The green doctor 

Dr. Indra Frank marries medicine and environmentalism

Dr. Indra Frank marries medicine and environmentalism

As a hematopathologist, Indra Frank diagnoses diseases of the blood. Most pathologists go quietly about their business, documenting diseases without becoming especially curious about what causes them. For Frank, curiosity about the links between leukemia and pesticide exposure was too compelling to ignore, leading her to shift from the laboratory to the town square, from study to action. Still a doctor but now an activist, Frank is working to raise consciousness about the prevention of diseases with environmental causes.
Hematopathologist Indra Frank is working to raise consciousness about the prevention of diseases with environmental causes.

NUVO: When was your first awareness of the link between environmental contaminants and illness?

FRANK: I have always been aware of environmental issues and principles of conservation since they were an integral part of my family life growing up. My parents are both environmentalists. My awareness of the links between environmental degradation and human disease has come gradually. From my upbringing and then classes in biology, I developed a sense of being part of a species that is subject to all the laws of nature and also dependent on a healthy, functioning ecosystem.

NUVO: Were the links between disease and environmental factors mentioned in medical school?

FRANK: Some issues in environmental medicine were covered, like the associations between asbestos and certain cancers and air quality and asthma. I was aware of environmental effects on health, but I tended to separate my own medical career from my efforts for the environment. I contributed to many environmental groups and tried to live lightly on the Earth, but I had always thought of people active in environmental work as having expertise in ecology or some area of biology or perhaps regulatory issues. It has only been in the last year that I recognized how my own medical background could be put to work on environmental issues.

NUVO: Can you give an example of a patient case that illustrates the link between environmental degradation and human health?

FRANK: I will tell a story of many patients rather than a single patient since it is one that I have found especially disturbing. Just as I was finishing medical school I came across data on how many millions of pounds of pesticides were being spread on American soil each year [the current total is around 1.2 billion pounds per year]. I majored in biochemistry in college, and from that background I understood that living organisms on Earth all share a lot of their biochemistry. Chemicals intended to kill one organism, a weed or insect, will inevitably have effects on other organisms. I had also briefly studied pesticide toxicity to farm workers in medical school. So I began buying organically produced food and organic cotton clothing.

Then, in the mid 1990s, I heard an oncologist refer to the American Midwest as the “lymphoma belt.” She explained that the area had higher rates of lymphoma, and that pesticide exposure was thought to be a cause. The comment touched me both because of my sense about pesticides and because my subspecialty is hematopathology, the diagnosis of lymphomas and leukemias.

Since then, I have seen more and more data in the medical literature showing an association between non-Hodgkins lymphoma and a variety of pesticides. There are also studies showing higher rates of miscarriage and birth defects in pregnant women exposed to pesticides. Also, risks for brain cancer and leukemia are higher in children exposed to pesticides like lawn chemicals or in-home insecticide sprays.

NUVO: Should parents pay special attention?

FRANK: For parents or parents-to-be it is important to know that children’s bodies are much more sensitive to contaminants. From conception on, their physiologic systems are attempting to build all of the structures necessary for a fully grown human body. Chemical contaminants can interfere with that development in much lower concentrations than it takes to affect adults.

Lead poisoning is a potential concern if you live in a house built prior to 1978. Consider having your home and your children tested for lead, and only paint or remodel such a home using a contractor who is certified in lead remediation. Sanding or scraping lead paint creates lead dust which causes lead poisoning.

NUVO: You have two daughters. What role does parenthood play in your concerns about health and the environment?

FRANK: Like any parent, I want my children to enjoy a healthy and happy life. I wish the same thing for their children and each successive generation. At the current rate of resource depletion and environmental degradation, I am concerned that our children and the future generations will see a diminishing quality of life. I think it has started already. When I was growing up, I remember drinking tap water without filtering and eating tuna without concern for mercury.

NUVO: The precautionary principle — the notion that we should err on the side of caution when deciding what chemicals are approved for use — has been adopted by the European Union. Should the United States?

FRANK: As a society we need to rethink our approach to chemical contaminants. It is estimated that more than 70,000 chemicals are being released into the environment and for most of them the health effects are unknown or poorly understood. Recent studies have documented that chemicals never meant for human consumption are present in our bodies. Some chemical contaminants are being inhaled, some unintentionally ingested and there are some substances that can be absorbed through skin.

NUVO: Such as?

FRANK: A striking example: the recent studies documenting a toxic flame retardant, PBDE [used on furniture and electronics], in the breast milk of American women. We are only beginning to learn what health effects the chemicals in our bodies might have. For some contaminants we have learned enough to be certain of their effect like tobacco smoke causing cancer or asbestos causing cancer. But for tobacco smoke and asbestos, our society had to suffer many deaths before that certainty was achieved. For the other chemicals we are being exposed to, wouldn’t it be better to act cautiously before people are harmed?

NUVO: Tell me about the movement among physicians nationwide in addressing environment-related health issues.

FRANK: There are a number of non-profit organizations focused on environment and health and there are university departments of environmental medicine doing research into the health effects of environmental conditions. Though many physicians are active in the cause, the day-to-day care of patients makes it difficult for those in clinical practice to participate in activism. Last fall, I got involved with Physicians for Social Responsibility, which has a nationwide program addressing issues of health and environment.

NUVO: Through the Hoosier Environmental Council, you are leading a Committee on Health and the Environment. What’s the agenda?

FRANK: The mission statement for the committee is to reduce environmental threats to public health in Indiana by raising awareness in the health community and among the public, by influencing public policy and by promoting solutions and prevention.

The contact list for the committee is now over 100 strong and includes 30 physicians, several nurses, members of the Indiana Public Health Association, members of the State Department of Health and at least one dentist. We meet monthly.

So far, the committee has focused on lead poisoning and mercury contamination. Both lead and mercury are irrefutably toxic and pose imminent threats to children. We are also working on bringing in speakers this fall, hosting continuing medical education, petitioning for lower mercury emissions in Indiana and publishing a brochure on environment and health in Indiana.

The next meeting of the Hoosier Environmental Council’s Health and the Environment Committee will be held at 1915 W. 18th St. Thursday, June 17 at 6 p.m. A light dinner including vegetarian option is available. To get involved, call HEC at 685-8800. Note: The interviewer is a board member of the Hoosier Environmental Council.

Polluting ourselves? Indra Frank’s advice on avoiding exposure To avoid exposure to chemical contaminants, Dr. Indra Frank recommends: • Eat organically grown foods • Avoid dry cleaning (or carefully ventilate newly dry cleaned items outdoors to avoid inhaling the perchloroethylene) • Avoid lawn chemicals containing herbicides or insecticides • Use insect traps rather than sprays or “bombs” in the home • Use filters for drinking and cooking water (the quality of bottled water varies dramatically with some being no better than tap water) • Check fish consumption advisories if you are going to eat fish. Most seafood, including canned tuna, contains mercury with the amount varying by species and many species are contaminated with PCBs. This applies to fish caught in Indiana as well as ocean-caught. —AL

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