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Author Interviews, Duke, Endocrinology, Environmental Risks, Thyroid Disease, Weight Research / 27.03.2019

MedicalResearch.com Interview with: Christopher D. Kassotis, Ph.D. NRSA Postdoctoral Research Scholar Stapleton Lab Duke University Nicholas School of the Environment Durham, NC 27708  MedicalResearch.com: What is the background for this study? What are the main findings?
  • So this was something that Heather Stapleton had been curious about for years, as she's been one of several researchers characterizing the hundreds of chemicals that have been measured in indoor house dust. Before I came to Duke, one of her PhD students had measured the ability of many common indoor contaminants to activate the peroxisome proliferator activated receptor gamma (PPARg). The majority of these chemicals did, often quite well, which led to them testing indoor house dust extracts, also finding that the majority of dust extracts were also able to do so at very low levels. As PPARg is often considered the master regulator of fat cell development, the next obvious question was whether these common contaminants (and house dust) could promote fat cell development in cell models. My first work at Duke evaluated a suite of common indoor contaminants, finding that many of these chemicals could promote fat cell development, and that low levels of house dust extracts did as well.
  • We next explored this more systematically in a group of adults involved in a thyroid cancer cohort (this was just recently published in Science of the Total Environment: https://www.sciencedirect.com/science/article/pii/S0048969719307715?dgcid=author
  • In this study we evaluated the extent to which house dust extracts could promote fat cell development in a common cell model, and associated this with the metabolic health of adults living in these homes. We found that the greater extent of fat cell development was associated with significantly greater thyroid stimulating hormone concentrations (control residents only, with no evidence of thyroid dysfunction) and lower free triiodothyronine (T3) and thyroxine (T4). We further found a significant and positive association between extent of fat cell development and the body mass index (BMI) of all adults in the study. So this suggested that the indoor environment might play a role in the BMI and metabolic health of residents, and we next wondered if this would be more pronounced in children, who may be exposed to these contaminants during a critical window of development.
  • The next step, for our current work, was to substantiate these effects in a larger group of households, each with children.
  • Our major conclusions thus far have been that ~80% of house dust extracts promote significant fat cell development in a cell model - either via development from precursor cells into mature fat cells, measured via accumulation of lipids into the cells, or via the proliferation of those precursor fat cells. We also reported positive correlations of fat cell development with the concentrations of 70 different contaminants in the dust from these homes, suggesting that mixtures of contaminants are likely all acting weakly to produce these effects in combination. We’ve also begun to assess the other chemicals present in dust - chemistry can be either targeted (measuring concentrations of specific known chemicals in a sample), or non-targeted, where you try and determine the identity of the other chemicals in a sample. This has greater utility for identifying many more chemicals, though you will often not get chemical concentrations from this, nor absolute confirmed identification - just varying degrees of certainty based on evidence. Thus far we report approximately 35,000 chemicals in house dust samples across this study, and differential analyses have begun to pick out the few (less than 10 in each case) chemicals most differentially expressed between samples that exhibit high degrees of fat cell development in the lab vs inactive samples, for example, or which are differentially present in the homes of children categorized as obese or overweight. We are now working to confirm identity of these select contaminants that are more likely to be causative factors in the results we have observed.
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Author Interviews, Dermatology, Environmental Risks, FDA / 21.03.2019

