Donald Trump Should Know: This Is

What Climate Change Costs Us

Last week, Donald J. Trump’s transition team sent a startling questionnaire to the
Department of Energy. Among other things, the questionnaire asked for the names of
all employees and contractors who attended meetings of the Interagency Working
Group on the Social Cost of Carbon, as well as all emails associated with those
meetings, and the department’s “opinion” on the underlying issues — a request it
essentially refused.
Though Mr. Trump’s transition team later said that the questionnaire was sent in
error, it should be understood in tandem with a memorandum, leaked last week,
from Thomas Pyle, the leader of the transition’s energy team and president of the
American Energy Alliance, which promotes “free market” policies. Mr. Pyle described
the steps the Trump administration will probably take to reduce environmental
regulations, including “ending the use of the social cost of carbon in federal rule
makings.”

If that happens, it will defy law, science and economics.

In 2009, the two of us — one from the Council of Economic Advisers and the other
from the Office of Management and Budget — convened the first meetings of the
working group to which the questionnaire referred. Our aim was to quantify the
social cost of carbon for the United States government by drawing from the latest
research in science and economics. This comprehensive measure would reflect the
monetary cost of the damage caused by the release of an additional ton of carbon
dioxide into the atmosphere, accounting for the destruction of property from storms
and floods, declining agricultural and labor productivity, elevated mortality rates and
more.

The working group, which consists of officials from agencies throughout the federal
government, now estimates that cost at about $36 per ton of carbon dioxide. This
figure plays a central role in the cost-benefit analyses that agencies use in deciding
whether to issue regulations to limit greenhouse gas emissions, and how stringent
such regulations should be. Thus far, it has been used for 79 regulations, including
energy-efficiency rules for refrigerators and washing machines, fuel-economy rules
for cars and trucks, and the Clean Power Plan, which requires reductions in
greenhouse gas emissions from existing power plants.

Without it, such regulations would have no quantifiable benefits. For this reason, the
social cost of carbon can be seen as the linchpin of national climate policy.

And yet not everyone is a fan of this concept. Those who think that climate change is
a hoax, or who oppose regulation as a rule, have a major problem with the social cost
of carbon, because it indicates that limits on emissions can deliver significant
benefits. Others believe that the $36 per ton figure is too high, overstating the
benefits of regulations.
But the working group’s process and output have been validated by the courts. In
August, a federal court of appeals rejected a legal challenge to the social cost of
carbon by a trade association of refrigerator companies. The association contended
that the government lacked the legal authority to consider the social cost of carbon
and that its judgments were arbitrary.
The court responded that it had “no doubt that Congress intended” to allow
consideration of the social cost of carbon and that the government’s judgments were
reasonable.

In fact, in 2008, a federal court of appeals ruled that the government essentially had

to specify a social cost of carbon: It was not permitted to ignore harms from climate
change, the court said, when setting regulatory policy.
The federal government is also required to quantify environmental damages under
prevailing executive orders. President Ronald Reagan started the practice in 1981,
when he required federal agencies to analyze the benefits and costs of their
regulations; his Democratic and Republican successors have followed his lead.
New scientific and economic evidence suggests that climate change probably poses
an even greater risk than the $36 figure reflects. For example, the West Antarctica ice
sheet appears to be retreating faster than we thought, raising the specter of
multimeter sea level rise in the next century. Recent research also found that climate
change will lead to shorter and sicker lives, primarily because of the harmful effect of
more extremely hot days on health. Extreme heat is also projected to reduce worker
productivity and increase energy consumption, while changes in temperature and
precipitation globally are expected to increase food prices and violence. Thus, there is
a strong case that if anything, the government’s estimate of the social cost of carbon
should be higher than it is.

To be sure, the exact number is uncertain, and the Trump administration will make
its own judgment. But a credible assessment must be based on the best science and
economics, not politics. And there is no justification for a chilling investigation of
civil servants who are just doing their jobs.

Ultimately, the social cost of carbon provides a necessary guidepost in decisions

about how to balance costs to our economy today with the coming climate damages.
Wishing that we did not face this trade-off will not make it go away.

Any effort to eliminate the social cost of carbon would reflect a neglect of science and
economics — and it would be quickly struck down in court.

