Dr. Adrienne Buffaloe on Pesticides at Hearing Held by Rep. Ackerman

Transcript of testimony of Dr. Adrienne Buffaloe on the effects of pesticides on people, particularly malathion and pyrethroids based on her own evaluations of her patients, before hearings held by a Congressional panel chaired by Congressional representative Gerald Ackerman, of Queens NY.

DR. ADRIENNE BUFFALOE: I am a physician in New York, and I had the good fortune of being the medical director of one of the country’s four chemical-free environmental medical centers, which treated chronic exposures to chemicals as well as allergies.

Routinely, I evaluated patients for exposure to pesticides, solvents, formaldehydes, and a wide variety of chemicals thought to be safe, but, in fact, are not safe for human health.

Because our center held such a special position in New York in medicine, when the pesticide spraying began, those who knew about our center called us for an explanation and for guidance on the possible health consequences of the spraying and what they might do to protect themselves.

We were more than happy to give that information, we were able to give it best to those callers who were already patients at our center, but we got a lot of calls from people who I didn’t know who weren’t patients of the center but who were experiencing the ill effects of pesticide exposure either from the truck spraying or from the aerial spraying.

I was surprised and a little bit appalled at first that there was no mechanism by any public agency to collect these health complaints and then register them so there could be a public health understanding and a strategy to modify the spraying or to eliminate it.

I called the Office of Emergency Management and later the New York City Department of Health early in September in the process, and neither were equipped or prepared to register complaints about the spraying.

Like many of the patients that I directed to call there as well, I was told that they were only trained to take complaints about the mosquito bite and there really was not any registry for any health complaints.

After a four-hour conversation with the Department of Health, it was then determined that the New York City Poison Center would be the agency to record the health complaints. And every single person who called our center from that date forward, even when we took formal complaints on forms that I had designed for the center, we also instructed those callers to call the New York City Poison Center so that they would have the same data that we had. I would assume that the callers did that.

When we had patients come in our center who were sick before they left the center, they had to call the Poison Center from our medical center so we could be certain that the Poison Center also had that information.

So there was every attempt on our part to have a city agency involved, to some extent, because we knew that there were many people in the city who didn’t know our center existed, and we wanted to make sure that their health complaints were registered.

I want to talk a little bit about the virus and a lot about the spraying. We know that there were four reported deaths in New York City and three deaths outside New York City from the virus. Although there is not a doctor I know of who would ever want to see anyone die from a viral infection, we do know that every year more people die from influenza than will ever die from West Nile virus.

On September 4th in a press release from the Office of Emergency Management when they thought it was St. Louis encephalitis, that press release reads that, “Prior outbreaks resulted in one in one thousand mosquitoes being infected. Most people bitten by infected mosquitoes did not get sick, will recover fully after a mild illness.”

And then later on on September 24th when the virus was reclassified, the press release was changed to say that, “Generally, West Nile virus causes a milder disease in humans than even St. Louis encephalitis. Most people who are infected have no symptoms whatsoever or may experience a fever and headache before fully recovering.”

This was in stark contrast to what I saw on television, where I would turn on the news in the evenings when I got home from the center at various times and I saw helicopters flying over the city and people spraying, and all of this spraying for something that was a very mild, almost innocuous virus.

As a physician, I couldn’t understand the hype over it, and I certainly couldn’t understand the decision by the city to expose eight million people in New York City to a combination of chemicals known to cause health problems.

Now, there has been a lot of talk about Malathion, and I am going to speak about that first. We know that Malathion belongs to the category of chemicals called organophosphate, we know that it’s dangerous and poisonous.

There is a packet in front of you. But even the “New York City Handbook on Biochemical Issues” that is given to the Fire Department and policemen and other people who are employed by the city lists Malathion as a toxic chemical. So for anyone to come from the city and say it’s entirely harmless is ignoring the training manual that they use and issue to their own employees.

The exact product that was used is called Pipanol ULV. ULV has an important tag on it, it means ultra-low volume, which means that they are using a small volume of the pesticide to spray, and that small volume means that the poison capacity is greater per amount. It’s not diluted, it’s ultra.

I think we heard the applicator to it testify earlier that this was released by aircraft in very, very small droplets. The smaller the droplets, the deeper through the respiratory tract these droplets penetrate. The big droplets, they might not get into their nose or their mouth, but the smaller you get, the more droplets penetrate into the respiratory tract.

These droplets are very, very dangerous. It penetrates deeply into the body, and it increases the likelihood that the body will absorb the chemical as well as absorption into the skin.