MedicalResearch.com Interview with: Anna Benevente Director of product, labeling, and ingredient review at Registrar Corp (registrarcorp.com), an FDA consulting firm that helps companies comply with FDA regulations. She has been assisting companies with U.S. FDA regulations since 2009. She and her team have researched thousands of products to determine whether they meet FDA requirements for compliance. In February 2019, the U.S. Food and Drug Administration (FDA) published a proposed rule to put into effect a final monograph for over-the-counter (OTC) sunscreen drug products.  If finalized, the rule will update conditions under which OTC sunscreen products may be marketed in the United States.  Given the effect this rule could have on the pharmaceutical and cosmetic industries, MedicalResearch.com sat down with Anna Benevente, Director of Product, Labeling, and Ingredient Review at FDA consulting firm Registrar Corp, to dig deeper into the article they recently published on the rule. MedicalResearch.com:  What is the background for this announcement? Response:  FDA issues monographs for specific types of over-the-counter (OTC) drug products, which establish conditions under which a drug may be marketed without FDA approval of a New Drug Application (NDA) or Abbreviated New Drug Application (ANDA). The conditions that are established by the monograph include the active ingredients that have been deemed generally recognized as safe and effective (GRASE) and statements that must appear on the labeling in the form of a Drug Facts panel. Sunscreens have never had an effective final monograph.  Instead, they have been largely regulated under enforcement discretion since 2001, when FDA issued a stay on a final monograph for OTC sunscreen drug products. The Sunscreen Innovation Act (SIA) of 2014 calls for FDA to establish a final monograph for OTC sunscreen by November 26, 2019. If finalized, the rule proposed in February would lift the stay on the final monograph and amend certain regulations for OTC sunscreen drug products. MedicalResearch.com:  What is enforcement discretion? Response: FDA rulemaking can take a considerable amount of time.  During this process, FDA may issue guidance or an enforcement policy that specifies stipulations under which the Agency permits the marketing of certain products in the absence of codified regulations.  While these documents are not legally-binding, they often outline provisions where FDA states that the Agency does not intend to take regulatory action.  These provisions are often incorporated into an FDA rule, as we are seeing in the case of this new rule for sunscreen. MedicalResearch.com:  Would you explain what GRASE ingredients are? Response: When FDA establishes a monograph for an OTC drug product, the Agency reviews scientific data on ingredients used for that product and classifies them into three categories: Category I: The ingredient is generally recognized as safe and effective for its intended use. Category II: The ingredient is not generally recognized as safe and effective for its intended use.  This ingredient may be not safe as a whole, may be not be safe for the specific intended use, or may not be effective for the specific intended use relative to its health risk. Category III: There is insufficient scientific data to determine whether the ingredient is safe and effective for its intended use. While a monograph is still in the rulemaking stage, FDA permits the marketing of products formulated with active ingredients that are deemed Category I or Category III. At this time, industry may submit data to support a Category I designation for a Category III ingredient. When the final monograph is published, FDA no longer uses the terms "Category I", "Category II", and "Category III."  Those ingredients that were deemed Category I become "monograph conditions," while Category II and III ingredients become "nonmonograph conditions" and may not be marketed after the compliance date identified in the final rule. Q: What are the main products that would require a label change? Response:The statement of identity for all sunscreen products would be required to list the sunscreen active ingredients in alphabetical order followed by “Sunscreen” and the product’s dosage form (e.g. “Titanium Dioxide, Zinc Oxide Sunscreen Lotion”).  Additionally, the rule proposes formatting changes to sunscreen labels that would make SPF, broad spectrum, and water resistance statements more prominent. The rule would require all products over 15 SPF to satisfy broad spectrum testing requirements and the associated labeling requirements for broad spectrum products.  Products under 15 SPF that do not satisfy broad spectrum requirements would be required to include “*See Skin Cancer/Skin Aging Alert” next to the SPF value as a reference to the warning required under 21 CFR 201.327(d)(2). (more…)
Author Interviews, Environmental Risks, Heart Disease, Nutrition / 05.12.2018

MedicalResearch.com Interview with: Dr. Lowell H. Steen, Jr., M.D. Interventional Cardiologist Loyola University Medical Center Dr. Steen discusses how holiday treats & stress can increase the risk of heart attack. MedicalResearch.com: What are the main factors that are linked to an increase in heart related adverse events during the Christmas holiday season? Who is most at risk?  Response: The increase in holiday season heart-related hospitalizations and deaths are due to a variety of behaviors such as putting off seeking medical help until after the holidays, overeating rich foods, strenuous travel, excessive alcohol consumption and stressful family interactions. These factors can all trigger heart issues. Factors such as age, diabetes, high cholesterol and smoking all increase heart risk. Additionally, those with high blood pressure, which is a leading risk factor for heart disease and stroke, are exceptionally at risk and should celebrate the hectic holiday season with caution.  (more…)
Author Interviews, Environmental Risks, JAMA, Melanoma / 24.11.2018

MedicalResearch.com Interview with: Reza Ghiasvand, PhD Oslo Centre for Biostatistics and Epidemiology Faculty of Medicne University of Oslo Oslo, Norway  MedicalResearch.com: What is the background for this study? Response: Melanoma is the most dangerous type of skin cancer. It is estimated that about 288,000 individuals will be diagnosed and about 61,000 will die from it in 2018, with the majority of patients in Australia, New Zealand, Europe and North America. Ultraviolet (UV) exposure (from both the sun and tanning beds) is the most important preventable risk factor for melanoma. However, the association between UV exposure and melanoma is complex and does not accord with a simple model in which risk increases directly with exposure. An individual risk of melanoma also depends on personal characteristics such as skin color and skin sensitivity to the UV exposure, hair color, number of moles, and age. It has been hypothesized that the pattern of UV exposure may play a role in melanoma development in different body sites. For example, melanoma on the trunk (chest and back) has been linked to the recreational UV exposure such as sunbathing and frequent sunburns in people with high number of moles on their body. In contrast, melanomas on the head and neck have been linked to constant sun exposure such as occupational UV exposure, mainly in older people. Epidemiologic and molecular evidence in support of this hypothesis has been published based on analyses of small datasets. Also, melanoma on legs and arms is less studied under this hypothesis. In our study, we examined UV exposure (sunbathing, sunburn and sunbed use) and pigmentary factors (skin, eye, and hair color, freckling, and number of moles), and risk of melanoma on different body sites. We used information from the Norwegian Women and Cancer Study, a population-based cohort study that started in 1991, and includes more than 161,000 Norwegian women followed for an average of 18 years. (more…)
Author Interviews, Environmental Risks / 19.11.2018