When Cutting Access to Health

Care, There’s a Price to Pay
Four years ago, a panel of experts convened by the Institute of Medicine and the
National Research Council set out to assess the nation’s health compared with that of
16 other rich nations. Americans, they found, had the second-highest mortality from
noncommunicable conditions — like diabetes, heart disease or violence — and the
fourth highest from infectious disease. In terms of infant and maternal mortality,
Americans are the worst off.
From adolescence to adulthood to old age, the chances of dying an early death are
higher in the United States than in any of the other 16 countries. A 15-year-old
American girl has a 1 in 25 chance of dying before she turns 50, twice the risk found
in the comparison group.

And early death is hardly surprising, since Americans lead a pretty sickly life.
Teenagers and young adults report higher rates of obesity, chronic illness, sexually
transmitted infections, mental illness and injuries than in peer countries, according
to the report. Americans in their 50s have higher rates of heart disease, stroke,
diabetes, hypertension and obesity.

The figures also reflect a toll in the workplace. The United States ranks in the bottom
fourth among the 30 industrialized nations in the Organization for Economic
Cooperation and Development in terms of days lost to disability: Women will lose
362 days between birth and their 60th birthday; men about 336. Mental health
problems like depression will account for most.

And the American deficit has been getting worse. “Each year, other high-income
countries are improving their health at a much faster rate than the United States, and
the United States currently ranks lowest on a variety of health measures,” the report
by the Institute of Medicine and the National Research Council noted.

I bring this up, senators, because you are considering a bill that would drive a stake
through the Affordable Care Act. As you mull the legislation over your holiday recess,
think about the consequences of cutting access to care for millions of mostly poorer,
sicker and older Americans.

The High Cost of Avoiding Health

Care
Americans die from noncommunicable diseases at higher rates than citizens of many
other advanced countries. And many people here have at times been reluctant to see
a doctor because of the cost.

Of course, the dismal health situation is not all the fault of the health care system —
which, until the passage of the Affordable Care Act, was the only one in the developed
world that routinely barred access or limited care for millions of people of modest
means.That is because violence accounts for a large share of Americans’ excessive
mortality, and accidents take a disproportionate toll. Nor is the health care system
entirely to blame for the nation’s elevated obesity rate — a leading cause of problems
like diabetes.

What’s more, the United States’ higher tolerance of poverty undoubtedly contributes

to higher rates of sickness and death. Americans at all socioeconomic levels are less
healthy than people in some other rich countries. But the disparity is greatest among
low-income groups.
Still, senators, you are not off the hook. Limited access to health care may not
entirely account for the poor health and the early deaths of so many of your fellow
Americans. But it accounts for a good chunk.

A study about equity in access to health care for 21 countries in 2000 revealed that
the United States had the highest degree of inequity in doctor use, even higher than
Mexico — which is both poorer and generally more inequitable.
And as noted in a 2003 study by the Institute of Medicine, insurance status, more
than any other demographic or economic factor, determines the timeliness and
quality of health care, if it is received at all.
It doesn’t require an advanced degree to figure out what limited access to a doctor
can do to people’s health. A review of studies published this week in Annals of
Internal Medicine reported that health insurance substantially raises people’s
chances of survival. It improves the diagnosis and treatment of high blood pressure,
significantly cutting mortality rates. It reduces death rates from breast cancer and
trauma. Over all, the review concluded that health insurance reduces the chance of
dying among adults 18 to 64 years old by between 3 and 29 percent.
Another assessment, published last week in The New England Journal of Medicine,
found that access to health insurance increases screenings for cholesterol and cancer,
raises the number of patients taking needed diabetes medication, reduces
depression, and raises the number of low-income Americans who get timely surgery
for colon cancer.
It said that expansions in three states of Medicaid, the federal health insurance for
the poor whose rolls Republicans are prepared to trim by 15 million over a decade,
were found to reduce mortality by 6 percent over five years, mostly by increasing
low-income Americans’ access to treatment for things like H.I.V., heart disease,
cancer and infections.

I understand, senators, that this sort of analysis may not sway all of
you. I’m aware of the view on the rightmost end of the political
spectrum that ensuring people’s well-being, which I assume
includes their health, is a matter of personal responsibility and not
the government’s job.

Yet there is a solid economic argument for protecting your fellow citizens’ access to
health care that does not rely on arguments from empathy, charity or the like. A
sickly, poorly insured population can be expensive.

