(Beyond Pesticides, October 18, 2021) The most recent science on pesticides raises serious health and environmental effects associated with pesticide use for lawn and landscape management. While the data is often not assembled in one place, updated factsheets bring together the science on the 40 commonly used pesticides used for conventional landscape management. Governors have the authority to stop the use of these hazardous materials that are used on parks and playgrounds, either by executive order or through their work with their state legislature, and transition land management to organic practices. Tell your governor to stop hazardous pesticide use on state lands and transition to organic land management. The new factsheets document with scientific citations a wide range of diseases and ecological effects linked to pesticides. The underlying analysis supporting the adverse health and environmental effects identified in the factsheets are based on toxicity determinations in government reviews and university studies and databases. What do the factsheets disclose? Of the 40 most commonly used lawn and landscape pesticides, in reference to adverse health effects… 26 are possible and/or known carcinogens 24 have the potential to disrupt the endocrine (hormonal) system 29 are linked to reproductive effects and sexual dysfunction 21 […]

Health and environmental effects disclosed on factsheets to guide community decisions on lawn and landscape management that do not poison people and contaminate the environment. WASHINGTON, D.C. (October 14, 2021) — Today, the national environmental and public health group Beyond Pesticides is releasing its health and environmental effects factsheets for “40 Commonly Used Lawn Pesticides,” updating and expanding on previous factsheets on 30 pesticides. These comprehensive factsheets documents with scientific citations a wide range of diseases and ecological effects linked to pesticides. The underlying analysis supporting the adverse health and environmental effects identified in the factsheets are based on toxicity determinations in government reviews and university studies and databases. What do the factsheets disclose? Of the 40 most commonly used lawn and landscape pesticides, in reference to adverse health effects, 26 are possible and/or known carcinogens, 24 have the potential to disrupt the endocrine (hormonal) system, 29 are linked to reproductive effects and sexual dysfunction, 21 have been linked to birth defects, 24 are neurotoxic, 32 can cause kidney or liver damage, and 33 are sensitizers and/or irritants. Regarding adverse environmental effects, 21 are detected in groundwater, 24 have the ability to leach into drinking water sources, 39 are toxic to […]

(Beyond Pesticides, August 23, 2021) “Biopesticides”—widely regarded as an alternative to chemical pesticides and hence given a special status in regulation—need a better definition. “Biopesticide” is generally poorly understood, and defined differently by various entities and stakeholders. The term can be misleading and mixes contradictory approaches. It is troublesome when we continue to look for product replacements or substitutions for agricultural practices that are clearly ineffective, and in the process avoid the changes necessary to transition to organic practices, which represent the real, long-term solution to concerns among chemical-intensive farmers that they are losing pesticides in their arsenal, either to organism resistance or regulatory restrictions. The U.S. Environmental Protection Agency (EPA) uses the following definition for “biopesticides”: Substances that interfere with mating, such as insect sex pheromones, as well as various scented plant extracts that attract insect pests to traps (and synthetic analogs of such biochemicals); Microbial pesticides consisting of a microorganism (e.g., a bacterium, fungus, virus or protozoan) as the active ingredient; Plant-Incorporated-Protectants (PIPs), pesticidal substances that plants are genetically engineered to produce. Tell EPA it’s time to redefine “biopesticide.” It is deceptive and misleading. The definition should not include genetically modified organisms or synthetic analogs of naturally occurring […]

(Beyond Pesticides, May 14, 2021) In a prime example of cart-before-the-horse, greenwashing, or perhaps “beewashing,” a British company has badly missed the mark in its latest attempt to market a product while “doing good” and generating goodwill with customers. As The Guardian reports, Marks & Spencer, the giant United Kingdom (UK) retailer, is releasing 30 million managed honey bees into rural British landscapes in what the company is promoting as an effort to support biodiversity and the beekeeping sector. However, according to experts and environmental advocates, unleashing that many honey bees may well actually harm both wild native bees and honey bees themselves. Critics of the move say this means that wild bees will likely face fiercer competition for already inadequate food sources. Beyond Pesticides adds that these honey bees have been dispatched to the same pesticide-contaminated habitats in which existing bee populations of all kinds face harmful exposures — exacerbating issues surrounding pollinator decline rather than solving them. Marks & Spencer’s Twitter marketing promotes the project in this way: “Did you know that bees contribute to a third of the food we eat? At M&S, we’re introducing more than 30 million bees to our Select Farms to help protect the […]