MedicalResearch.com Interview with: Dr. Gilbert Rochon, III PH.D., MPH Adjunct Professor, Dept. of Global Health Management & Policy Tulane University’s School of Public Health & Tropical Medicine Senior Consultant with MSF Global Solutions, LLC New Orleans MedicalResearch.com: What is the background for this study? Response: Having observed the frequency with which President Donald Trump characterized changes in regulatory policies and funding levels with respect to public health and the environment as eliminating or curtailing "unnecesssary Obama-era regulations," I became curious as to the full extent and impact of such deregulation and under-funding of health and environmental safeguards. In the process, I found it necessary to review federal government contributions to public health and the environment under all previous presidents.  (more…)
Author Interviews, Autism, Environmental Risks, JAMA, Pediatrics / 16.11.2018

MedicalResearch.com Interview with: "Cairo Air Pollution with less smog - Pyramids1" by Nina Hale is licensed under CC BY 2.0Lief Pagalan, MSc Faculty of Health Sciences, Simon Fraser University Research Trainee, Centre for Hip Health and Mobility Vancouver Coastal Health Research Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pregnant women more heavily exposed to air pollution had higher chances of having children with autism spectrum disorder (ASD). The causes of ASD are not fully understood, but this study adds to the growing evidence that environmental risk factors have a role to play. Our study found an association between autism spectrum disorder in the children of women more heavily exposed to air pollution. We observed these results using well-defined cases of ASD and in Vancouver, Canada, which typically has lower air pollution. These findings are consistent with studies done in the U.S., Israel, and Taiwan, which have also found an increased risk of ASD from exposure to air pollution.  (more…)
Author Interviews, Dermatology, Environmental Risks / 15.11.2018

MedicalResearch.com Interview with: Audra Stinchcomb, PhD Principal Investigator Professor of Pharmaceutical Sciences University of Maryland School of Pharmacy MedicalResearch.com: What is the background for this study?   Response: We have been studying the heat effects and repeated dose effects on the absorption of drugs across the skin for more than 5 years.  We were curious to see if the effects we saw on gel, cream, and ointment pharmaceuticals also occurred with sunscreen. Sunscreens are typically used in the hot sun and with reapplication every 80 minutes or so, depending on the product and user. (more…)
Author Interviews, Environmental Risks, NIH, Nutrition, OBGYNE, Pediatrics / 14.11.2018

MedicalResearch.com Interview with: "Baby Bottle" by brokinhrt2 is licensed under CC BY 2.0Kristen Upson, PhD, MPH and Donna D. Baird, PhD Epidemiology Branch National Institute of Environmental Health Sciences Research Triangle Park, NC 27709  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Menstrual pain is the most common menstrual complaint and can substantially affect the quality of women’s lives. A prior study in young adults who participated in feeding studies as infants reported an increased risk of greater menstrual pain severity in adulthood with soy formula feeding. Since that study, evidence from laboratory animal studies support the disruptive effects of a phytoestrogen present in soy formula, genistein, on reproductive system development, including aspects involved in menstrual pain. The laboratory animal studies also demonstrate that the developmental changes with genistein can persist into adulthood. Given these results, we were interested in further evaluating the association between infant soy formula feeding and menstrual pain in a cohort of young women. In our study of women ages 23-35 years old, we observed that soy formula feeding during infancy was associated with several indicators of severe menstrual pain in reproductive-age women. This included a 40% increased risk of ever using hormonal contraception for menstrual pain and 50% increased risk of moderate/severe menstrual discomfort with most periods during early adulthood.  (more…)
Author Interviews, Environmental Risks, Toxin Research / 09.11.2018

MedicalResearch.com Interview with: "Protect Coral Reefs" by NOAA's National Ocean Service is licensed under CC BY 2.0Ariel Kushmaro and Esti Kramarsky-Winter Department of Biotechnology Engineering, Ben Gurion University Beer Sheva, Israel The Republic of Palau, a South Pacific island nation, became the world's first country to ban sunscreen products containing environmentally harmful ingredients MedicalResearch.com: What is the background for this announcement? What are the main findings?  Response: Coral reefs are important ecosystems that are under threat due to global human driven climate change. In addition to global changes, local hazards such as point pollution by eutrophication, dredging and chemical pollution are exacerbating and promoting reef destruction at local levels. This destruction affects not only island nations that depend on these reefs for protection and livelihood, they affect humanity as a whole as they are an important source for food and novel drugs and new materials. Our recent studies have shown that chemicals found in most commercial sunscreens and creams used to protect humans from deleterious effects of UV A and UVB wash off into the environment are persistent, have endocrine disruptive effects, and thus deleteriously affect marine organisms including corals.  (more…)
Author Interviews, Environmental Risks, Social Issues / 07.11.2018