As noted by a study from the Joint Center for Political and Economic Studies, poor
health and limited access to health care not only raise the cost of providing such care
but also reduce productivity, eat into wages, increase absenteeism, weigh on tax
revenues and generally lower the nation’s quality of life.

The study, which focused on the disadvantages of African-Americans, Latinos and

Asians, added up the costs of inequalities in health and premature death between
2003 and 2006 and came up with a price tag of $1.24 trillion.
The good news, senators, is that solving these inequities needn’t be particularly
expensive. The analysis relayed in The New England Journal of Medicine suggested
that each additional life saved by expanding Medicaid costs $327,000 to $867,000.
That is much cheaper than other public interventions, such as workplace safety and
environmental regulations, which achieve a similar reduction in mortality for each
$7.6 million spent on compliance.

Even better: Instead of taking away the health insurance of more than 20 million
Americans, what if you could offer nearly universal access and still make that work
within your broader agenda?
In 2015, according to the Organization for Economic Cooperation and Development,
the United States government spent 8.4 percent of its gross domestic product to pay
for health care for about half of all Americans, including Medicare, Medicaid and
subsidies under the Affordable Care Act. That year, Britain spent 7.7 percent to cover
virtually all of its citizens. Finland, Canada and Italy spent even less.
I understand, senators, that these places have what is known as single-payer systems
— which tend to stick in the craws of some of you. But think about it. If your primary
motivation to repeal the Affordable Care Act is to provide a large tax cut for high-
income Americans, think what you could do with a full percentage point of G.D.P. It
could even be worth the effort to provide health care for all.

Drug Overdoses Propel Rise in

Mortality Rates of Young Whites
Drug overdoses are driving up the death rate of young white adults in the United
States to levels not seen since the end of the AIDS epidemic more than two decades
ago — a turn of fortune that stands in sharp contrast to falling death rates for young
blacks, a New York Times analysis of death certificates has found.

The rising death rates for those young white adults, ages 25 to 34, make them the
first generation since the Vietnam War years of the mid-1960s to experience higher
death rates in early adulthood than the generation that preceded it.

The Times analyzed nearly 60 million death certificates collected by the Centers for
Disease Control and Prevention from 1990 to 2014. It found death rates for non-
Hispanic whites either rising or flattening for all the adult age groups under 65 — a
trend that was particularly pronounced in women — even as medical advances
sharply reduce deaths from traditional killers like heart disease. Death rates for
blacks and most Hispanic groups continued to fall.

The analysis shows that the rise in white mortality extends well beyond the 45- to 54-
year-old age group documented by a pair of Princeton economists in a research paper
that startled policy makers and politicians two months ago.

While the death rate among young whites rose for every age group over the five years
before 2014, it rose faster by any measure for the less educated, by 23 percent for
those without a high school education, compared with only 4 percent for those with a
college degree or more.

The drug overdose numbers were stark. In 2014, the overdose death rate for whites
ages 25 to 34 was five times its level in 1999, and the rate for 35- to 44-year-old
whites tripled during that period. The numbers cover both illegal and prescription
drugs.

“That is startling,” said Dr. Wilson Compton, the deputy director of the National
Institute on Drug Abuse. “Those are tremendous increases.”

Rising rates of overdose deaths and suicide appear to have erased the benefits from
advances in medical treatment for most age groups of whites. Death rates for drug
overdoses and suicides “are running counter to those of chronic diseases,” like heart
disease, said Ian Rockett, an epidemiologist at West Virginia University.

In fact, graphs of the drug overdose deaths look like those of deaths
from a new infectious disease, said Jonathan Skinner, a Dartmouth
economist. “It is like an infection model, diffusing out and catching
more and more people,” he said

Yet overdose deaths for young adult blacks have edged up only slightly. Over all, the
death rate for blacks has been steadily falling, largely driven by a decline in deaths
from AIDS. The result is that a once yawning gap between death rates for blacks and
whites has shrunk by two-thirds.

“This is the smallest proportional and absolute gap in mortality between blacks and
whites at these ages for more than a century,” Dr. Skinner said. If the past decade’s
trends continue, even without any further progress in AIDS mortality, rates for
blacks and whites will be equal in nine years, he said.