(Beyond Pesticides, May 7, 2021) Soil health is one of the linchpins on which the food production that sustains human life — as well as biodiversity, pollinator health, and carbon sequestration — depend. A recent meta-review of nearly 400 studies finds that, in 71% of the cases reviewed, pesticides kill or otherwise harm soil invertebrates that contribute mightily to soil health. In their paper, “Pesticides and Soil Invertebrates: A Hazard Assessment,” published in Frontiers in Environmental Science in early May, the researchers write, “A wide variety of soil-dwelling invertebrates display sensitivity to pesticides of all types . . . [These results] support the need for pesticide regulatory agencies to account for the risks that pesticides pose to soil invertebrates and soil ecosystems.” Beyond Pesticides, which has long reported on impacts of pesticides on soil health, concurs with that conclusion, and adds that the real solutions to noxious pesticide impacts lie in the adoption of  regenerative organic approaches to all land management because they obviate any need for petroleum-based toxic chemical controls. The term “pesticide” can refer to myriad kinds of chemical treatments — including antimicrobials, disinfectants, rodenticides, and others — but in the agricultural and land management realms, primarily means insecticides, […]

(Beyond Pesticides, April 13, 2021) A new study is making it increasingly clear that current laws are not protecting wild, ground nesting bees from the hazards of neonicotinoid insecticides. According to research conducted under a grant from the U.S. Department of Agriculture’s Sustainable Agriculture Research and Education (SARE) projects, Blue Orchard Mason Bees (Osima spp) are at particular risk from pesticide-contaminated soil they use to create their nest. Authors of the study note that with honey bees already in decline, pollination services provided wild managed bees like Mason bees are growing in importance. “Wild bees such as Osmia are becoming increasingly popular as managed pollinators in many systems, as there is growing concern that honeybees may not be able to continue to meet the increasing demands of agricultural pollination if these trends continue,” the study reads. The study looked at three overarching threats to mason bee populations, aiming to identify risks from pesticide contaminated soil used as a nest, effects on larvae exposed to contaminated soil, and whether female mason bees could determine the difference between contaminated and uncontaminated soil. “Imidacloprid is a neonicotinoid, which is a group of pesticides that are highly toxic to bees,” said Christine Fortuin, PhD, […]

(Beyond Pesticides, March 3, 2021) Earlier this week, pesticide regulators in the commonwealth of Massachusetts voted to restrict outdoor consumer uses of neonicotinoid insecticides. The move is the result of sustained advocacy from broad coalition of individuals and organizations focused on protecting pollinators and ecosystem health. While advocates are pleased that the Pesticide Board Subcommittee made Massachusetts the first state in the country to restrict neonicotinoids through a regulatory process, they note this is only the first step in eliminating these hazardous insecticides. “This marks an incremental victory which took us 6 years to land, and it only happened because of immense, ongoing grassroots action and legislative allies who are willing to hold state regulators accountable,” said Martin Dagoberto, Policy Director of the Northeast Organic Farming Association, Mass. Chapter in a press release. “We still have a monumental endeavor ahead if we are to reduce toxins and rein in the toxic influence of the chemical lobby,” Mr. Dagoberto added. Advocates had been pushing the legislature to pass An Act to protect Massachusetts Pollinators, sponsored by pollinator champion Representative Carolyn Dykema, since 2014. Following several failures by state lawmakers to bring the bill over the finish line, efforts in 2019 resulted […]

(Beyond Pesticides, August 6, 2020) New research finds that a decline in wild pollinator abundance, notably wild bees, limits crop yields in the U.S., according to the study, “Crop Production in the USA Is Frequently Limited by A Lack of Pollinators.” The study results, published in the journal Proceedings of the Royal Society B, find the annual, national average value of wild bee pollination for the most economically important and pollinator-dependent crops is approximately $1.5 billion, with the total value of all U.S. pollinator-dependent crops equaling $50 billion annually. The United Nations states that 75% of the 115 top global food crops depend on insect pollination, with one third of all U.S. crops dependent on pollinators, according to the U.S. Department of Agriculture (USDA). However, research finds that many insect populations are declining by half with a third threatened by extinction, including managed and wild pollinators, mainly due to habitat fragmentation, climate change, and extensive pesticide use. With the global reliance on pollinator-dependent crops increasing over the past decades, a lack of pollinators threatens food security and stability. The researchers in the study note, “Our findings show that pollinator declines could translate directly into decreased yields or production for most of the crops studied, […]