MedicalResearch.com Interview with: "Cockroaches at night" by Sigurd Tao Lyngse is licensed under CC BY 2.0Changlu Wang, PhD The Urban Entomology lab Department of Entomology Rutgers University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cockroaches are an important public health pest. They carry pathogens and produce allergens which causes asthma. Some residential communities always have chronic cockroach infestations. This study is designed to understand the environmental and behavioral factors associated with cockroaches in low-income homes occupied by senior citizens. We found 30% of the 388 surveyed homes had German cockroaches. Sanitation and residents’ tolerance are two factors significantly associated with the presence of cockroaches. A dirty apartment is 2.7 times more likely to have German cockroaches. Gender, ethnicity, and clutter level are not associated with presence of cockroaches. People would be bothered by cockroaches when more than 3 cockroaches are caught in sticky traps when 4 traps were placed per apartment over 2 weeks period. A high percentage (36%) of residents were unaware of cockroaches when they were caught in traps in their homes. These findings are important for property managers and policy makers in designing better intervention methods to reduce the cockroach infestations.  (more…)
Author Interviews, Dermatology, Environmental Risks / 15.10.2018

MedicalResearch.com Interview with: Dr. Janet Prystowsky, MD Dr. Prystowsky is a leading board-certified dermatologist in New York City.   In addition to her private practice, Dr. Prystowsky is a senior attending physician at Mount Sinai Roosevelt/St. Luke’s Medical Center. http://www.janetprystowskymd.com/ MedicalResearch.com: When does sun damage to the skin start?  Is there such a thing as a 'safe tan'?  Who is most susceptible to photoaging?  What parts of the body are more likely to show signs of sun damage?  Response: Sun damage will increase a person’s risk of premature aging and skin cancer.  Although tanning does function to help protect your skin from excessive ultraviolet radiation tanning is still a form of sun damage.  Also, people with very fair skin may not tan at all; only burn.  They are the most susceptible to sun damage. Certain medical conditions (e.g., Lupus), medications, cosmetics, and food can make your more reactive (photosensitive) to sunlight. "Sunburn" by Kelly Sue DeConnick is licensed under CC BY-SA 2.0Sunburns are caused by UV damage from sun rays, almost entirely due to UVB rays. UVA rays are weaker for burning but can contribute to blistering sunburns as well. For example, If you get lime peel rubbed on your skin while you are in the sun, you could get a bad burn.  UVA can also cause significant skin damage that can result in premature wrinkling, brown spots, and skin cancer. That's why you'll see dermatologists pushing for broad-spectrum sunscreens as opposed to sunscreens that just protect against UVB rays.  (more…)
Author Interviews, Columbia, Environmental Risks, Genetic Research, Ophthalmology, PLoS / 09.10.2018

MedicalResearch.com Interview with: Andrei V. Tkatchenko, M.D., Ph.D. Associate Professor Columbia University Medical Center Edward S. Harkness Eye Institute New York, NY 10032 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clear distance vision is rapidly becoming a rare privilege around the world, especially in Asia, due to increasing prevalence of myopia. Although much effort has been directed towards elucidating the mechanisms underlying refractive eye development and myopia, treatment options for myopia are mostly limited to optical correction, which does not prevent progression of myopia or pathological blinding complications often associated with the disease. During early childhood development, the axial length of the eye normally grows to match its optical power in a process called emmetropization, producing focused images on the retina. However, very often environmental and genetic factors lead to a mismatch between the optical power of the eye and its axial length resulting in the development of myopia if eyes grow too long for their optical power. Experimental studies in many animal species suggest that emmetropization is regulated by optical defocus. The eye can compensate for imposed negative and positive optical defocus by increasing or decreasing its growth rate, respectively. However, the molecular mechanisms underlying emmetropization are poorly understood which prevents development of anti-myopia drugs. (more…)
Author Interviews, Environmental Risks, Microbiome, Pediatrics, Weight Research / 20.09.2018

MedicalResearch.com Interview with: Anita Kozyrskyj PhD Professor in Pediatrics Faculty of Medicine & Dentistry School of Public Health University of Alberta MedicalResearch.com: What is the background for this study? Response: Data for this study were collected in the Canadian Healthy Infant Longitudinal Development (CHILD) cohort of over 3,500 full-term infants born between 2009 and 2012. When infants were 3-4 months of age, parents provided a sample of their poop. At that time, parents checked-off responses to questions about their home, including type and frequency of cleaning product use. The infant poop was initially frozen, then thawed later to extract DNA from the sample and identify microbes on the basis of their DNA sequence.  (more…)
Author Interviews, Endocrinology, Environmental Risks, JAMA, Pediatrics, Thyroid Disease / 17.09.2018