There is a reason that blacks appear to have been spared the worst of the narcotic
epidemic, said Dr. Andrew Kolodny, a drug abuse expert. Studies have found that
doctors are much more reluctant to prescribe painkillers to minority patients,
worrying that they might sell them or become addicted.

“The answer is that racial stereotypes are protecting these patients from the
addiction epidemic,” said Dr. Kolodny, a senior scientist at the Heller School for
Social Policy and Management at Brandeis University and chief medical officer for
Phoenix House Foundation, a national drug and alcohol treatment company.

Not many young people die of any cause. In 2014, there were about 29,000 deaths
out of a population of about 25 million whites in the 25-to-34 age group. That
number had steadily increased since 2004, rising by about 5,500 — about 24 percent
— while the population of the group as a whole rose only 5 percent. In 2004, there
were 2,888 deaths from overdoses in that group; in 2014, the number totaled 7,558.
Mortality rates, said Mark D. Hayward, a professor of sociology at the University of
Texas at Austin, are one of the most sensitive measures of quality of life.

By that measure, said Anne Case, a Princeton economist, “there’s a real rumbling
that bad things are coming down the pike.” Dr. Case made the original observation
with her husband, the Nobel laureate Angus Deaton, in a published paper that
showed death rates for middle-aged whites rising in contrast to those in every other
rich country.

For young non-Hispanic whites, the death rate from accidental poisoning — which is
mostly drug overdoses — rose to 30 per 100,000 from six over the years 1999 to
2014, and the suicide rate rose to 19.5 per 100,000 from 15, the Times analysis
found.

For non-Hispanic whites ages 35 to 44, the accidental poisoning rate rose to 29.9
from 9.6 in that period. And for non-Hispanic whites ages 45 to 54 — the group
studied by Dr. Case and Dr. Deaton — the poisoning rate rose to 29.9 per 100,000
from 6.7 and the suicide rate rose to 26 per 100,000 from 16, the Times analysis
found But deaths from the traditional killers for which treatment has greatly
improved over the past decade — heart disease, H.I.V. and cancer — went down.

Drug abuse, of both illegal drugs like heroin and prescription painkillers, has become
a part of the American political discourse as never before in this country, with some
presidential candidates, including Jeb Bush and Carly Fiorina, telling stories of
addiction in their own families.

Sad stories abound.

Maline Hairup died of a heroin overdose on Aug. 24, 2014. She was 38 and a
Mormon, engaged to be married in the Salt Lake City Temple, near her home. Her
religion taught her to spurn addictive substances — no alcohol, no caffeine. But that
night, after years of taking prescription narcotics for chronic pain complicated by
mental illness, she tried heroin, her sister Mindy Vincent said. Ms. Vincent believes it
was the only time her sister used that drug.

There are men like Steve Rummler, who lived in Minnesota and died of a heroin
overdose at age 43, taking the drug after becoming addicted to OxyContin, which was
initially prescribed for a back injury. “He didn’t understand the risks,” said his
mother, Judy Rummler.

Researchers are struggling to come up with an answer to the question of why whites
in particular are doing so poorly. No one has a clear answer, but researchers
repeatedly speculate that the nation is seeing a cohort of whites who are isolated and
left out of the economy and society and who have gotten ready access to cheap heroin
and to prescription narcotic drugs.
“There are large numbers of people who never get established in the economy, who
live outside family relationships and are on the edge of poverty,” Dr. Hayward said.
Many end up taking prescription narcotics, he added.

“Poverty and stress, for example, are risk factors for misuse of prescription
narcotics,” Dr. Hayward said.

Eileen Crimmins, a professor of gerontology at the University of Southern California,

said the causes of death in these younger people were largely social — “violence and
drinking and taking drugs.” Her research shows that social problems are
concentrated in the lower education group.

“For too many, and especially for too many women,” she said, “they are not in stable
relationships, they don’t have jobs, they have children they can’t feed and clothe, and
they have no support network.”

“It’s not medical care, it’s life,” she said. “There are people whose lives are so hard
they break.”

How the Epidemic of Drug Overdose

Deaths Rippled Across America
UPDATE The number of overdose deaths reached 64,000 people in 2016, but county
data is not yet available.
Deaths from drug overdoses jumped in nearly every county across the United States,
driven largely by an explosion in addiction to prescription painkillers and heroin.