The Malathion that was used was 96 to 97 percent pure Malathion. To a lay person, that might suggest that it is really pure, but pure Malathion really is 99 percent pure. So the three or four percent of other stuff, which is usually Iso-Malathion (phonetic), (inaudible) are two additives that are more toxic than the Malathion themselves.

As we heard before, the company —

CONGRESSMAN ACKERMAN: Can I just ask if the presenters would later just speak to the official stenographer to give him these long, Latin or multi-syllabic chemicals so that we don’t have to burden him with trying to figure it out and put that in there.

DR. ADRIENNE BUFFALOE: No problem.

Back to Malathion, the manufacturer’s own sheets state what the health effects are. There is a note on those data sheets to the doctors informing the doctors that Pipanol and Malathion can cause respiratory, cardiac and neurological dysfunction, including coma, muscle spasms, labor breathing, frothing of the mouth and nose, nausea, vomiting, headache, and weakness.

I brought a box with me called the “MERCK Index,” and it’s produced by MERCK Pharmaceuticals in its 12th edition. It lists the problematic symptoms of thousands of chemicals, it doesn’t pick on any one chemical over another. Malathion is listed in the “MERCK Index” as being toxic with those symptoms as well as ataxia, meaning people are not able to walk in straight lines, anorexia, losing your appetite, dizziness and confusion.

These symptoms are important, because as I will talk about later, these are some of the exact health complaints that callers called to the center to register without the advantage of reading the “MERCK Index.” Hazards of acute exposure to Malathion are, if you are exposed to Malathion, you may have symptoms at that moment, you may not have symptoms at that moment, but the next time you are exposed to any organophosphate, you may go into chronic symptoms without any prior notice.

So people who didn’t get sick from the first spraying, in eight months from now, you walk into someone’s backyard, you see a little concentrate of organophosphate in their flower garden, and they will become sick from that and never realize that the fall 1999 spraying sensitized this.

We know that it’s toxic to fish. We know that in a very good study published in Israel when they did aerial spraying, they actually found the metabolites of organophosphates in the residents’ urine more than half a mile away from the spraying. So this drift is a very important factor. And the smaller the particle, the farther it will drift.

So to say that this was not sprayed over water, I would think that it would be impossible for it not to reach water, especially in the northern areas of Manhattan where the width of the island is probably not much more than a half a mile.

Most doctors know how to recognize an acute organophosphate exposure, liquid coming out of their patients through urinating, coughing of the mouth, secretion of the nose, and they start tearing. But that’s not what happens really with lower exposure. That’s what happens with massive, massive exposure.

There are basically four presentations that occur from Malathion exposure. One is immediate, it causes the secretions, but it […] paralysis.

There is an intermediate exposure which occurs one to four days after the exposure to the pesticide. Patients develop weakness or paralysis of their proximal muscles, meaning their thighs and their shoulders, or their cranial nerves, meaning their eyelids, facial droops, inability to smile symmetrically, et cetera. If they went to a neurologist at that time, the neurologist would be able to document abnormal nerve-conduction studies.

Long-term effects called delayed presentation actually has a name in the toxicology literature. It’s called OPIDN, organophosphate induced delayed neuropathy. It occurs one to three weeks after the exposure, and patients develop weakness, imbalance, strange sensations, which are called paresthesias, and (inaudible) abnormalities, meaning that their hands and their feet selectively can develop either numbness or tingling when the rest of their body might be free from any symptom.

We think that this delayed presentation is probably caused by an inhibition of what we call NTE, neuropathy target esterase. (Inaudible) organophosphate exposure decreased cholinesterase, but you never hear anyone talk about NTE, which is a separate inhibition of a different enzyme in the body. It can cause very, very long-term effects from organophosphate exposure, and you can have symptoms from exposure when a person’s cholinesterase level is normal, and we think that NTE is involved in that.

The long-term effects happen weeks to months after the exposure, and one reason is because Malathion is fat-soluble and it gets stored in fat tissues. You can have long-term nerve damage that may never clear up even after your cholinesterase levels, which is a marker, return to normal.

Specific illnesses that have been reported in the medical literature for long-term effects of Malathion are death, which I’m not sure was something that was announced by the New York City Department of Health, that Malathion exposure can kill and do kill, nerve disease in the arms and legs, memory impairment, confusion, personality changes, depression and health disorders. And these can be lifelong after an initial exposure.