(Beyond Pesticides, July 28, 2020) With honey bees around the world under threat from toxic pesticide use, researchers are investigating a new way to track environmental contaminants in bee hives. This new product, APIStrip (Adsorb Pesticide In-hive Strip), can be placed into bee hives and act as a passive sampler for pesticide pollution. Honey bees are sentinel species for environmental pollutants, and this new technology could provide a helpful way not only for beekeepers to pinpoint problems with their colonies, but also track ambient levels of pesticide pollution in a community. According to a study published by an international team of researchers, APIStrip has the potential to detect 442 pesticides as well as their primary break down products at levels lover than parts per billion. The strip, comprised of polymer, is what scientists describe as “a bee-proof, in-hive passive sampler.” Current methods of sampling honey bee hives for contaminants is time-consuming, requiring removal of bees, pollen, honey or beeswax, and can result in significant hive disturbance. This new method was piloted by citizen-science beekeepers, and according to researchers proved to be a simple and effective tool that any interested citizen-scientist could employ. Passive sampling of environmental contaminants by citizen scientists […]

(Beyond Pesticides, June 23, 2020) Next-generation systemic insecticides, billed by the agrichemical industry as “safer for bees” than neonicotinoids, have been found to stress and kill honey bees. As reported, a study by researchers at Oregon State University in the journal PLOS One, sulfoxaflor and flupyradifurone (in the products Transform and Sivanto, respectively) were found to increase apoptosis (cell death) and increase oxidative stress in exposed honey bees. The study indicates that, “With the recent Environmental Protection Agency (EPA) approval for use of both flupyradifurone and sulfoxaflor, and with the growing concern regarding pollinator health, it is important to better understand any potential negative impacts (especially sub-lethal) of these pesticides on bees.” However, this statement begs the question ‘why these two new bee-toxic pesticide were approved by EPA in the first place.’ This process is familiar and frustrating to those who continue to fight against the decline of pollinators: the chemical industry introduces and EPA approves new toxic pesticides marketed as “safer” to the specific problem caused by its older products, only to find out through independent and academic research that the problem is not solved in the least. Researchers conducted two exposure assessments: one six-hour long study, and another […]

(Beyond Pesticides, May 27, 2020) Research published last week in the journal Scientific Reports uncovers new ways that neonicotinoid (neonic) insecticides hamper the growth and development of honey bee colonies. As new data on the link between neonics and pollinator declines continues to flow from academic institutions, the U.S. Environmental Protection Agency (EPA) has re-opened the public comment period on its proposal to renew the registration of these highly toxic insecticides. The present study, led by German scientists at Goethe University Frankfurt am Main, uses new video techniques to observe the behavior of honey bees behind a glass-pane hive. Researchers filmed their study from start to finish, focusing on the effect of chronic sublethal doses of the neonciotinoids clothianidin and thiacloprid. Colonies were fed these chemicals in a sugar syrup over the course of three weeks in May and June. Even at low levels, scientists found significant changes to brood rearing and development, and the behavior of nurse bees. Nurse bees play a pivotal role in honey bee colonies. These young worker bees clean out old brood cells (where larvae develop), feed larval bees after a queen lays its eggs, and finish by capping a brood cell with wax. Within […]

(Beyond Pesticides, April 9, 2020) Honey bees (Apis mellifera) remain in severe decline, with U.S. beekeepers losing 30% of their managed colonies each year. A Texas A&M University (Dr. Juliana Rangel’s laboratory)  study provides evidence that chemical-intensive farming practices contaminate honey bee hives with pesticides that cause developmental delays. Researchers found that toxic pesticides adversely affect honey bee queen physiology and worker bee performance. Moreover, pesticides exacerbate the health risks associated with the declining honey bee population. When maturing honey bees’ exposure to pesticides is limited, there is an improvement in honey bee queen health and colony behavior. In agricultural settings, honey bees are exposed to an amalgamation of pesticides. AAFC and Texas A&M researchers determined which pesticides (miticides, insecticides, and fungicides) are commonly used in combination and then used those pesticide combinations to expose honey bees to field-realistic doses in the lab: tau-fluvalinate and coumaphos, amitraz, or chlorothalonil and chlorpyrifos. Researchers cultivated maturing honey bee queens in plastic cups coated with either pesticide-free or pesticide-contaminated beeswax. Honey bee queens were transferred into hives upon maturation and bred naturally. Researchers measured their egg-laying frequency along with worker bee entourage size. Post-reproduction, scientists performed a bioassay (a measurement of substance potency or concentration effects on living cells) on […]

