Policy News - July 3, 2003

The beat goes on: researchers consider aging baby boomers' health

The U.S. EPA is undertaking a first-of-its-kind "aging initiative", a comprehensive research program designed to link environmental hazards and the health of older people. The push to study seniors' health problems is all the more urgent now that the nation's baby boomer generation moves into its 60s. The 76 million people born between 1946 and 1964 will begin to turn 65 years old in 2011, according to EPA figures, making it clear that in the next 20 to 30 years, the number of Americans over 65 will double, creating the largest cohort in history.

President Bush has proposed $1 million to fund the initiative in the upcoming fiscal year (FY) budget, which begins in October. EPA leaders envision the research involving several government groups, such as the U.S. Centers for Disease Control and Prevention, the National Institute of Environmental Health Sciences, and the National Institute on Aging, where research on the elderly is already under way. But with the recent budget crunch, many government researchers privately worry that the funds won't come through.

Seniors behave differently than younger adults in ways that can negatively affect their health, and their older immune systems are less able to recover from hazardous exposures, senior advocates note. They typically spend more time at home than kids and middle-aged adults, many as much of 95% of their time, exposing them to indoor air risks such as mold and dust, which can trigger life-threatening asthma. Water-borne pathogens in drinking water can be deadly. And for retirees who have lived near a toxic waste dump for 40 years or more, exposures to environmental hazards are higher than for other groups. "We need new research into the microenvironments that older adults live in," urges Andrew Geller, senior staff scientist for the initiative, with EPA's Office of Research and Development (ORD).

Those over 65 typically ingest several different medications and have been exposed to higher levels of synthetic chemicals from food residues and other sources. All of these factors can make them more vulnerable to environmental hazards, but for most of these issues, there are great gaps in research.

"It must be noted that our current elderly population has been exposed to a cumulative dose of environmental chemicals above and beyond that of past generations," said Jane Lipscomb, associate professor at the University of Maryland School of Nursing, speaking in May at an EPA "listening session" on the initiative. "Despite this, to date the elderly's lifetime exposure and unique vulnerability to synthetic chemicals in the environment have not been a focus of epidemiology or toxicological study."

At the same time, the elderly metabolize chemicals differently than kids or younger adults. "A rapidly accumulating literature regarding changes in the pharmacokinetics and pharmacodynamics with advancing age suggest that the elderly are particularly vulnerable to drug reactions," Lipscomb added. "In the absence of research exploring the harmful effects of multiple drug and environmental chemical interactions, we can only project the vulnerability of this population to the harmful effects of these complex mixtures."

The initiative was a favorite of former EPA Administrator Christie Whitman, who shortly after taking office asked staffers from the Office of Children's Health Protection about agency efforts to protect those older than 65, says Kathy Sykes, aging initiative coordinator. For the past decade, EPA researchers have taken a close look at children's health issues, leading to decisions that differ when applied to adults. Whitman asked for a similar focus on older people, and researchers are urging the same.

EPA launched its initiative during a December 2002 workshop with the National Academy of Sciences where experts considered environmental hazards and their impact on respiratory and cardiovascular disease, as well as neurotoxicity, infectious disease, and cancer.

If the funds are approved, ORD officials will direct EPA's projects, where some work is under way, says Geller. An inventory of EPA activities from 1996 to the present shows that a total of $12.8 million has been spent so far on 75 projects, with 31 of those from ORD. Forty-six of the total are research studies.

Many medical and health research groups support the initiative. Janet Allen, dean of the School of Nursing at the University of Maryland, Baltimore, says that nurses, who are often the first to see emergency room patients, are not trained in the appropriate diagnosis or treatment of illness related to environmental hazards in older persons. As the number of retirees rises, more will be entering emergency rooms. "I commend EPA for doing this before it becomes a critical health problem," Allen said.

EPA officials are seeking public comments on actions that local governments or planners can take to anticipate the needs of today's older citizens. The agency wants to hear from outsiders about how the migration of retirees to regions with warmer climates might cause ecological pressure. And agency staffers are interested in recruiting retirees to volunteer to speak about ecological preservation.

Once information about this topic is made public, baby boomers are likely to act, notes Steven Wallace, professor of Public Health at the University of California at Los Angeles Center for Health and Policy Research. "It is the generation that changed things in the 1960s," Wallace says. "They have definitely been seen as a group that is hyper about their health concerns." For more information, go to www.epa.gov/aging. —CATHERINE M. COONEY