to maintain a pleasing balance between textual and visual elements proved challenging. As Chris Silverman, a web designer in Vassar’s Office of College Relations and project designer for the ERBC CD, puts it, “Too much text would feel like a textbook; too many graphics would feel like Saturday-morning cartoons.” Terumi Cox ’05, a 3D animator on the project, agrees: “The goal of this CD was to get the hardcore research to the public without making them fall asleep, but also without compromising the evidence or creating a sense of hopelessness. The graphics create an interface that allows for a more user-friendly experience, bringing to life the words on the page and egging you on to the next chapter.” To this end, Silverman attempted to design the ERBC CD “to look like something people already knew how to use. I used colored file folders and sticky notes instead of rows of links because these are tangible real-world elements that people are familiar with…. Generally I wanted the project to feel like an information packet, not a doctor’s office.” Silverman’s logo choice further distanced the CD from anything too alarming or clinical. “A human/female shape was the obvious first choice, but I wanted something that didn’t force people to think about their bodies. I finally settled on the four-color ‘ERBC’ because…I thought it better conveyed the concept of information rather than disease, since that’s really what the CD is about—informed awareness, not sickness.” For Silverman, the CD isn’t about fear. “ERBC doesn’t scream that the sky is falling. It acknowledges the risks and offers reasonable suggestions.”

The interactive CD includes general information, such as original animations illustrating breast anatomy, carcinogenesis, and the estrogen mechanism, and also detailed information on specific chemicals linked to breast cancer, along with practical, budget-conscious solutions on how to minimize exposure to these chemicals. There is also a full bibliography, a searchable glossary, and links to related websites, and the full project is in both English and Spanish on each CD. “What I think the ERBC CD does better than any similar resource is consolidate useful information under one interface and one voice,” says Silverman. “The program offers a distinct path, from introduction to final suggestions. Another advantage of the CD is that it’s distributable. As a physical object it has a little more presence than an emailed article or web link.” And after two years the CD was ready for distribution, following a media preview in June 2006 at the home of Oxygen Media President and CEO and Vassar Trustee Geraldine Bond Laybourne ’69 in New York City. With a grant from UPCI to support partially the first production run of the CD, 12,000 CDs were made, with commitments from the Silent Spring Institute, the Breast Cancer Fund, Breast Cancer Action, and Breast Cancer Options to use the CD in their own educational programming and to join in the distribution of the project. A project website was also created to allow people to order the CD directly from the ERBC team at Vassar.

Since then there have been write-ups in numerous media outlets, including Vogue, WebMD, and the New York Daily News, leading to the distribution of the first full run of CDs, as well as most of a follow-up run of an additional 5,000 CDs. Another 5,000 CDs were being ordered early this semester to keep up with the requests that have come from every state in the United States and 75 countries around the world. “We want this to be used as a public health tool,” Gray says.

No doubt, the CD has caught on: doctors have been requesting copies, organizations such as the Alabama Nursing Association have ordered multiple copies, and Gray hopes to take the CD to local high schools in the Poughkeepsie area to educate young people there about potential risks. But the CD is being used on a much more personal level as well. When users request a complimentary copy of the CD they often include messages like “To Mommy with Love,” or they request one copy for themselves and then come back and ask for more for their mother, daughters, sisters, and aunts. “We’ve been getting requests from people with the same name in the same area, which suggests that people are telling family members,” says Silverman.

Images from ERBC CD
Images from ERBC CD

People need tools like the ERBC CD because a recent (2005) report by the Government Accountability Office confirms that the vast majority of the commonly used chemicals in the United States have never been tested for potentially harmful effects on human health. And the United States, unlike the European Union, has no industrywide or government safety standards on many cosmetics and personal care products. Gray hopes the CD will “empower people to make smarter choices; any degree of change might help.” And if breast cancer never becomes a health issue for you? Well, you’ll probably be healthier in general for these smarter choices, says Gray. “Scientific evidence suggests that the combined exposures to a number of factors discussed in this project may account for a considerable portion of the current high rate of breast cancer. We argue that, when possible, it is worthwhile to look for less harmful alternatives.” “We are all looking for a cure, which is absolutely important,” says Cox. “But to overlook our individual ability to decrease future breast cancer cases is irresponsible. Prevention, apparently, is not nearly as exciting, especially when it threatens big businesses. But if people are armed with the facts at least they can make safer choices and put pressure on the right people for safe options. The ERBC CD is arming people with those essential insights.”

Because of her work with the CD, the Breast Cancer Fund will honor Gray with one of their Hero Awards during a March 23 ceremony in San Francisco. “The award is just over the top. I am astonished to receive it, but I am thrilled for the recognition it gives to the ERBC team’s work,” says Gray. 

Jeanne Rizzo, executive director of the Breast Cancer Fund, specifically chose the ERBC CD project because “it speaks effectively to a young audience that can be difficult to reach,” she says. “That’s key because cancer prevention is something that’s most effectively acted on before the exposures have taken place. It’s important to me to get this CD in the hands of all of the Breast Cancer Fund’s advocates, donors, and partners because it’s going to take all of us, acting collectively, to eliminate the environmental causes of this disease and turn the tide on breast cancer.”

To request your own copy of the CD, visit http://erbc.vassar.edu; the CD can run on Windows XP, 2000, or Macintosh OS X and higher.

Vassar ERBC CD Team

Vassar Faculty
Janet Gray: Project Director

Vassar Administrative Staff (College Relations and Computer & Instructional Services)
Christian Opazo: Technology Project Manager and Translator
Chris Silverman: Project Designer and 2-D Animator Ginny Jones: Instructional Designer
Dede Hourican: Voiceover Artist

Vassar Students
Josh de Leeuw ’08: Project Software Developer Molly Nadelson ’05: Content Specialist Jessica Schifano ’05: Content Specialist Serra Schlanger ’05: Content Specialist
Sara Bodach ’04: Content Specialist
Sara Gale ’04: Content Specialist
Carolina Fasola ’05: Translator
Michael Fischthal ’05: 3-D Designer and Animator Terumi Cox ’05: 3-D Designer and Animator
Tiffany Chow ’07: 2-D Designer Michael Chico ’05: 2-D Animator