MedicalResearch.com Interview with: Carrie Breton ScD Associate Professor and Director of the MADRES Center Division of Environmental Health Los Angeles, CA 90032 MedicalResearch.com: What is the background for this study? What are the main findings? Response: I am interested in how the environment can influence our very early development, starting in the womb. I have studied the health effects of air pollutants on children for several years and wanted to focus now on the earliest windows of susceptibility.  Thyroid hormones play a critical role in fetal growth and development. We knew we could get information on newborn thyroid levels from the California Department of Public Health’s newborn screening program therefore look at this question in our study population. We found that exposure to high levels of PM2.5 and PM10 throughout most of pregnancy affected TT4 levels in newborns. (more…)
Author Interviews, Dermatology, Environmental Risks, JAMA, Melanoma / 15.09.2018

MedicalResearch.com Interview with: Lori A. Crane, PhD Department of Community and Behavioral Health Colorado School of Public Health University of Colorado Anschutz Medical Campus, Aurora CO  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nevi, which are commonly called “moles”, are brown or black spots on the skin that are usually raised.  Moles are the number one risk factor for malignant melanoma, the most dangerous kind of skin cancer.  About 9,000 people die of melanoma each year in the U.S. The more moles a person has, the higher their risk for melanoma.  Sun exposure is a major factor in the development of moles, and in order to prevent melanoma, it is important to better understand how moles are formed on the skin. Most moles are formed during childhood and adolescence.  We studied non-Hispanic and Hispanic white children age 3-16 and found that non-Hispanic children developed many more moles than Hispanic children.  Overall, boys developed more moles than girls, but there were some important differences.  For parts of the skin that are often covered by clothing but sometimes exposed to the sun, such as the chest and back, upper arms and upper legs, girls developed more moles than boys, especially among Hispanic children.  In contrast, for parts of the skin that are usually exposed to the sun, such as the face, boys developed many more moles than girls.  The development of moles leveled off by age 16 for parts of the skin usually exposed to the sun, while for the less often exposed skin, children continued to develop moles to age 16. (more…)
Author Interviews, ENT, Environmental Risks, Occupational Health / 06.09.2018

MedicalResearch.com Interview with: Beatrice Golomb, MD, PhD Director of the Golomb Research Group Professor of Medicine University of California, San DiegoResponse: MedicalResearch.com: What is the background for this study? How was the radiation emitted? Response: Possibilities include surveillance devices (or things to jam them), electronic weapons, or, less likely, “innocent” communications devices. MedicalResearch.com: What are the main findings? Response: That all key features of diplomats’ experiences comport with pulsed radiofrequency/ microwave (RF/MW) radiation.
  1. The nature of the “sounds” heard – chirping, clicking, ringing, grinding/buzzing – are known “sounds” produced via the “microwave auditory effect” aka Frey effect.  Different sounds are heard by different people, because the character of the sound heard depends on head dimensions (as well as pulse characteristics). Sounds were primarily heard at night: consistent with the microwave auditory effect, which requires low ambient noise. Some diplomats reported that sounds were spatially localized with “laserlike” specificity – said to defy known physics. This defies the physics of sound, but not radiation. The “sound” was reported to follow a diplomat as he walked, within the territory in which it was heard. Sound from a fixed source does not seem to follow people – but the microwave auditory affect does, often perceived as being located just behind (or in some cases just above, or inside) the head of the person, irrespective of the person’s orientation relative to the radiation source.
  2. The symptoms reported following these experiences also fit. Rates of reported symptoms in diplomats – headache, cognitive and sleep problems dominating, then dizziness, tinnitus, anxiety, nausea at lesser but still high rates – match closely with rates of the same symptoms reported in a 2012 Japanese study of people who report health effects from radiation, typically including pulsed RF/MW. Hearing loss is a relatively distinctive and prominent symptom in both diplomats, and RF/MW affected civilians. In both groups, some reportedly experience speech problems, balance problems, nosebleed, and strange sensations of vibration and pressure.
Reports of symptoms with RF/MW exposures date at least to the 1920s, affecting radio amateurs and shipboard radio operators as well as others working with radar or microwaves in occupational settings. By 1971/72, a Naval report with over 2300 citations (many from Russia and Eastern Europe), assessing effects of low intensity RF radiation, had whole sections devoted to each of a number of the symptoms diplomats report.
  1. Hundreds (if not thousands) of studies have illuminated mechanisms by which these effects may arise, centered on oxidative stress (the kind of injury that antioxidants help to defend against) – and many downstream effects of oxidative stress (membrane damage, blood brain barrier impairment with potential for brain swelling, inflammation, voltage gated calcium (and other) channel effects (which can also lead to oxidative stress), mitochondrial impairment, autoimmune activation, etc.)
Affected persons are a minority (in both settings), and in the nondiplomat setting, vulnerability has been tied to genetic variants less adept at defending against oxidative stress; and low concentrations of a critical antioxidant. In both groups, brain imaging studies resemble traumatic brain injury; and in both, at least some of those affected had prior head injury. Head injury may be a predisposing factor, as well as possible consequence. Reprising findings also shown for research on other lucrative products with potential to cause harm in some, there is a powerful tie between study results and financial conflict of interest (e.g. source of study funding or conflicts by authors).
  1. There is precedent for use of microwaves in the diplomat setting. It is known that the US embassy in Moscow was microwaved for several decades beginning in the early 1950s (with some embassy staff citing – disputed - health problems). A 1976 NY Times story (“Moscow rays linked to U.S. bugging”) referenced speculation these were for surveillance; the Soviets claimed their purpose was to thwart U.S. listening devices on the roof of the embassy.
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Author Interviews, Environmental Risks, JAMA, Pediatrics, Toxin Research / 29.08.2018