Little attention has been given to Resmethrin, and I want to speak about that, because Resmethrin belongs to the category of Pyrethroid pesticides and Resmethrin was sprayed from trucks in Manhattan and some of the other boroughs.

The Resmethrin that was chosen for New York City is Scourge, and it was utilized in three different concentrations; one and a half percent, four percent, and eighteen percent.

And, with repeated calls by me to the Office of Emergency Management, they were never able to tell me why they would choose eighteen percent on a given day versus one and a half percent.

On the sheet for Scourge, it says the symptoms are transient headaches, dizziness, stuffy or runny nose and scratchy throat. You have to remember that a company is not going to put on its own sheets anything that it is not really pressed to do.

If we look at the “MERCK Index,” which is a general reference book for Pyrethrins or Pyrethroids, we see that it causes severe allergy attacks in sensitive people, dermatitis, asthma, rhinitis, anaphylactic reactions, numbness of the lips and tongue, sneezing, vomiting, diarrhea, ringing in the ears and restlessness; it can also cause convulsions, which is seizures, incoordination, and death from respiratory paralysis.

To say that these pesticides are perfectly safe is an outrage. With Resmethrin or Pyrethroid, it’s particularly problematic, because the first death from a Pyrethroid exposure was reported right here in New York City in 1994, just five years before the spraying, by the current director of the New York City Poison Center. And that article has been given to the legislators, and it is in your packet. This death was as a result of a very brief exposure to Pyrethroid.

You can imagine the dangers of breathing these compounds —

CONGRESSMAN ACKERMAN: I’m sorry to interrupt you, you are saying the current director in ’94 reported the first death himself?

DR. ADRIENNE BUFFALOE: Yes. He is the co-author of the article.

CONGRESSMAN ACKERMAN: So the director knows that this chemical can kill and did not share that with — maybe I missed it. Did he share that with anyone?

DR. ADRIENNE BUFFALOE: I have no information that he shared it, no. But it is a fact, and you have the article in front of you.

It’s Mayor Giuliani; Howard Safir, Commissioner, New York City Police Department; Jerome Hauer, Director of the Mayor’s Office of Emergency Management; and Thomas Vanessant, Commissioner of New York Fire Department. Those are the names that are on there. I don’t know if they actually produced it —

ASSEMBLYMAN McLAUGHLIN: For the stenographer, the names that she mentioned, Mayor Giuliani, Commissioner Safir, Thomas Vanessant, the Commissioner of the Fire Department, are the names that are listed in the New York City “Chem Bio Handbook,” where the City of New York in this handbook says that Malathion is quite the opposite of safe.

The presenter was just reading off the names to our Administration who are the authors of that handbook.

You can proceed now.

DR. ADRIENNE BUFFALOE: Some of the issues with Resmethrin are whether you are using one and half percent or four percent or eighteen percent. There are the other percentages that are in other ingredients, and those other ingredients are problematic, especially one ingredient called (inaudible) butoxide, because it actually increases the toxicity of the Resmethrin.

So the other ingredients that are added to the compound makes the primary compound, or the target compound, even more poisonous than it would be if it was just mixed in water.

A further problem with these chemicals is that there was aerial spraying and ground spraying during the same period of time. And so, you had a person breathing two different compounds, each of which poisons in a different way, but whose clearance through the body goes through a similar mechanism.

So it’s like taking a funnel, a two-cup funnel, and pouring in one compound and then pouring in a second one, where the second compound decreases the first compound’s flowing through the funnel.

So as you add different compounds from different classifications, you actually impede the body’s ability to clear either compound, so that they will be able to stay in the body’s bloodstream longer and have a longer mechanism of action on the body.

I want to talk a little bit about some of the people who got sick, because this is really the reason why I came to testify.

One was a patient of mine who was doing well until the spraying. She had what we call a delayed presentation. So a few weeks after the spraying had started, we immediately got her out of New York, meaning because of the spraying, she had to leave her home. So we got her out of New York and she went to upstate New York. She would come back to New York only to do errands and visit.

While she traveled back to upstate New York, she developed a right-face droop, which is a cranial nerve condition consistent with delayed reaction to Malathion. She went to her local emergency department, and they did not know what it was. They saw the facial droop, they were concerned, but in a few hours, it cleared, and they sent her home. She didn’t understand what was wrong but contacted the center and felt better later that night.

When she returned to New York, the facial droop returned. We had her sent to one of the local hospitals, and she ended up being hospitalized there for more than three weeks. We did draw cholinesterase levels on her, which is one of the biological markers of organophosphate exposure, and her cholinesterase levels were decreased.

