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Comedian Amy Schumer’s recent statement about her battle with endometriosis has brought a much-needed voice to an under-addressed and unseen illness. “I’ve been in so much pain … this pain you can’t see,” she says, adding it is a “lonely disease” for women.

Endometriosis is a chronic disease in which tissue similar to the lining of the uterus grows outside the uterus, such as on the fallopian tubes, bowels or bladder. According to the World Health Organization, it can cause “severe, life-impacting pain,” and can lead to infertility. The disease afflicts millions of people with ovarian reproductive systems globally.

Reproductive diseases are linked to environmental contaminants such as endocrine-disrupting chemicals — parabens, plastics, xenoestrogens and pesticides all have hormone-disrupting compounds that can lead to health issues. Decades of research suggest links between these environmental toxins and diseases like endometriosis, PCOS, breast cancer and ovarian cancer.

In Canada, the Canadian Environmental Protection Act (CEPA) regulates critical environmental issues directly related to health. It has not been updated since 1999, and therefore 24 years of updated scientific evidence is unaccounted for in the act, rendering it woefully inadequate at protecting people’s bodies from present-day environmental health harms.

The Standing Committee on Environment and Sustainable Development (ENVI) resumed its clause-by-clause review of Bill S-5 on Monday, Jan. 30. We have an incredibly small window to strengthen the bill before this opportunity closes.

Organizations in Canada have been pushing for a strengthened Bill S-5 to amend CEPA so legislation can do its job of protecting people and the planet more effectively. ​​Applying a gender-based analysis to this bill, Women’s Healthy Environments Network argues Bill S-5 does not go far enough to address disproportionate gendered and racialized impacts and that strengthening amendments will help to make Bill S-5 more equitable.

The health network's submission to ENVI presses for the implementation of risk mitigation measures, including safe substitution of toxics, mandatory hazard labelling and improved access to information. These amendments have the potential to lessen the burden of environmental exposures and protect people from harm.

Safe substitution

CEPA currently approaches chemical management as controlling exposure to hazardous substances rather than eliminating a hazardous substance altogether. Safe substitution would ensure identifying safer alternatives or non-chemical replacements become the first response to hazardous chemicals. It would also ensure that regrettable substitution does not occur.

The Canadian Environmental Protection Act can't protect people from environmental health harms, writes @HonourStahl of @WHENonline. #WomensHealth #cdnpoli

We saw regrettable substitution in action with bisphenol-A (BPA), as many of its replacement chemicals were found to have an equal or higher level of “estrogenic activity” or toxicity, likely resulting in similar associated health effects such as breast and ovarian cancer, hormonal disruption, reproductive disease, precocious puberty, behavioural changes, endometriosis, PCOS and obesity.

Safe substitution could easily occur with a substance like talcum powder, an ingredient commonly found in baby powder that can cause ovarian cancer when applied to the perineal region. Alternatives such as arrowroot powder or cornstarch are both considered safe substitutions; it raises ethical questions that these substitutions have not yet been made.

Mandatory hazard labelling

Right now, industries and producers are not required to identify all the hazardous substances in their products on the label. This places the burden on the consumer to ensure the products they are using are safe, which means individuals must develop personal strategies of precautionary consumption in order to avoid toxic substances. This burden typically falls on women who choose products for their families and avoid toxic substances while pregnant.

The burden of attempting to reduce toxic exposures during pregnancy in particular is a highly gendered and racialized issue. Women who are socially vulnerable due to their immigration or economic status are even less likely to have the resources to determine which products are safe for them to use, which means they (and their fetus) are disproportionately exposed to toxics.

Putting the onus on individuals, particularly during pregnancy, is a profound form of environmental injustice. CEPA reform is a prerequisite to protecting women’s bodies and can act as a first step to remedy this injustice.

Improved access to information

As it stands, companies are allowed to keep some information on toxics in their products confidential, which hinders the ability of the public to avoid toxic substances. CEPA provisions should ensure information on chemicals relating to the health and safety of humans and the environment is not regarded as confidential business information.

Rather, Bill S-5 should establish the presumption of non-confidentiality that not only requires reasons to accompany a request for confidentiality but puts the onus on the requesting party to demonstrate the necessity for confidentiality. People in Canada need improved access to information, and CEPA must make access to this information publicly available in plain language, including for the most vulnerable individuals.

These changes are only the starting point for strengthening CEPA and could mean a better life for not just stars like Schumer, but for all people, particularly women, marginalized or vulnerable populations whose suffering and disproportionate health impacts have not been adequately addressed and prevented in our toxics legislation.

*The term women is inclusive of all women, trans, cis and AFAB (assigned female at birth) individuals. Both sex and gender play a role in how toxic material can affect the body.

Honour Stahl is a graduate of the ethics, society and law program at the University of Toronto and is the executive director at Women's Healthy Environments Network. Her research focuses on the human and planetary health impacts of plastics, women's health and knowledge translation tools.