MedicalResearch.com Interview with: Joseph M. Braun, MSPH, PhD Associate Professor of Epidemiology Epidemiology Master's Program Director Brown University School of Public Health MedicalResearch.com: What is the background for this study? Response: Childhood lead poisoning continues to be a problem in the United States and residential lead hazards are the major source of Pb exposure in young children. However, no studies have attempted to prevent exposure to lead hazards through primary prevention. Thus, we randomized 355 pregnant women to a comprehensive residential intervention and followed their children for up to 8 years to determine if childhood lead poisoning and associated cognitive deficits and behavior problems can be prevented. (more…)
Accidents & Violence, Author Interviews, Environmental Risks, JAMA / 06.08.2018

MedicalResearch.com Interview with: Dr. Alexis R. Santos-Lozada Director, Graduate Program in Applied Demography Assistant Teaching Professor, Department of Sociology and Criminology Research Affiliate, Population Research Institute College of Liberal Arts Penn State University MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Dr. Howard and I have been working on the topic of deaths attributable to Hurricane Maria since November, and provided rapid-response estimates by the end of November about the humanitarian crisis experienced by Puerto Ricans following the Hurricane. Our main findings are that there are approximately 1,139 deaths in excess of historical patterns between September, October and November in Puerto Rico. (more…)
Author Interviews, Dermatology, Environmental Risks / 04.08.2018

MedicalResearch.com Interview with: sunscreen creative commonsAdela J. Li, PhD Research Affiliate Wadsworth Center, Rm. D597 New York State Dept. of Health Empire State Plaza Albany, NY, 12201-0509 On the behalf of Dr. Kelvin Leung  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Most people love the beach. In order to block the sun’s damaging UV radiation, people generally slather on a thick layer of sunscreen against sunburn and skin cancer. Sunscreen is suggested to be re-applied every few hours regarding its effectiveness as well as being washed off into the water. These UV filters have been detected in the environment but most studies concluded that individual sunscreen chemicals pose no/low risk to animals or human. However, UV filters constitute a heterogeneous group of chemicals in sunscreens. We are wondering if combination of UV filters would induce higher toxicity than individual compounds, and whether these chemical interactions would develop over time, becoming increasingly dangerous to the living systems. Our study found seven of the nine UV filters in Shenzhen waters, China --- a rapidly urbanized city with over 20 popular recreational beaches, surprisingly, a reservoir and tap water. After exposing artemia to three dominant UV filters and then feeding these artemia to zebrafish adults, concentrations in both were up to 4 times higher when exposed to the mixtures than when exposed to only a single UV filter. A short-term of 25-day dietary exposure to the zebrafish adults did not appear to significantly influence early life stage development of the second generation; however, relatively long exposure over 47 days had significant adverse effects on embryo development. (more…)
Aging, Author Interviews, Dermatology, Environmental Risks, JAMA, Technology / 25.07.2018

MedicalResearch.com Interview with: Startup Screen Dermatology APPDr. med. Titus Brinker Head of App-Development // Clinician Scientist Department of Translational Oncology National Center for Tumor Diseases (NCT) Department of Dermatology University Hospital Heidelberg Heidelberg MedicalResearch.com: What is the background for this study? What are the main findings? Response: ​While everyone in the dermatologic community appears to agree on the importance of UV-protection for skin cancer prevention, busy clinicians often lack time to address it with their patients. Thus, the aim of this study was to make use of waiting rooms that almost every patient visiting a clinic spends time in and address this topic in this setting by the means of modern technology rather than clinicians time. We used our free photoaging app "Sunface" which shows the consequences of bad UV protection vs. good UV protection on the users' own 3D-animated selfie 5 to 25 years in the future and installed it on an iPad. The iPad was then centrally placed into the waiting room of our outpatient clinic on a table and had the Sunface App running permanently. The mirroring of the screen lead to a setting where every patient in the waiting room would see and eventually react to the selfie taken by one individual patient which was altered by the Sunface App. Thus, the intervention was able to reach a large proportion of patients visiting our clinic: 165 (60.7%) of the 272 patients visiting our waiting room in the seven days the intervention was implemented either tried it themselves (119/72,12%) or watched another patient try the app (46/27,9%) even though our outpatient clinic is well organized and patients have to wait less than 20 minutes on average. Longer waiting times should yield more exposure to the intervention. Of the 119 patients who tried the app, 105 (88.2%) indicated that the intervention motivated them to increase their sun protection (74 of 83 men [89.2%]; 31 of 34 women [91.2%]) and to avoid indoor tanning beds (73 men [87.9%]; 31 women [91.2%]) and that the intervention was perceived as fun (83 men [98.8%]; 34 women [97.1%]). (more…)
Author Interviews, Environmental Risks, Pediatrics, Toxin Research / 24.07.2018