She had such severe nervous system dysfunction that by the time they could get her out of the hospital — I was not her doctor in the hospital but consulted with him extensively — she got discharged on 150 milligrams of steroids a day, which is an extremely high number. They weren’t able to get her off of it in order to have the information in her body, the nerve dysfunction in her body, quiet down to the point where she could stand up and walk out of the hospital.

It’s five months after the spraying, she is not back to normal, it is questionable that she will return to normal, although she is better. And right now, she is out of state, and I will not have her come back to New York if the spraying is going to resume. I feel the next round of this exposure will pretty much do her in.

We’ve gotten calls from a wide variety of callers, different boroughs, different age groups, different ethnicities, and although I started entering them into a spreadsheet, and you have a couple of pages in your handouts, I just want to read the reports we got about children and about adults, some of whom have no past medical history whatsoever.

So it’s not true that the spray is just problematic for people who have asthma already or for people who have chemical sensitivity already, although New York City boasts the highest asthma rate in the country, which would make spraying of these pesticides even more problematic. And one of every three in a general population is sensitive to ambient chemicals. So we have certain parts of the population that are predisposed to problems from this, but we also have medical complaints reported from people with no past medical history.

We had a person called initial S.T.B. from Manhattan complaining of dizziness, sore throat, eye irritation, numbness in tongue and lips, respiratory tightness, sleepiness, loss of appetite and anxiety.

There was a family that reported from Whitestone, the mother had burning on her skin, pulling and itching and stinging feelings and thickening of the skin on her arms. Her seven-year-old child had chronic fatigue, skin lesions, and could not go to school, and also had intermittent fevers. Her ten-year-old child became fatigue, feverish, and also couldn’t go to school. She ended up at the time writing a letter to the children’s dean at their school, explaining that the children had gotten sick from the pesticide spraying and that’s why they aren’t in school.

From Long Beach, someone who developed red, burning sensation on the skin; from Little Neck, someone who became fatigued, nauseated and weak; Whitestone, burning, itching; The Bronx, dizzy, nervous, weaker, lost one week from work; another person who became severely weak, was unable to concentrate and lost a day of work.

CONGRESSMAN ACKERMAN: Doctor, the last thing we want to do is rush you because this is important. We are in somebody’s building, and we have some time constraints.

Could you just give us the number of complaints. That will pretty much flavor it for us, give us the gist of it.

DR. ADRIENNE BUFFALOE: We had about 40 complaints to our center, all of whom we have followed up on or attempted to. We have another 60 complaints that were sent to us by other groups in the community who were the recipients of complaints as well. So right now, we have about 100 complaints.

The very interesting part is, as we started following up with some of these callers, it was almost like going on a treasure hunt, because each person could give us like five more names of someone else they knew in their community or at work who had gotten sick as well.

So from those 100, I think it’s safe to say that we generated about 500. We need a (inaudible) to be able to follow up and categorize these and put these in a database. That would make sense.

The other thing I want to say quickly is, under the New York City Department of Health, there is a Division of Environmental Health Services whose mission statement is to track environmental exposure and survey them and give support to those who are affected. And as far as I know, they have not had no position on this whole set of issues whatsoever.

So the city agencies that are kind of delegated to do this haven’t really done it, and it has fallen to a private agency that isn’t staffed to do the follow-up really necessary to document these cases.

ASSEMBLYMAN McLAUGHLIN: Perhaps part of the plan.

DR. ADRIENNE BUFFALOE: The other thing I want to mention as a finishing remark, the Florida spraying in 1998, which was reported late in ’99, have numbers that pretty much document the 100 cases that we have.

It reports about 72 percent of women got sick, and that’s what we have, and a smaller percentage of children who became ill. And so, our findings are very, very similar to theirs.

CONGRESSMAN ACKERMAN: You don’t mean to indicate 72 percent of women got sick, of the 72 percent of people who got sick, within that high percent, 72 percent were women?

DR. ADRIENNE BUFFALOE: That’s correct. Of those 123 cases that were reported as probable or possible Malathion-related illnesses, of those 123 cases, about 72 percent of them were women.

The difference is the surveillance for the illness — and I just want to read this short paragraph.

“Reports of potential adverse health effects from the spraying were solicited by State Health and Agriculture Authorities and collected through telephone hotlines maintained by the Florida Poison Information Network. The public was advised of the pesticide use and the hotline number through public meetings hosted by federal and state agricultural officials, news articles, and radio and television reports.”