(Beyond Pesticides, February 21, 2020) Last week in Minnesota, state Representative Jean Wagenius introduced measure H.F. 1255 that would give cities the opportunity to ban local use of bee-lethal pesticides. This is the latest in a series of attempts to fight state pesticide preemption, an industry-promoted law that prevents localities from restricting pesticide use more stringently than the state. In the face of inaction at the federal and state levels, advocates and legislators in Minnesota are attempting to regain local control to help save their declining, Midwestern pollinators. Representative Wagenius says about the measure, “Minnesotans should be able to protect pollinators if they want to. We value local control in this state, and we always have.” H.F. 1255 will allow cities to opt into a blanket ban of pesticides determined by the Environmental Protection Agency (EPA) to be hazardous to bees. Pesticides with an EPA bee-advisory box are listed on the state’s Department of Agriculture website and referred to as “bee-lethal” by Minnesota legislators. Patrick Hanlon, director of environmental programs for the city of Minneapolis, says cities would work with Department of Agriculture, businesses, and residents that might be impacted by these restrictions before enacting the bill. Local advocates have […]

(Beyond Pesticides, January 28, 2020) The practice of coating seeds with insecticides, now widely adopted as a result of the agrichemical industry, has created increasingly toxic conditions for pollinators foraging on US cropland, finds a study published in Scientific Reports by Penn State University scientists. The data finds that even as overall volume of insecticide use has decreased, the total “bee toxic load” – a term branded by researchers – has increased markedly due in large part to the use of hazardous seed coatings. The switch from one toxic chemical to another is indicative of a chemically-driven agricultural system that, in order to reverse insect, pollinator and bird declines, must undergo rapid changes over the next several decades. Researchers used information from multiple US databases to determine regional patterns in pesticide use and corresponding toxicity loads to pollinators. Thus the term “bee toxic load” was determined by combining the area of land where insecticides were applied with the total toxicity of the particular insecticide used. To compare the impact of changes in the mode of action of the insecticides used, toxicity data was separated between oral and contact toxicity.    Findings indicate that from 1997-2012, contact bee toxic load remained […]

(Beyond Pesticides, December 10, 2019) Thousands of fox, coyote, and other carnivores will continue to be poisoned to death by hydrogen cyanide after the Trump Administration’s Environmental Protection Agency (EPA) re-approved the use of M-44 “cyanide bombs” earlier this month. Cyanide bombs are essentially small, poison-filled land mines baited with food and placed on rural land with the intent of killing predators that prey on grazing livestock.  “EPA is blatantly ignoring its fundamental duty to protect the public, our pets and native wildlife from the cruel, lethal impacts of cyanide bombs lurking on our public lands,” said Kelly Nokes, an attorney with the Western Environmental Law Center (WELC). “We will continue to hold our federal government accountable to the law, and will continue our fight for a ban on M-44s once and for all.” After denying a petition to ban the products last year, the agency delayed a decision to reregister M-44s in response to over 20,000 public comments, 99.9% of which opposed renewal, according to an analysis by the Center for Biological Diversity and WELC. Despite overwhelming public opposition, EPA Administrator Andrew Wheeler is renewing the products with only minor changes to the labels that govern their use. The […]