MedicalResearch.com Interview with: “Pipe” by Sharon Mollerus is licensed under CC BY 2.0Adrienne Katner, DEnv Assistant Research Professor of Environmental & Occupational Health Sciences LSU Health New Orleans School of Public Health MedicalResearch.com: What is the background for this study? Response: Ever since Flint, there's been a lot of interest by the public in how to reduce exposures to lead in water. Several news articles suggested that many consumers and school officials have been considering flushing as a routine exposure prevention measure. But before Flint, we had a much worse lead in water crisis which didn't get as much public attention- an event which happened in Washington DC between 2001 and 2004. That event demonstrated that flushing for only 15–30 seconds would expose people to lead in cities which had lead service lines- these are water pipes which bring water from the main in the street to the home. A decade of follow up research confirmed that flushing protocols are highly dependent on variables that are difficult or impossible to control, including the length, material, condition and disturbance of water service lines, and water use patterns. However, this knowledge has not translated into widespread changes in public health messaging. In fact, the EPA still requires water utilities to promote flushing as an exposure prevention measure. The original required messaging was to run the water for 15–30 seconds. EPA eventually recognized the need for longer flush times in homes with lead service lines, and they revised the regulations to allow utilities to modify flush times, but many water utilities continued to rely on the same messaging year after year. We thought it was about time to test the recommendations in one of these cities- New Orleans, LA.  Best estimates from the mid-1990s suggested that lead service lines may comprise 65–80% of the city’s service line system. The city’s water utility encouraged residents to flush their taps for 30 sec to 2 min daily under normal use conditions. New Orleans is unique in that extensive hurricane damage to water infrastructure has necessitated a historically unprecedented scale of infrastructure replacement.  While over ten years have passed since Hurricane Katrina, the rebuilding process is ongoing—city and utility officials are in the process of conducting 16,000 partial lead service lines replacements- activities which are well known to destabilize scale that has been intentionally built up in the pipes over time to reduce lead from leaching into the water. We had previously observed high water lead levels in homes after line replacements- along the order of 200 ppb. To put that into perspective, the EPA's water standard for lead is 15 ppb. But even in undisturbed normal use homes we observed lead levels as high as 58 ppb. To evaluate whether flushing could effectively reduce water lead levels, we collected over 1400 water samples from 376 residential sites. Samples were collected at first draw, and after incremental flushes of 30–45 s; 2.5–3 min; and 5.5–6 min. We also collected survey data to better understand water use habits, homes treatment systems, and flushing practices. (more…)
Author Interviews, Dermatology, Environmental Risks, JAMA, Melanoma / 19.07.2018

MedicalResearch.com Interview with: “Sunscreen” by Tom Newby is licensed under CC BY 2.0Dr Caroline Watts  PhD Post-doctoral Researcher The University of Sydney. MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The study analysed data collected from nearly 1700 young Australians who participated in the Australian Melanoma Family Study, a population-based case-control-family study that focused on people who had a melanoma under 40 years of age and compared them with people the same age who did not have a melanoma. We examined sunscreen use during childhood and adulthood and its association with melanoma risk and found that compared to people who did not use sunscreen, regular sunscreen use during childhood reduced melanoma risk by 30-40 per cent.  (more…)
Author Interviews, Dermatology, Environmental Risks, Exercise - Fitness, JAMA / 18.07.2018

MedicalResearch.com Interview with: Sherry Pagoto, PhD Director, UConn Center for mHealth and Social Media President, Society of Behavioral Medicine UConn Institute for Collaboration in Health, Interventions, and Policy Professor, Department of Allied Health Sciences University of Connecticut Storrs, CT 06268 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Recent research has shown that while physical activity is associated with reduced risk for many cancers, it is associated with an increased risk for melanoma. We are not sure why this is the case, however, we have noticed that popular gym chains (e.g., Planet Fitness) often offer tanning beds, which are carcinogenic. We surveyed over 600 people who had used a tanning bed at least once in their life to see how many had used tanning beds in gyms. About one-quarter had used tanning beds in gyms and those folks actually tanned significantly more than people who had not tanned in gyms.  Gym tanners were also more likely to show signs of “tanning addiction.”  We also found an association between tanning and physical activity, such that the people who were the most physically active were the heaviest tanners.  (more…)
Abuse and Neglect, Author Interviews, Dermatology, Environmental Risks, Melanoma, Occupational Health / 18.07.2018

