ReThink Plastic

Institution: Public Health Institute
Investigator(s): Barbara Cohn, Ph.D., MPH, MCP - Marie Loverde,  - Sandra Curtis, BS, MS, PhD -
Award Cycle: 2016 (Cycle 22) Grant #: 22AB-1200 Award: $146,094
Award Type: CRC Pilot Award
Research Priorities
Etiology and Prevention>Prevention and Risk Reduction: ending the danger of breast cancer

This is a collaboration with: 22AB-1201 - 22AB-1202 -

Initial Award Abstract (2016)

Introduction:We will test an intervention to reduce the impact of environmental estrogens on breast cancer by reducing use of plastics. We judge that the scientific evidence linking environmental estrogens to breast cancer is strong enough to act. We choose plastics because they are common sources of environmental estrogens. This application is for a Community Research Collaboration pilot study that joins researchers from the Child Health and Development Studies (CHDS) with two community partners, the Participant Advisory Council (PAC) of the CHDS and the Plastics Pollution Coalition (PPC). The PAC are participants in the CHDS study, a 56 year study of three generations where we have studied the impact of early-life environmental exposures on breast cancer.  PPC is a community organization that advocates for reduction of plastic pollution. Together we plan to recruit family and friends of our PAC members to spread a message to reduce plastic use, a program called ReThink Plastic.

Questions:Will PAC members be able to recruit their own and other families to the ReThink Plastic program? Will these participants (Tier 1) change their knowledge, attitudes and behavior? Will Tier 1 participants spread the message to other friends and social contacts (Tier 2)? Will participants provide a blood sample before and after the ReThink Plasticprogram? Can we test these blood samples for changes in estrogen activity using a special test developed recently via past CBCRP support?

General methodology: Six PAC members will be trained about how to reduce exposure to plastics and how to spread the message to others. Each PAC member will be asked to recruit their family members plus two additional families. We estimate that 72 people will be recruited this way. These recruits will be asked to spread the message to others. Participants will be asked about their knowledge, attitudes and behaviors before and after ReThink Plastic, and they will be asked about who they talked to. We will collect blood samples from postmenopausal participants at a full-day “health fair” before and after ReThink Plastic so participants can drop in conveniently. We chose post-menopausal women to simplify evaluation of estrogenic activity in their blood in this pilot study. Blood specimens will be shipped to Dr. Shiuan Chen who will screen blood samples for baseline estrogenic activity and for changes after the program.

Innovative elements: As some chemicals are removed from plastics, others are being substituted creating an exposure emergency where product safety testing lags behind new products. Our proposed project avoids specifying a single chemical target. Instead we aim to reduce use of all plastics because most contain estrogenic chemicals. This innovative feature of our design avoids rapid obsolescence. For example, manufacturers have recently removed bisphenol A (BPA), an estrogenic chemical, from some plastics, replacing it with another chemical that may also be estrogenic. This change would make a BPA intervention too narrow and too late. But a plastics intervention would remain relevant. Targeting plastics rather than a single chemical greatly simplifies the intervention message, and increases the potential for compliance and dissemination. Thus this project is an innovative model for breast cancer prevention linked to the environment.

Community involvement: Elimination of plastics exposure is not possible in today’s world. Therefore ReThink Plastic will emphasize achievable goals regardless of social class such as microwaving food in glass containers. The close collaboration of the PAC and PPC in the message design will enhance relevance and compliance in the target population. The simple nature of the message will make it accessible to low literacy populations as compliance will not require interpreting plastic labeling numbers or advanced knowledge about which plastics are more or less toxic. The simplicity of the message will make it translatable later into the multiple languages that are represented in California. Avoiding a complex message will likely increase compliance and dissemination potential. Asking participants to spread the message to family and friends will spread the ReThink Plastic message to many people. We estimate that 6 PAC members can reach up to 300 people in this way.

Future Plans: This intervention will be modified for a full award application. Additional CHDS study participants will be trained to implement ReThink Plastic. Two geographic areas will be chosen to receive the intervention, one will receive the intervention first and the other will serve as a control community that will receive the intervention later after the post-intervention evaluation. Change in knowledge, behavior, attitudes, levels of estrogen activity and amount of message spread will be compared between the two communities.