Some of the largest concentrations of overdose deaths were in Appalachia and the
Southwest, according to county-level estimates released by the Centers for Disease
Control and Prevention.

The number of these deaths reached 52,404 people in 2015, or the equivalent of
about 145 Americans every day.

Deaths from overdoses are

reaching levels similar to the
H.I.V. epidemic at its peak.
The death rate from drug overdoses is climbing at a much faster pace than other
causes of death, jumping to an average of 16 per 100,000 in 2015 from six per
100,000 in 1999.

The trend is now similar to that of the human immunodeficiency virus, or H.I.V.,
epidemic in the late 1980s and early 1990s, said Robert Anderson, the C.D.C.’s chief
of mortality statistics.
H.I.V. deaths rose in a shorter time frame, but their peak in 1995 is similar to the
high point of deaths from drug overdoses reached in 2014, Mr. Anderson said. H.I.V.,
however, was mainly an urban problem. Drug overdoses cut across rural-urban
boundaries.
In fact, death rates from overdoses in rural areas now outpace the rate in
large metropolitan areas, which historically had higher rates.
Drugs deaths have skyrocketed in New Hampshire. In 2014, 326 people died from an
overdose of an opioid, a class of drugs that includes heroin and fentanyl, a painkiller
100 times as powerful as morphine.

Nationally, opioids were involved in more than 61 percent of deaths from overdoses
in 2014. Deaths from heroin overdoses have more than tripled since 2010 and are
double the rate of deaths from cocaine.

In New Hampshire, which holds this year’s first presidential primary, residents have
repeatedly raised the issue of heroin addiction with visiting candidates.

“No group is immune to it — it is happening in our inner cities, rural and affluent
communities,” said Timothy R. Rourke, the chairman of the New Hampshire
Governor’s Commission on Alcohol and Drug Abuse.

Most of the deaths from overdose in the state are related to a version of fentanyl.
“Dealers will lace heroin with it or sell pure fentanyl with the guise of being heroin,”
Mr. Rourke said.

But fentanyl can be deadlier than heroin. It takes much more naloxone, a drug that
reverses the effects of an opioid overdose, to revive someone who has overdosed on
fentanyl.

Mr. Rourke said that high death rates in New Hampshire were symptomatic of a
larger problem: The state is second to last, ahead of only Texas, in access to
treatment programs. New Hampshire spends $8 per capita on treatment for
substance abuse. Connecticut, for example, spends twice that amount.

In New Mexico, drug addiction is

being passed to the next generation
While New Mexico has avoided the national spotlight in the current wave of opioid
addiction, it has had high death rates from heroin overdoses since the early 1990s.

Heroin addiction has been “passed down from generation to generation in small
cities around New Mexico,” said Jennifer Weiss-Burke, executive director of Healing
Addiction in Our Community, a nonprofit group formed to curb heroin addiction.
“I've heard stories of grandparents who have been heroin users for years, and it is
passed down to younger generations; it’s almost like a way of life.”

Dr. Michael Landen, the state epidemiologist, said the state recently began grappling
with prescription opioids. Addictions have shifted to younger people and to more
affluent communities.
Ms. Weiss-Burke, whose son died from a heroin overdose in 2011, said it was much
harder to treat young people. “Some young people are still having fun and they don’t
have the desire to get sober, so they end up cycling through treatment or end up in
jail,” she said.

Her center recently treated a 20-year-old man who was sober for five months before
relapsing, then relapsed several more times after that.

“When you go right back to the same environment, it’s hard to stay clean,” she said.
“Heroin craving continues to haunt a person for years.”

A Strong Case Against a Pesticide

Does Not Faze E.P.A. Under Trump
Some of the most compelling evidence linking a widely used pesticide to
developmental problems in children stems from what scientists call a “natural”
experiment.

Though in this case, there was nothing natural about it.

Chlorpyrifos (pronounced klor-PYE-ruh-fahs) had been used to control bugs in

homes and fields for decades when researchers at Columbia University began
studying the effects of pollutants on pregnant mothers from low-income
neighborhoods. Two years into their study, the pesticide was removed from store
shelves and banned from home use, because animal research had found it caused
brain damage in baby rats.