MedicalResearch.com Interview with: “Brad at Santa Monica Pier on Ferris Wheel” by Brad Cerenzia is licensed under CC BY 2.0Sonia Duffy, PhD, RN, FAAN Professor, College of Nursing The Ohio State University MedicalResearch.com: What is the background for this study? Response: Prior to conducting a tobacco cessation study with Operating Engineers, I conducted a survey of 498 Operating engineer and found that many of them were at risk for sun burning, which can lead to skin cancer.  So as a follow up study, I conducted a study to prevent sun burning, which randomized 357 Operating Engineers to were randomized to four interventions: education only; education and text message reminders; education and mailed sunscreen; and education, text message reminders, and mailed sunscreen. (more…)
Accidents & Violence, Author Interviews, Environmental Risks / 13.07.2018

MedicalResearch.com Interview with: “Subaru cars waiting for ride” by JackeOb is licensed under CC BY-NC-ND 3.0Dr. Peng Liu, Assistant Professor Department of Industrial Engineering College of Management and Economics Tianjin University, China MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Self-driving vehicles promise to considerably reduce traffic crashes. However, they cannot eliminate all crashes. On March 18, 2018, a female pedestrian was killed after being struck by an autonomous Uber vehicle in the self-driving mode in Arizona, USA. This fatal crash triggered a widespread public debate over the safety of self-driving vehicles. So, how safe is safe enough for self-driving vehicles? Our findings show that our participants implicitly think self-driving vehicles should be four to five times as safe as the current human-driven vehicles.  (more…)
Author Interviews, Environmental Risks, PLoS, UCSF / 12.07.2018

MedicalResearch.com Interview with: Lara Cushing PhD Assistant Professor of Health Education, College of Health and Social Sciences San Francisco State University San Francisco, CA 94132 MedicalResearch.com: What is the background for this study? Response: More and more countries are adopting cap-and-trade programs as a way to reduce emissions of greenhouse gases to address climate change. These efforts can lead to short-term health benefits because when you reduce greenhouse gas emissions, you usually also reduce emissions other harmful air pollutants that can cause cardiovascular disease, asthma and cancer. However, environmental equity concerns were raised early on about whether cap-and-trade would result in localized differences in emissions reductions that would also result in uneven reductions in harmful co-pollutants, such as particulate matter and air toxics. This is because companies can trade pollution permits under a cap-and-trade system and choose to buy more permits rather than reduce their emissions locally. Prior studies show that low income communities and communities of color are much more likely to live near polluting industries. (more…)
Author Interviews, Dermatology, Environmental Risks / 10.07.2018

MedicalResearch.com Interview with: Dr. Janet Prystowsky, MD Dr. Prystowsky is a leading board-certified dermatologist in New York City.   In addition to her private practice, Dr. Prystowsky is a senior attending physician at Mount Sinai Roosevelt/St. Luke’s Medical Center. http://www.janetprystowskymd.com/ MedicalResearch.com: Are all sunscreens created equally?  Response: Not all sunscreens are created equally. Always choose a broad-spectrum sunscreen that is water resistant if you are planning outdoor sports (with sweating) or swimming. Water resistance is a must when you are swimming or sweating (and who isn’t sweating on a hot summer day?) However, you do not need water resistance if you are walking a few blocks in moderate temperatures. In that situation, a moisturizer sunscreen that is not water resistant is OK and may feel more comfortable on your skin. As far as ingredients go, your best choice is a mineral based sunscreen with zinc oxide and/or titanium dioxide. Sunscreens that are not broad spectrum may protect you from sunburns but will not protect you from photodamage that can lead to premature aging and skin cancer. Mineral based sunscreens are preferable over chemical sunscreens because the long-term effects of chemical sunscreens aren’t well understood. What we do know is that chemical sunscreens can absorb into our bloodstream and potentially have hormonally disruptive effects.  (more…)
Author Interviews, Dermatology, Environmental Risks, Pharmacology / 28.06.2018

MedicalResearch.com Interview with: Sidsel Arnspang Pedersen MD Department of Public Health, Clinical Pharmacology and Pharmacy Anton Pottegård PhD Associate professor, Clinical Pharmacy Odense University Hospital University of Southern Denmark, The following is based on results from three published papers in JAAD and JAMA Internal Medicine. (1–3)   MedicalResearch.com: What is the background for this study? Response: Hydrochlorothiazide is one of the most frequently used diuretic and antihypertensive drugs in the United States and Western Europe. The drug is known to be photosensitizing and has previously been linked to lip cancer.4–6 Based on these previous findings, the International Agency for Research on Cancer (IARC) has classified hydrochlorothiazide as ‘possibly carcinogenic to humans’ (class 2B). This prompted us to investigate whether use of hydrochlorothiazide was associated to other UV dependent skin cancers, including non-melanoma skin cancer (i.e. basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)), cutaneous melanoma, as well as the more rare non-melanoma skin cancers Merkel cell carcinoma and malignant adnexal skin tumours. (more…)