I believe if that had been done proactively in New York, you would get a much more accurate representation of what the actual illnesses were that were caused by the pesticide spraying, than those independently collected by a private medical center.

ASSEMBLYMAN McLAUGHLIN: If I could just say one thing. I would like to thank the Congressman and the audience for their appearance today. I, again, would like to thank the Congressman for his response to my call when I placed it to him.

There are many who, to satisfy their own agenda, would claim that what we are trying to go through here today is an exercise that originates from some kind of political agenda. We were very careful today, although they couldn’t stay for the afternoon, to put together a bipartisan panel.

While we certainly are just as concerned in regard to the outbreak of encephalitis, which was uncovered again in our community here, Flushing Hospital, if just one person became seriously ill when we may have alternatives or other ways that we can contain and prevent this outbreak from occurring again, or make it less likely to occur to the extent that it did last year, then what you are presenting here to us today makes a very powerful statement; because we’ve put at risk hundreds of thousands of our constituents in our respective districts, and the record is quite clear from private entities, such as yours, and the other presenter, Dr. Simon, who sits alongside you, that these, in fact, are the facts.

We at the same time, as the Congressman pointed out earlier, have a Health Department that maintains the most precise records, and yet, we have no database that takes all of these findings and makes that information available to us so that we can move forward in an intelligent fashion.

So I just want to say we want to thank you, and one of our constituents, not my constituent, but Joyce Sheppard, who is not here today. It’s people like her and then dedicated professionals like yourself that took the time to show an interest that really give the Congressman and I perhaps as much information as any governmental agency can provide us at this time, and we are very grateful for that.

DR. ADRIENNE BUFFALOE: What I hope would be one of the outcomes of this whole practical experience in New York would be Congressional hearings. The reason I say that is I think it has really crossed city, state and federal borders about the misinformation that was given to the public; as we saw in the video, the lack of truth in reporting that was given about these pesticides, even in people who co-authored articles describing the injury.

And tragically, because of New York’s lead, there are other states that are spraying because New York said it was fine, and I think that is as much a tragedy as anything.

It’s going across state borders now, and I think just a very comprehensive truth finding set of meetings and investigations is really required to stop this insanity of spraying in the view of very minimal health threats.

THE AUDIENCE: Applause.

ASSEMBLYMAN McLAUGHLIN: What’s interesting is we implemented regulations that cost hundreds of millions of dollars for good reason when we found that the soil was contaminated under the Throgs Neck and Whitestone Bridges from the lead chips that fell; but yet, at the same time, we won’t invest maybe five percent of that money to create a database to record the kind of information that you’ve brought forward today.

That certainly will be one of the outcomes of this process here today, request to the proper level of government to mandate that this information is recorded accurately and we can present it to the legislature or a body, such as the one that convened here today, so that we can make recommendations to the legislature.

CONGRESSMAN ACKERMAN: Let me say this before Dr. Simon makes his presentation.

I associate myself with the very remarks of my colleague, Assemblyman Brian McLaughlin, who has steadfastly persisted in this effort and whose organization, whose ability and talent are quite evident here today, and I just want to speak of his leadership and this effort.

Indeed, we joke, but we mentioned Joyce Sheppard, who we kid about all the time, because she also is so persistent. Those of you who know who we are talking about know what we are talking about.

It’s because of that citizen effort and the effort of people who are concerned and who are in the room with us now that causes the public spotlight and the pressure to be put on public officials to make sure that the right thing is consistently done.

One of the things that I’m concerned about within our democracy — and we have seen it evidenced during the course of our gathering of information right here today — is very often, when you have bureaucrats who make decisions or who go along with decisions, if the decisions seem to be problematic, they will circle the wagons, they will obfuscate, they will cloud, they will cover, they will stonewall, they will whitewash in order to CYA, as they call it in the business.

I think it’s very important that we have distinguished scientists, such as the two of you, who are not here on somebody’s payroll, but are here investing your own time, energy and effort so as to edify those of us who are concerned and the general public whose lives and health are at stake, for taking the time to share your knowledge and expertise with nothing to gain but good public policy. Those of us who have a serious interest in public policy appreciate and applaud your efforts and the expertise that you have provided us during the course of the last several weeks in getting prepared. We are not scientists, but we are serious about what our responsibilities are to the public.

It was disturbing to see some of the things that we saw today, which I think most of you who saw it understood basically what the maneuvering was all about; I was there from the beginning, but I didn’t do anything, it wasn’t my job. We heard a lot of that today.

I just want to add my accolades to those of Senator McLaughlin’s.

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