(Beyond Pesticides, December 9, 2019) Although the influence of regulated corporations has historically silenced science that threatens profits – as shown by industry reaction to Rachel Carson’s Silent Spring – attacks on science in federal agencies have increased in the Trump administration. EPA has dismissed findings of scientists concerning chlorpyrifos, atrazine, and synthetic pyrethroids. The U.S. Department of Agriculture has discontinued collecting data on honeybees. The U.S. Fish and Wildlife Service refused to designate critical habitat for the endangered rusty patched bumblebee. Tell your Congressional Representative to cosponsor H.R. 1709, the Scientific Integrity Act, and thank those who already have cosponsored. H.R. 1709, the Scientific Integrity Act, was introduced by Rep. Paul Tonko of New York, in an effort to restore scientific integrity to government agency decision-making. The bill begins with the premise that “science and the scientific process should inform and guide public policy decisions on a wide range of issues, including improvement of public health, protection of the environment, and protection of national security.” It prohibits scientific misconduct, suppression of scientific findings, intimidation of researchers, and creation of barriers to communicating scientific or technical findings. It limits the actions an agency may take in the process of approving dissemination of scientific results and gives individual researchers […]

(Beyond Pesticides, December 5, 2019) Five years after three neonicotinoids were banned for use on bee-attractive crops in the EU, researchers found that these bee-toxic chemicals are contaminating soils and poisoning the nectar of oilseed rape (canola). The results of this research point to an immediate need to end the use of persistent environmental contaminants and promote organic practices. Researchers set out to determine whether the EU moratorium eliminated the risk for bees that forage on oilseed rape nectar. They tested for imidacloprid, thiamethoxam, and clothianidin residues in the nectar of winter-sown oilseed rape in from 291 oilseed rape fields in western France for five years following the EU moratorium (2014-2018). Results show all three neonicotinoids were present at least once in the study’s time period. Imidacloprid was detected every year with “no clear declining trend,” though its prevalence fluctuated widely between years. Two samples from 2016 show residues that are five times the expected maximum concentration in nectar of a plant directly treated with imidacloprid. Residue levels in the nectar depend on soil type and increase with rainfall. The researchers put forth in their discussion that the imidacloprid contamination may likely be caused by runoff from neighboring, treated plants. […]

(Beyond Pesticides, August 23, 2019) The Office of the Inspector General (OIG) for the U.S. Environmental Protection Agency (EPA) recently released a report criticizing EPA’s oversight of states’ Managed Pollinator Protection Plans (MP3s). OIG conducted an audit, on which the report is based, to evaluate agency performance in overseeing MP3s, voluntary plans adopted at the state level with the goal to “reduce pesticide exposure to pollinators (generally, honey bees managed and contracted out to growers for pollination services) through timely communication and coordination among key stakeholders.” The report’s findings include the following: EPA has no means to evaluate the national impact of MP3s. The agency has not developed a strategy to use data from a planned fall 2019 survey (see more below on the AAPCO/SFIREG/EPA survey) to evaluate either the national impact of MP3s or the agency’s support of state MP3 implementation efforts. EPA focuses primarily on acute risks (those that occur during a single exposure to a specific pesticide), and gives insufficient attention to chronic exposures to pesticides and to native pollinator protection activities. The history of the MP3 program starts in 2014, when President Obama issued a memo establishing a Pollinator Health Task Force (PHTF), directing federal agencies […]

(Beyond Pesticides, June 8, 2019) Scientists studying the precipitous decline in populations of monarch butterflies are searching for causes, and pesticide use is one of the factors under their (figurative) microscopes. Purdue University entomology professor Ian Kaplan, PhD and doctoral student Paola Olaya-Arenas recently turned their attention to a poorly studied potential factor — exposure during monarchs’ larval stage to non-target pesticides on their primary host plant and food source, common milkweed (Asclepias syriaca). In Frontiers in Ecology and Evolution, the researchers report finding evidence of 14 different agricultural pesticides on milkweed near Indiana farm fields, including neonicotinoids clothianidin and thiamethoxam, the pyrethroid deltamethrin, and imidacloprid in a few samples. The research team’s primary aim was to identify and measure the range of pesticides to which monarch caterpillars might be exposed, or which they might consume, on milkweed plants in agricultural landscapes. Secondarily, they hoped to learn how pesticide presence varies with distance between milkweed plants and nearby agricultural sites. In the subject Indiana environs, where corn and soybeans are dominant crops, the study found neonicotinoid residues on milkweed, particularly those of the active ingredients in clothianidin and thiamethoxam. They note, “Although seed treatment data are no longer reported for U.S. […]