Pesticide levels dropped in the cord blood of many newborns joining the study.
Scientists soon discovered that those with comparatively higher levels weighed less at
birth and at ages 2 and 3, and were more likely to experience persistent
developmental delays, including hyperactivity and cognitive, motor and attention
problems. By age 7, they had lower IQ scores.

The Columbia study did not prove definitively that the pesticide had caused the
children’s developmental problems, but it did find a dose-response effect: The higher
a child’s exposure to the chemical, the stronger the negative effects.

That study was one of many. Decades of research into the effects of chlorpyrifos
strongly suggests that exposure at even low levels may threaten children. A few years
ago, scientists at the Environmental Protection Agency concluded that it should be
banned altogether.

Yet chlorpyrifos is still widely used in agriculture and routinely sprayed on crops like
apples, oranges, strawberries and broccoli. Whether it remains available may become
an early test of the Trump administration’s determination to pare back
environmental regulations frowned on by the industry and to retreat from food-
safety laws, possibly provoking another clash with the courts.
In March, the new chief of the E.P.A., Scott Pruitt, denied a 10-year-
old petition brought by environmental groups seeking a complete
ban on chlorpyrifos. In a statement accompanying his decision, Mr.
Pruitt said there “continue to be considerable areas of uncertainty”
about the neurodevelopmental effects of early life exposure to the
pesticide.
Even though a court last year denied the agency’s request for more time to review the
scientific evidence, Mr. Pruitt said the agency would postpone a final determination
on the pesticide until 2022. The agency was “returning to using sound science in
decision-making — rather than predetermined results,” he added.
Agency officials have declined repeated requests for information detailing the
scientific rationale for Mr. Pruitt’s decision.

Lawyers representing Dow and other pesticide manufacturers have also

been pressing federal agencies to ignore E.P.A. studies that have found chlorpyrifos
and other pesticides are harmful to endangered plants and animals.

A statement issued by Dow Chemical, which manufactures the pesticide, said: “No
pest control product has been more thoroughly evaluated, with more than 4,000
studies and reports examining chlorpyrifos in terms of health, safety and
environment.”

A Baffling Order

Mr. Pruitt’s decision has confounded environmentalists and research scientists

convinced that the pesticide is harmful.

Farm workers and their families are routinely exposed to chlorpyrifos, which leaches
into ground water and persists in residues on fruits and vegetables, even after
washing and peeling, they say.

Mr. Pruitt’s order contradicted the E.P.A.’s own exhaustive scientific analyses, which
had been reviewed by industry experts and modified in response to their concerns.

In 2015, an agency report concluded that infants and children in

some parts of the country were being exposed to unsafe amounts of
the chemical in drinking water, and to a dangerous byproduct.
Agency researchers could not determine any level of exposure that
was safe.
An updated human health risk assessment compiled by the E.P.A. in November
found that health problems were occurring at lower levels of exposure than had
previously been believed harmful.
Infants, children, young girls and women are exposed to dangerous levels of
chlorpyrifos through diet alone, the agency said. Children are exposed to levels up to
140 times the safety limit.

“The science was very complicated, and it took the E.P.A. a long time to figure out
how to deal with what the Columbia study was saying,” said Jim Jones, who ran the
chemical safety unit at the agency for five years, leaving after President Trump took
office.

The evidence that the pesticide causes neurodevelopmental damage to children “is
not a slam dunk, the way it is for some of the most well-understood chemicals,” Mr.
Jones conceded. Still, he added, “very few chemicals fall into that category.”

But the law governing the regulation of pesticides used on foods doesn’t require
conclusive evidence for regulators to prohibit potentially dangerous chemicals. It errs
on the side of caution.

The Food Quality Protection Act set a new safety standard for pesticides and
fungicides when it was passed in 1996, requiring the E.P.A. to determine that a
chemical can be used with “a reasonable certainty of no harm.”
The act also required the agency to take the unique vulnerabilities of young children
into account and to use a wide margin of safety when setting tolerance levels.

Children may be exposed to multiple pesticides that have the same toxic mechanism
of action at the same time, the law noted. They’re also exposed through routes other
than food, like drinking water.

Environmental groups returned last month to the United States Court of Appeals for
the Ninth Circuit, asking that the E.P.A. be ordered to ban the pesticide. The court
has already admonished the agency for what it called “egregious” delays in
responding to a petition filed by the groups in 2007.