(Beyond Pesticides, May 6, 2019) Beleaguered pollinators deal with a multitude of human-engineered threats: habitat fragmentation and loss via development and agricultural intensification, ecosystems and food sources tainted with toxic synthetic pesticides, and shrinking food sources via habitat and biodiversity loss. Research out of the Imperial College of London shows that such challenges are exacerbated, for bumblebees, by another impact of pesticide exposure — impaired flight endurance and dynamics. Published in the journal Ecology and Evolution in late April, ”Pesticide exposure affects flight dynamics and reduced flight endurance in bumblebees” examines how acute exposure to the neonicotinoid imidacloprid affects the nature of bumblebee foraging flight. The study’s researchers find that worker bumblebees so exposed exhibit significant diminishment of flight endurance — measured as both distance and duration — to approximately one-third of what control workers demonstrate. This new information, aggregated with the many other factors that threaten pollinators, points to the importance of ending the use of chemical controls, such as the neonicotinoid imidacloprid, and transitioning to organic systems of agricultural pest management that do not rely on toxic compounds that harm wildlife, ecosystems, water resources, and humans. Previous research has shown numerous impacts of pesticide exposure on bumblebees, and of neonicotinoid exposure, in […]

(Beyond Pesticides, April 17, 2019)  A neurotoxic pesticide labeled “bee-safe” has been found to be harmful to bees, according to a new study. Flupyradifurone (FPF), the subject of the study, is a novel chemical that was hastily registered in the wake of public awareness about the impact of neonicotinoid insecticides on bees. A systemic insecticide and a nicotinic acetylcholine receptor (nAChR) agonist, it functions in the same way as a neonicotinoid, though it is in the butanolide family. “Lethal and sublethal synergistic effects of a new systemic pesticide, flupyradifurone (Sivanto®), on honeybees,” not only debunks the myth that FPF is safe on its own, it also delves into the FPF’s synergistic effects with a commonly used fungicide propiconazole (PRO). PRO, on its own, has no impact on bee mortality. A rarely studied realm of pesticides, the study defines a synergistic effect as, “when combined exposure to two factors results in an effect that is significantly greater than the sum of individual effects.” Researchers manipulated six healthy honey bee (Apis mellifera ligutica) colonies and observed the impact of varying amounts of pesticide exposure, including both individual and synergistic effects, on behavior and mortality. They recorded data over seasons and between worker […]

(Beyond Pesticides, April 12, 2019) The Center for Biological Diversity (CBD) announced on April 3 that it is suing the U.S. Fish and Wildlife Service (FWS) for its failure to release public records, despite multiple FOIA (Freedom of Information Act) requests, that would reveal on-the-ground impacts of FWS allowing use of neonicotinoids and genetically engineered (GE) crops in wildlife refuges. Last August, in yet another rollback of protections for wildlife, the environment, and public health, the Trump administration reversed a 2014 FWS decision to ban the use of neonicotinoids and GE crops in National Wildlife Refuges. If successful, the CBE lawsuit, filed in U.S. District Court for the District of Columbia, would compel the agency to provide the requested documents. This would allow the public, largely through the work of NGO (non-governmental organization) watchdogs, such as CBD and Beyond Pesticides, to understand what harms are being caused on the nation’s protected public lands by the administration’s reversal of the 2014 ban. Hannah Connor, a CBD senior attorney, said, “The goal of the lawsuit is to get them to comply with the Freedom of Information Act and produce the records that have been requested. . . . We aren’t asking them to […]

(Beyond Pesticides, March 1, 2019) The costs of pesticide use extend far beyond the invoices farmers pay for purchase of the chemicals to use on their crops. The real costs related to pesticide use and exposure include those of health care, lost productivity and income, and environmental damage (loss of environmental services and biodiversity; compromised air, water, and soil quality). There has been relatively little research focused on those real and extensive costs; this Daily News Blog turns its attention to several that have made the attempt. January 2019 saw the publication of a new book, Sicker Fatter Poorer: The Urgent Threat of Hormone-Disrupting Chemicals to Our Health and Future … and What We Can Do About It, by Leonardo Trasande, MD, MPP, which examines how some chemicals — including organophosphate and organochlorine pesticides — disrupt human endocrine (hormonal) function, and damage health, sometimes irreparably. The book further investigates the economic costs of associated diseases and other health problems to the U.S. economy — on the order of 2.3% of GDP (gross domestic product), or $340 billion, annually. As Dr. Trasande notes, “The reality is that policy predicts exposure, exposure predicts disease and disease ultimately costs our economy.” Dr. Trasande is […]