The E.P.A. responded on April 28, saying it had met its deadline when Mr. Pruitt
denied the petition.

Erik D. Olson, director of the health program at Natural Resources Defense Council,
one of the groups petitioning the E.P.A. to ban chlorpyrifos, disagreed.

“The E.P.A. has twice made a formal determination that this chemical is not safe,”
Mr. Olson said. “The agency cannot just decide not to act on that. They have not put
out a new finding of safety, which is what they would have to do to allow it to
continue to be used.”

Devastating Effects

Chlorpyrifos belongs to a class of pesticides called organophosphates, a diverse group

of compounds that includes nerve agents like sarin gas.
It acts by blocking an enzyme called cholinesterase, which causes a toxic buildup of
acetylcholine, an important neurotransmitter that carries signals from nerve cells to
their targets.

Acute poisoning with the pesticide can cause nausea, dizziness,

convulsions and even death in humans, as well as animals.
But the scientific question has been whether humans, and especially small children,
are affected by chronic low-level exposures that don’t cause any obvious immediate
effects — and if so, at what threshold these exposures cause harm.

Scientists have been studying the impact of chlorpyrifos on brain development in

young rats under controlled laboratory conditions for decades. These studies have
shown that the chemical has devastating effects on the brain.

“Even at exquisitely low doses, this compound would stop cells from dividing and
push them instead into programmed cell death,” said Theodore Slotkin, a scientist at
Duke University Medical Center, who has published dozens of studies on rats
exposed to chlorpyrifos shortly after birth.

In the animal studies, Dr. Slotkin was able to demonstrate a clear cause-and effect
relationship. It didn’t matter when the young rats were exposed; their developing
brains were vulnerable to its effects throughout gestation and early childhood, and
exposure led to structural abnormalities, behavioral problems, impaired cognitive
performance and depressive-like symptoms.

And there was no safe window for exposure. “There doesn’t appear to be any period
of brain development that is safe from its effects,” Dr. Slotkin said.

Manufacturers say there is no proof low-level exposures to chlorpyrifos causes

similar effects in humans. Carol Burns, a consultant to Dow Chemical, said the
Columbia study pointed to an association between exposure just before birth and
poor outcomes, but did not prove a cause-and-effect relationship.

Studies of children exposed to other organophosphate pesticides, however, have also

found lower IQ scores and attention problems after prenatal exposure, as well as
abnormal reflexes in infants and poor lung function in early childhood.

“When you weigh the evidence across the different studies that have looked at this, it
really does pretty strongly point the finger that organophosphate pesticides as a class
are of significant concern to child neurodevelopment,” said Stephanie M. Engel, an
associate professor of epidemiology at University of North Carolina at Chapel Hill.

Dr. Engel has published research showing that exposure to organophosphates during
pregnancy may impair cognitive development in children.

But Dr. Burns argues that other factors may be responsible for cognitive impairment,
and that it is impossible to control for the myriad factors in children’s lives that affect
health outcomes. “It’s not a criticism of a study — that’s the reality of observational
studies in human beings,” she said. “Poverty, inadequate housing, poor social
support, maternal depression, not reading to your children — all these kinds of
things also ultimately impact the development of the child, and are interrelated.”

While animal studies can determine causality, it’s difficult to do so in human studies,
said Brenda Eskenazi, director of the Center for Environmental Research and
Children’s Health at the University of California, Berkeley.

“The human literature will never be as strong as the animal literature, because of the
problems inherent in doing research on humans,” she said.

With regard to organophosphates, she added, “the animal literature is very strong,
and the human literature is consistent, but not as strong.”

If the E.P.A. will not end use of the pesticide, consumer preferences may.

In California, the nation’s breadbasket, use of chlorpyrifos has been declining, Dr.
Eskenazi said. Farmers have responded to rising demand for organic produce and to
concerns about organophosphate pesticides.

She is already concerned about what chemicals will replace it. While
organophosphates and chlorpyrifos in particular have been scrutinized, newer
pesticides have not been studied so closely, she said.

“We know more about chlorpyrifos than any other organophosphate; that doesn’t
mean it’s the most toxic;” she said, adding, “There may be others that are worse
offenders.”